首发抑郁症患者局部脑葡萄糖代谢的PET初步研究

A PET study on regional cerebral metabolic rate of glucose in first-episode patients with major depressive disorders using ROI analysis

目的 探讨首发抑郁症脑葡萄糖代谢特点及与临床症状、神经心理的相关性。方法 对14例首发抑郁症患者与 11例健康对照者进行正电子发射断层扫描 (positionemissiontomography ,PET)。抑郁症患者行汉密尔顿抑郁量表 (HAMD17)、Montgomery Asberg抑郁量表 (MADS)、汉密尔顿焦虑量表 (HAMA)、临床疗效总评量表 (CGI)、中国修订版韦克斯勒成人智力量表 (WAIS RC)、中国修订版韦克斯勒记忆量表 (WMS RC)、威斯康星卡片分类测验 (WCST)评定。结果 (1)感兴趣区 (ROI)分析显示抑郁症组右侧额上回、右侧扣带回的rCMRglc显著低于健康对照组 (P <0 0 5 ) ;抑郁症组右侧额上回rCMRglc降低甚于左侧额上回rCMRglc降低 (P <0 0 5 )。 (2 )抑郁症组左侧、右侧rCMRglc与其MADS评分值呈负相关 (分别为P <0 0 5、P <0 0 1) ;右侧额上回、双侧额中回、双侧扣带回、双侧颞叶rCMRglc与SI评分值呈负相关 (除右颞叶P <0 0 1,余区域P <0 0 5 ) ;左侧额下回rCMRglc与其WMS评分值呈正相关P <0 0 5 )。 (3)抑郁症组右侧丘脑rCMRglc与其 1→ 10 0数数值呈正相关 (P <0 0 5 ) ;右侧额中回rCMRglc与其图片值呈负相关 (P <0 0 5 ) ;右侧岛叶rCMRglc与其再认值呈正相关 (P <0 0 5 ) ;左侧颞叶、左侧枕叶rCMRglc与其理解记忆?

Objective: To investigate the characteristics of regional cerebral metabolic rate of glucose (rCMRglc) and its relationship with clinical symptoms and neuropsychology in first-episode patients with major depressive disorders. Methods: Position emission tomography (PET) with [^(18)F]fluorodeoxyglucose was performed on 14 first-episode patients with major depressive disorders and 11 healthy volunteers. The patients were conducted by HAMD_(17)、MADS、HAMA、CGI、WAIS-RC、WMS-RC、WCST. Results: (1) ROI analysis: Compared with healthy controls, the first-episode patients with depressive disorders demonstrated decreased normalized rCMRglc in right superior frontal gyrus and right cingulated gyrus (P<0.05) and lower rCMRglc in right region than that in left region(P<0.05). (2) The rCMRglc in bilateral temporal lobe is negative to scores of MADS (P<0.05 or P<0.01); the rCMRglc in right superior frontal gurus、bilateral middle frontal gyrus、bilateral cingulated gyrus、bilateral temporal lobe is negative to scores of SI (P<0.05, except for the right temporal P<0.01); the rCMRglc in left inferior frontal gyrus is positive to scores of WMS (P<0.05). (3)The rCMRglc in right thalamus is positive to scores of 1→100 (P<0.05); the rCMRglc in right middle frontal gyrus is negative to scores of picture(P<0.05); the rCMRglc in right insula is positive to scores of recognition (P<0.05); the rCMRglc in left temporal lobe、left occipital lobe is positive to scores of understanding (P<0.01 total); the rCMRglc in left temporal lobe、right occipital is positive to scores of recitation. Conclusion: The rCMRglc of prefrontal lobe and cingulated gyrus is decreased in first-episode patients with depressive disorders, lower in the right; the rCMRglc in right superior frontal gurus、bilateral middle frontal gyrus、bilateral cingulated gurus、bilateral temporal lobe is positive to the severity of depression; the rCMRglc in some regions is relative to the change of memory, especially for the instant memory and short terms of memory.