抑郁症首次发病患者额叶三维磁共振氢质子波谱分析研究

Frontal biochemical abnormalities in major depression: a three-dimension hydrogen proton magnetic resonance spectroscopy study

目的探讨抑郁症首次发病患者额叶灰、白质可能存在的神经生化异常。方法对24例首次发病抑郁症患者(抑郁症20例,双相障碍抑郁发作者4例;抑郁症组)进行磁共振常规扫描及应用三维磁共振氢质子波谱(1HMRS)检查,测量双侧额叶背外侧白质和前部扣带回皮质的N-乙酰天门冬氨酸(NAA)、胆碱复合物(CHO)、肌醇(MI)和肌酸(CR)的绝对值,计算NAA、CHO、MI与CR的比值,并与21名正常对照者(对照组)作比较。结果(1)抑郁症组患者前额叶扣带回皮质CHO[(772±59)MMOL/L]、MI[(131±39)MMOL/L]的绝对值及CHO/CR(2·3±0·4)、MI/CR(0·39±0·14)均高于对照组[分别为(663±70)MMOL/L,(99±26)MMOL/L,2·0±0·4,0·30±0·01],差异均有统计学意义(P均<0·01);而NAA的绝对值及NAA/CR与对照组的差异无统计学意义(P>0·05)。(2)抑郁症组患者额叶背外侧白质内NAA、CHO、MI的绝对值以及NAA/CR、CHO/CR、MI/CR的比值与对照组的差异均无统计学意义(P均>0·05)。结论抑郁症患者额叶扣带回皮质的CHO、MI绝对值以及CHO/CR、MI/CR比值均增高。

Objective To determine the neuroehemieal abnormalities in gay matter of cingulate gyrus and white matter of the dorsolateral frontal lobe in major depression. Methods Twenty-four patients with major depression （MD） [ males： 9, mean age of （23 ± 7 ） years] and 21 gender- and age-matched normal controls [ males： 8, mean age, （22± 7） years ] were involved. The neurochemical abnormalities including the levels of N-acetylaspartate （NAA）, choline （Cho）, myo-inositol （MI） and creatine （Cr） were measured with three-dimension ^1H proton spectroscopy （3DIH MRS ）. Results The absolute values of Cho and MI , Cho/Cr and MI/Cr ratios in cingnlate gyrus gay matter were significant higher in MD patients than that in controls, but no significant difference in the absolute value of NAA and NAA/Cr ratio in cingulate gyrus gay matter between both groups. There were no significant differences in the levels of NAA, Cbo, MI, and NAA/Cr, Cho/Cr, MI/Cr ratios in dorsolateral frontal white matter between both groups. Conclusion The higher levels of Cho, MI, and Cho/Cr, MI/Cr ratios in cingnlate gyrus gay matter may be involved in the neurobiological bases of MD.