抑郁症患者脑白质微结构改变及与认知功能的相关性研究  

Study on the relationship between the changes of white matter microstructure and cognitive function in patients with major depressive disorder

作　　者：孙浩 阎锐[1] 花玲玲[1] 史家波[1] 陈瑜[1] 夏逸 王晓芹 卢青[2] 姚志剑[1] 刘海燕[1] SUN Hao;YAN Rui;HUA Ling-ling;SHI Jia-bo;CHEN Yu;XIA Yi;WANG Xiao-qin;LU Qing;YAO Zhi-jian;LIU Hai-yan(The Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院心境障碍科,210029 [2]东南大学生物科学与医学工程学,儿童发展与学习科学教育部重点实验室

出　　处：《临床精神医学杂志》2025年第1期1-5,共5页Journal of Clinical Psychiatry

基　　金：国家自然科学基金(82271568,82101573,82301718,82151315);江苏精神疾病医学创新中心(CXZX202226);江苏省重点研发计划专项(BE2019675);江苏省自然科学青年基金(BK20230154);南京市科技发展计划重点项目(ZKX22043);苏州市社会发展科技创新重点项目(2022SS04);南京医科大学科技发展基金(NMUB20220128)。

摘　　要：目的:探讨抑郁症(major depressive disorder,MDD)患者脑白质微结构变化及与认知功能异常的相关性。方法:招募MDD患者完成弥散张量成像(diffusion tensor imaging,DTI)磁共振扫描及认知功能评估,对招募的MDD患者在其出院≥5年后进行复核诊断,诊断未发生改变的患者74例纳入抑郁组,同期招募性别、年龄相匹配的健康对照者71名,完成磁共振扫描及认知功能评估。比较两组间认知功能差异,比较两组间的各向异性分数(fractional anisotropy,FA)、平均扩散率(mean diffusivity,MD)差异,并进一步探讨差异的白质纤维束与认知功能的关联性。结果:与健康对照相比,MDD组符号数字转换能力下降(P<0.05),右侧丘脑前辐射、左侧皮质脊髓束FA值均下降(P均<0.05)及MD值上升(P<0.05),右侧丘脑前辐射MD值与符号数字转换测验(r=-0.221,P<0.05)成负相关。结论:MDD患者右侧丘脑前辐射、左侧皮质脊髓束白质纤维完整性异常,且右侧丘脑前辐射的损害可能与信息处理速度存在相关性。Objective:To explore the relationship between the changes of white matter microstructure and cognitive dysfunction in patients with major depressive disorder(MDD).Method:Patients with MDD were recruited,and diffusion tensor imaging(DTI)magnetic resonance scanning and cognitive function assessment was completed.Among them,74 patients who completed 5 years follow-up and did not change their diagnosis during the period were included in the MDD group.71 healthy controls matched in gender and age were recruited at the same time,and MRI scanning and cognitive function assessment were completed.The differences of cognitive function,fractional anisotropy(FA)and mean diffusivity(MD)were compared between the two groups and the correlation between the abnormal white matter fibers and cognitive function were explored.Results:Compared with the healthy controls,the digit symbol substitution test(DSST)of MDD group decreased(P<0.05).The FA value of the right anterior thalamic radiation(ATR.R)and the left corticospinal tract(CST.L)decreased(P<0.05).The MD value of ATR.R and CST.L increased(all P<0.05).The MD value of ATR.R was negatively correlated with the DSST(r=-0.221,P<0.05).Conclusion:The white matter fiber integrity of the ATR.R and the CST.L are abnormal in patients with MDD,and the abnormality of the ATR.R may be related to information processing speed.

关 键 词：抑郁症 白质 弥散张量成像 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]