双相障碍躁狂发作患者背外侧前额叶皮质氢质子磁共振波谱研究

A ~1H magnetic resonance spectroscopy study on dorsolateralprefrontal cortex in patients with bipolar mania

目的:研究双相障碍躁狂发作患者背外侧前额叶皮质氢质子磁共振波谱(1H magnetic resonance spectrosco-py,1H-MRS)的特点。方法:选择20例双相躁狂发作未服药患者(双相躁狂组)和20例健康志愿者(正常对照组),对其背外侧前额叶皮质行1H-MRS扫描,检测N-乙酰天门冬氨酸(NAA)、谷氨酸复合物(Glx)和肌酸(Cr)3种代谢物含量。比较两组代谢物含量,计算NAA/Cr、Glx/Cr值,并对代谢指标与病程及Bech-Rafaelsen躁狂量表(BRMS)评分的相关性进行分析。结果:双相躁狂组左侧和右侧背外侧前额叶皮质NAA/Cr值明显低于正常对照组。双相躁狂组左侧背外侧前额叶皮质Glx/Cr值明显高于正常对照组(P<0.05),而其右侧背外侧前额叶皮质Glx/Cr值与正常对照组比较,差异无统计学意义(P>0.05)。双相躁狂组背外侧前额叶皮质的代谢指标与病程及BRMS无相关性(P均>0.05)。结论:双相障碍躁狂发作患者可能存在背外侧前额叶神经生化异常。

Objective： To measure the metabolic features of the dorsolateral prefrontal cortex in patients with bipolar mania by using proton magnetic resonance spectroscopy（1H-MRS）.Methods： 1H-MRS was performed on dorsolateral prefrontal cortex in 20 unmediated patients with bipolar mania and 20 healthy controls.The levels of N-acetylaspartate（NAA）,glutamate/glutamine（Glx） and creatine（Cr） were measured,and ratios of NAA/Cr and Glx/Cr were calculated.The 1H-MRS metabolites levels in dorsolateral prefrontal cortex between patients and healthy controls were compared.The associations between the metabolite levels and the course of disease or the Beth Rafaelsen Mania Scale（BRMS）score were examined.Results： Bipolar mania patients had significantly lower NAA/Cr ratios in bilateral dorsolateral prefrontal cortex than healthy controls,The Glx/Cr ratios from left dorsolateral prefrontal cortex were significantly higher in patients than healthy controls.There were no significant differences in Glx/Cr ratios in right dorsolateral prefrontal cortex between the two groups（P0.05）.There were no significant relationships between all the metabolic indexes and the course of disease or the BRMS score（P0.05）.Conclusion： There might be nerve biochemical dysfunction in the dorsolateral prefrontal cortex of patients with bipolar mania.