多模态MRI对脑白质高信号伴抑郁状态患者脑微结构的研究  

Study on brain microstructure in patients with white matter hyperintensities and depressivesymptoms based on multimodal MRI

作　　者：周莹 张硕 谭中建[2] 路一坤 高金阳 韩笑[1] 马丽芳 崔方圆[1] ZHOU Ying;ZHANG Shuo;TAN Zhongjian;LU Yikun;GAO Jinyang;HAN Xiao;MA Lifang;CUI Fangyuan(Department of Neurology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Department of Radiology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院脑病科,北京100700 [2]北京中医药大学东直门医院放射科,北京100700

出　　处：《磁共振成像》2024年第11期24-31,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82004303);北京中医药大学东直门医院人才培养计划青年后备人才项目(编号:DZMG-QNHB0013)。

摘　　要：目的基于多模态MRI探索脑白质高信号伴抑郁状态患者的脑微结构改变。材料与方法纳入35例脑白质高信号伴抑郁状态患者(试验组)及年龄、性别、受教育年限匹配的35例健康对照者(健康组),进行临床精神认知相关量表数据和MRI数据采集,应用基于纤维束示踪的空间统计方法(tract-based spatial statistics,TBSS)和基于体素的形态学分析(voxel-based morphometry,VBM)技术分析两组间脑白质和脑灰质的差异,并分析脑结构差异与汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分的相关性。结果采用无阈值聚类增强(threshold-free cluster enhancement,TFCE)的统计方法进行置换检验,运用族错误率(family-wise error,FEW)方法对研究结果进行多重比较校正(P<0.05),试验组在胼胝体体部、双侧丘脑后辐射、右侧内囊豆状核后部、右侧上纵束的各向异性分数(fractional anisotropy,FA)与健康组的差异均有统计学意义(P<0.05);采用错误发现率(false discovery rate,FDR)进行多重比较校正,试验组在双侧海马、右侧海马旁回、中央前回、颞上回、颞中回、舌回等脑区灰质体积缩小(FDR校正,P<0.05)。相关性分析显示胼胝体体部FA值与右侧海马体积呈正相关(r=0.495,P=0.004),与HAMD评分呈显著负相关(r=-0.530,P=0.002)。结论脑白质高信号伴抑郁状态患者存在较广泛的白质纤维受累和灰质微结构改变,胼胝体体部白质纤维完整性可能与情绪调节有关,可为临床早期识别干预提供参考依据。Objective:To explore the changes in brain microstructure in patients with white matter hyperintensities and depression symptoms based on multimodal MRI.Materials and Methods:Thirty-five patients with white matter hyperintensities and mild depression,as well as 35 healthy individuals matched by age,gender and years of education were recruited.Clinical assessments and MRI data were collected.Tract-based spatial statistics(TBSS)and voxel-based morphometry(VBM)were used to investigate the microstructural changes of the brain between the two groups,and the correlation between the structural differences and the Hamilton Depression Scale(HAMD)score was analyzed.Results:Using the statistics of no-threshold-freecluster enhancement(TFCE)for permutation test and applying(family-wise error,FEW)to correct for multiple comparisons of the study results(P<0.05).Significantly lower FA(P<0.05)values were found in areas including the body of corpus callosum,bilateral posterior thalamic radiation,the right retrolenticular part of internal capsule,and right superior longitudinal fasciculus in the experimental group were statistically significant compared to the healthy group(P<0.05);the experimental group showed a reduction in gray matter volume in brain regions such as bilateral hippocampus,right parahippocampal gyrus,anterior central gyrus,superior temporal gyrus,middle temporal gyrus,and lingual gyrus(FDR corrected,P<0.05).The FA value of the corpus callosum was negatively correlated with the volume of the right hippocampus(r=0.495,P=0.004),and significantly negatively correlated with the HAMD score(r=−0.530,P=0.002).Conclusions:Patients with white matter hyperintensities and depression symptoms have extensive involvement of white matter fibers and changes in gray matter microstructure.The integrity of white matter fibers in the body of corpus callosum may be related to depressive symptom,which can provide reference for early clinical identification and intervention.

关 键 词：脑白质高信号 抑郁 脑微结构 脑白质 脑灰质 磁共振成像 多模态磁共振成像 扩散张量成像 基于纤维束示踪的空间统计 基于体素的形态测量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]