抑郁症患者治疗前后认知功能与前扣带回γ-氨基丁酸水平的关联  

Association between cognitive function and anterior cingulate cortex gamma-aminobutyric acid concentrations in patients with depression before and after treatment

作　　者：昝思妍 库从文 赵少琨 马瑞华 刘思佳[1] 石晶[1] 李颖娜 李慧[1] 王璇[1] 杨甫德[1] 谭云龙[1] 田宝朋 王志仁[1] ZAN Siyan;KU Congwen;ZHAO Shaokun;MA Ruihua;LIU Sijia;SHI Jing;LI Yingna;LI Hui;WANG Xuan;YANG Fude;TAN Yunlong;TIAN Baopeng;WANG Zhiren(Bejing Huilongguan Hospital,Peking University Huilongguan Clinical Medical School,Bejing 100096,China;First School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;State Key Laboratory of Cognitive Neuroscience and Learning,Beijing Normal University,Beijing 100875,China)

机构地区：[1]北京回龙观医院,北京大学回龙观临床医学院,北京1000962 [2]北京中医药大学第一临床医学院,北京1000293 [3]北京师范大学认知神经科学与学习国家重点实验室,北京100875

出　　处：《中国心理卫生杂志》2024年第9期737-744,共8页Chinese Mental Health Journal

基　　金：首都卫生发展科研专项项目(2022-2-2133);北京市医院管理中心临床技术创新项目(XMLX202130);北京市科技计划项目(Z17110000107022)。

摘　　要：目的:探讨抑郁症患者治疗前后认知功能与前扣带回γ-氨基丁酸(GABA)水平的相关关系。方法:选取31例符合美国精神障碍诊断与统计手册第5版(DSM-5)抑郁症诊断标准的未服药患者和33例正常对照,患者入组后给予单一选择性5-羟色胺再摄取抑制剂治疗8周。采用认知功能成套测验(MCCB)评估认知功能,氢质子磁共振波谱成像技术检测前扣带回的GABA水平。结果:抑郁症组基线期前扣带回GABA相对于水的浓度(GABA+/W)低于对照组(P<0.05),治疗后升高(P<0.05);基线期抑郁症组前扣带回GABA+/W与言语学习和记忆以及视觉记忆和学习存在负相关(r=-0.40,P<0.05;r=-0.42,P<0.05);抑郁症组治疗前后前扣带回GABA+/W的差值与工作记忆评分的差值及推理和问题解决能力评分的差值存在正相关(r=0.58,P<0.05;r=0.66,P<0.05)。结论:抑郁症患者认知功能障碍可能与其抑郁、焦虑程度不相关,认知功能的改善可能与前扣带回GABA水平的升高有关。Objective:To explore the association between cognitive function and the level of gamma-amino-butyric acid(GABA)in anterior cingulate cortex(ACC)before and after treatment in patients with major depres-sion disorder.Methods:Totally 31 medication-naive patients with major depression disorder meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 33 normal controls were col-lected.Each eligible patient received treatment with selective serotonin reuptake inhibitor agents for 8 weeks.The MATRICS Consensus Cognitive Battery(MCCB)was used to evaluate the cognitive function.By means of 1H magnetic resonance spectroscopy,anterior cingulate cortex GABA concentrations were measured.Results:At base-line,the concentration of ACC GABA relative to water(GABA+/W)was lower in the patient group than in the control group(P<0.05)and increased after treatment(P<0.05).ACC GABA+/W was negatively associated with verbal learning and visual memory score in patient group at baseline(correlation coefficient and P value were r=-0.40,P<0.05;r=-0.42,P<0.05,respectively).The ACC GABA+/W difference resulted of treatment in patient group was positively associated with the difference of working memory score and the difference of reasoning and problem-solving score(correlation coefficient and P value were r=0.58,P<0.05;r=0.66,P<0.05,respec-tively).Conclusion:The cognitive dysfunction of patients with major depression disorder may not be related to the degree of depression and anxiety.And improvement of cognitive function may be associated with increase of ACC GABA concentrations.

关 键 词：抑郁症 磁共振波谱学 Γ-氨基丁酸 认知功能 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]