难治性抑郁症患者MECT前后脑局部一致性研究  

Regional homogeneity alterations before and after MECT in patients with treatment resistant depression

作　　者：刘蕊蕊 于东升[2] 吕东升 韩子亮 LIU Ruirui;YU Dongsheng;LV Dongsheng(Tianjin Mental Health Center,Tianjin 300222,China)

机构地区：[1]天津市安定医院,天津市300222 [2]内蒙古自治区精神卫生中心

出　　处：《精神医学杂志》2023年第6期567-572,共6页Journal of Psychiatry

基　　金：内蒙古自治区科技计划项目(编号:2017MS08135)。

摘　　要：目的 探索难治性抑郁症患者在改良电休克治疗(MECT)前后脑局部一致性(ReHo)的变化,并分析其改变与24项汉密尔顿抑郁量表(HAMD-24)之间的关联性。方法 分别收集11例难治性抑郁症患者(研究组)在MECT前后和15名健康对照者(对照组)的静息态功能磁共振成像(rs-fMRI)数据及HAMD-24评分,计算研究组HAMD减分率,找出ReHo变化的脑区,并分析其与HAMD减分率之间的相关性。结果 研究组经过MECT治疗后,ReHo值在右前额叶和右枕叶的部分区域上升,而在左侧额中回眶部、左侧额叶下回三角部、左侧颞中回、左侧脑岛以及右侧顶下小叶缘上回下降。左侧额下回三角部ReHo值差异值与HAMD减分率呈负相关(P<0.05),右侧顶下小叶缘上回ReHo值差异值与HAMD减分率呈负相关(P<0.05)。结论 经过MECT治疗后难治性抑郁症患者部分脑区活性发生变化,这些变化与患者的抑郁严重程度有关。Objective To explore the regional homogeneity(ReHo) alterations before and after MECT in patients with treatment resistant depression(TRD), and to analyze its correlation with Hamilton Depression Scale-24 items(HAMD-24). Methods A total of 11 patients with TRD(study group) and 15 healthy controls(control group) were selected. Resting-state functional magnetic resonance imaging(rs-fMRI) data and HAMD scores of study group before and after MECT and of control group were collected. HAMD reduction rate in study group was calculated, to analyse its correlation with ReHo differential brain areas. Results After MECT treatment, the study group showed increased ReHo values in some areas of the right prefrontal and right occipital lobes, and decreased ReHo values in left medial frontal gyrus orbitalis, left inferior frontal gyrus triangle, left medial temporal gyrus, left insula and right subparietal lobule superior marginal gyrus. There were negative correlations between the ReHo change value in left inferior frontal gyrus triangle and HAMD reduction rate(P<0.05), and between the ReHo change value in right subparietal lobule superior marginal gyrus and HAMD reduction rate(P<0.05). Conclusion After MECT treatment, some brain regions in patients with TRD undergo changes in activity, which are related to the severity of depression in the patients.

关 键 词：难治性抑郁症 MECT 局部一致性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]