基于扩散张量成像的卒中后抑郁患者脑白质微结构改变分析  

Changes in Brain White Matter Microstructure in Post-Stroke Depression Based on Diffusion Tensor Imaging

作　　者：付玉婷 张海熠 张勇 刘勇 揭平平 FU Yu-ting;ZHANG Hai-yi;ZHANG Yong;LIU Yong;JIE Ping-ping(Magnetic Resonance Unit,the Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou 646000,China;Department of Rehabilitation and Acupuncture,the Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属中医医院磁共振室,四川泸州646000 [2]西南医科大学附属中医医院康复针灸科,四川泸州646000

出　　处：《南昌大学学报（医学版）》2024年第4期70-74,98,共6页Journal of Nanchang University：Medical Sciences

基　　金：四川省中医药管理局中医药科研专项项目(2021MS537);泸州市科学技术和人才工作局重点研发项目(2022-SYF-87);北京医学奖励基金会(YXJL-2022-0105-0142)。

摘　　要：目的对急性缺血性脑卒中后抑郁患者进行颅内扩散张量成像,探究卒中后抑郁患者各脑区白质微结构的改变,旨在研究脑区结构改变与抑郁的关系。方法依据美国精神障碍诊断与统计手册(DSM-IV)将50例急性缺血性脑卒中患者按年龄性别进行1∶1匹配分为抑郁组与对照组,每组25例,采用PANDA软件计算并比较2组患者各脑区扩散张量成像的分数各向异性(FA)和表观扩散系数(ADC)的差异,分析汉密尔顿抑郁量表(HAMD-17)评分与各脑区FA值及ADC值的相关性。结果抑郁组的双侧额叶、双侧颞叶、左侧岛叶和胼胝体膝部的FA值较对照组显著降低(P<0.05),双侧额叶、左侧颞叶和胼胝体膝部的ADC值较对照组显著升高(P<0.05)。双侧额叶和胼胝体压部的FA值与HAMD-17评分呈中等强度负相关;左侧颞叶、双侧岛叶、右侧扣带回和胼胝体压部的ADC值与HAMD-17评分呈中等强度正相关。结论扩散张量成像结果显示抑郁组较对照组的双侧额叶、双侧颞叶、左侧岛叶和胼胝体膝部结构发生显著改变,脑白质结构与抑郁评分具有一定的相关性。Objective To investigate changes in white matter microstructure in various brain regions of patients with post-stroke depression(PSD)by using intracranial diffusion tensor imaging(DTI)and to explore the relationship between structural changes in brain regions and depression.Methods According to the American Diagnostic and Statistical Manual of Mental Disorders(DSM-IV),50 patients with acute ischemic stroke were divided into the depression group and the control group,with a 1∶1 match according to age and gender,25 cases in each group;PANDA software was used to calculate and compare the differences in fractional anisotropy(FA)and apparent diffusion coefficients(ADC)of DTI in various brain regions in the 2 groups;the correlation between Hamilton depression scale(HAMD-17)scores and FA and ADC values in each brain region was analyzed.Results FA values in bilateral frontal lobes,bilateral temporal lobes,leftinsula lobe and genu of the corpus callosum were significantly lower in the depression group than those in the control group(P < 0.05);ADC values in bilateral frontal lobes, left temporal lobes and genu of the corpus callosum were significantly higher in the depression group compared with the control group(P < 0.05);FA values in bilateral frontal lobes and splenium of the corpus callosum showed a moderate negative correlation with HAMD-17 scores;ADC values in left temporal lobe, bilateral insular lobes, right cingulate gyrus, and splenium of the corpus callosum showed a moderate positive correlation with HAMD-17 scores. Conclusions DTI results indicate significant changes in the structure of bilateral frontal lobes, bilateral temporal lobes, left insular lobe, and genu of the corpus callosum in the depression group compared with the control group, suggesting that brain white matter microstructure may be correlated with depression scores.

关 键 词：急性缺血性脑卒中 卒中后抑郁 扩散张量成像 各向异性分数 表观扩散系数 

分 类 号：R445[医药卫生—影像医学与核医学]