抑郁症首次发病与复发患者静息态功能磁共振低频振幅比率的差异

The difference of fractional amplitude of low frequency fluctuation between first-episode and recurrent depressed patients: a resting-state functional magnetic resonance imaging study

目的:探讨首发与复发中青年抑郁症患者静息态下功能磁共振脑区低频振幅比率(fALFF)特征的差异,以及与症状严重程度和发作次数的相关性。方法:对16例首发抑郁患者(首发抑郁症组),16例复发抑郁患者(复发抑郁症组)和16名健康对照进行3.0T静息态功能磁共振扫描。结果在方差分析的基础上进行两两双样本t检验,将差异脑区与汉密尔顿抑郁量表总分及抑郁发作次数进行相关分析。结果:3组间fALFF值差异有统计学意义的脑区是左颞横回/左脑岛、左壳核、左前扣带回、左额上回及额中回(P<0.05,Alphasim矫正)。复发抑郁组与首发抑郁组相比,复发抑郁组左壳核、左前扣带回、左额中回及左脑岛fALFF值升高(P<0.05,Alphasim矫正);复发抑郁组与健康对照组相比,复发抑郁组左额上回及左前扣带回fALFF值升高(P<0.05,Alphasim矫正)。抑郁症差异脑区与临床症状相关分析显示,左脑岛和左侧壳核fALFF值与发作次数正相关(r=0.450,P=0.021;r=0.535,P=0.004)。结论:复发抑郁患者脑区fALFF升高,从能量的角度提示首发与复发抑郁存在差异,并表现出与复发抑郁患者更易复发的临床现象相关。

Objective：To explore the difference of fractional amplitude of low frequency fluctuation （ fALFF） between the first-episode and recurrent young depressed patients with resting-state functional magnetic resonance imaging （ MRI） ,and make correlation analysis on the score of Hamilton rating scale for depression and the number of episodes. Method：16 first-episode depressed patients,16 recurrent depressed patients and 16 healthy volunteers were scanned with 3. 0T fMRI scanner. According to results of ANOVA,group-wise two sample t-test was completed. The correlation analysis were conducted between fALFF of significant difference brain regions and the score of Hamilton rating scale for depression,and the number of episodes,respectively. Results：The brain regions showing differences among three groups were located in the left heschl /insula,the left putamen,the left anterior cingulate and the middle of frontal / superior of frontal （ P 0. 05,corrected by Alphasim） . Compared with first-episode group,the recurrent group showed significantly increased fALFF in the left insula,the left putamen,the left anterior cingulate and the middle of frontal lobe（ P 0. 05,corrected by Alphasim） . Compared with healthy group,the recurrent group showed significantly increased fALFF in the superior of frontal lobe and the left anterior cingulate（ P 0. 05,corrected by Alphasim） . The fALFF of left insula and left putamen were positively correlated with the number of episodes （ r = 0. 450,P = 0. 021; r = 0. 535, P = 0. 004） . Conclusion：The increased fALFF of recurrent depression prompt the differences from the first-episode depression from the point of view of energy,and implicate the recurrent group was more likely to relapse.