无抽搐电休克联合阿立哌唑增效剂治疗双相情感障碍抑郁相患者的静息态脑功能MRI研究  

Resting-state cerebral functional MRI study of patients with depressive phase of bipolar disorder treated by modified electroconvulsive therapy combined with aripiprazole synergist

作　　者：秦君 刘靖琛 孙波[1] QIN Jun;LIU Jingchen;SUN Bo(Qingdao Mental Health Center,Qingdao 266000,China;Qingdao Eighth People’s Hospital,Qingdao 266121,China)

机构地区：[1]青岛市精神卫生中心,山东青岛266000 [2]青岛市第八人民医院,山东青岛266121

出　　处：《中国实用神经疾病杂志》2025年第3期351-355,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2024年度青岛市医疗卫生科研面上项目(编号:2024-WJKY131)。

摘　　要：目的观察无抽搐电休克疗法(MECT)联合阿立哌唑增效剂治疗双相情感障碍抑郁相患者静息态脑功能磁共振成像(MRI)的变化。方法研究对象为青岛市精神卫生中心2020-04—2022-04收治的104例双相情感障碍抑郁相患者,分为对照组、观察组各52例,对照组采用阿立哌唑增效剂治疗,观察组在对照组治疗基础上联合MECT,对比2组治疗前后的抑郁状态、精神状态及总有效率,同时对观察组患者治疗前后的静息态脑功能MRI变化情况进行观察。结果治疗后观察组患者蒙哥马利-艾森贝格抑郁评定量表(MADRS)中的10个项目评分均低于对照组,简易智能状态检查量表(MMSE)中的5个项目得分均优于对照组,治疗总有效率也高于对照组(P<0.05)。MRI检查发现观察组患者治疗后双侧小脑后叶、双侧小脑前叶、右侧丘脑脑区的低频振幅值较治疗前高,右侧小脑前叶、额叶中央旁小叶、中央前回脑区和左侧顶下小叶的低频振幅值明显较治疗前低。结论MECT联合阿立哌唑治疗对双相抑郁患者病情具有良好的改善作用,总有效率高,MECT的作用机制与右侧颞叶、岛叶、小脑功能活动的改变相关。Objective To observe the effect of modified electroconvulsive therapy(MECT)combined with ariprazole synergist on patients with bipolar disorder and the changes of resting-state cerebral functional magnetic resonance imaging(MRI).Methods The observation objects of this study were selected from 104 patients with bipolar disorder and depression admitted to Qingdao Mental Health Center from April 2020 to April 2022.They were divided into control group and observation group,52 cases in each group.The control group was treated with aripiprazole synergist,and the observation group was treated by MECT on this basis.The depression state,mental state and total effective rate of the two groups were compared before and after treatment.At the same time,the resting-state cerebral functional MRI changes of the observation group before and after treatment were observed.Results After treatment,the scores of 10 items in Montgomery-Asberg depression rating scale(MADRS)in the observation group were lower than those in the control group,the scores of 5 items in the simple intelligence state scale(MMSE)were higher than those in the control group,and the total effective rate was also higher than that in the control group(P<0.05).It was found by MRI that the low-frequency amplitude values of the bilateral posterior cerebellar lobe,bilateral anterior cerebellar lobe and right thalamic brain region were higher after treatment in the observation group than those before treatment,while the low-frequency amplitude values of the right anterior cerebellar lobe,paraventral lobule,anterior central gyrus and left inferior parietal lobule were significantly lower than those before treatment.Conclusion MECT combined with aripiprazole synergist can improve the depressive state and mental state of patients with depressive phase of bipolar disorder,and the total effective rate is high.The mechanism of MECT is related to the changes of the functional activities of right temporal lobe,insula and cerebellum.

关 键 词：双相情感障碍抑郁相 无抽搐电休克疗法 阿立哌唑增效剂 静息态脑功能磁共振成像 

分 类 号：R749.4[医药卫生—神经病学与精神病学]