脑卒中后抑郁患者前扣带回、海马灰质体积磁共振成像研究

Magnetic resonance imaging of grey matter volume in anterior cingulate and hippocampus in patients with post-stroke depression

目的探讨脑卒中后抑郁(post-stroke dpression,PSD)患者前扣带回、双侧海马灰质体积的改变及其与抑郁严重程度的相关性。方法 13例脑卒中后抑郁患者(PSD组)和18例脑卒中后无抑郁患者(non-PSD组)接受3D高分辨率T1WI磁共振扫描,采用VBM-DARTEL方法对扫描获得的结构图像进行预处理,并将双侧海马及前扣带回作为感兴趣区(region of interest,ROI),最后用双样本t检验比较PSD组与non-PSD组组间灰质体积差异。结果与non-PSD组相比,PSD组患者双侧前扣带回(体素>200)及双侧海马(左侧体素>200,右侧体素>200)体积下降差异具有统计学意义(P<0.001,未校正),未发现灰质体积显著增加的区域。在PSD组中,显著下降的灰质体积与汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分及抑郁持续时间无显著相关关系(与HAMD评分:r双侧前扣带回=0.343,r左侧海马=0.356,r右侧海马=0.240;与抑郁持续时间:r双侧前扣带回=0.379,r左侧海马=0.452,r右侧海马=0.413;P>0.05)。结论与原发性抑郁相似,卒中后抑郁患者也存在前扣带回和海马灰质体积下降,但海马和前扣带回灰质体积下降与抑郁严重程度无显著相关关系。

Objective To determine the changes of gray matter volumes in the hippocampus and anterior cingulate cortex （ACC） in patients with post-stroke depression （PSD）, and investigate the correlation of the changes with depression severity. Methods Thirteen patients with PSD and 18 patients without PSD after stroke undergoing examination of three-dimensional high-resolution T1 weighted MRI in our hospital from June 2012 to May 2013 were enrolled in this study. Voxel-wise analyses of regional gray matter volume were conducted by the VBM analysis using DARTEL algorithm in SPM8. The bilateral hippocampus and ACC were regarded as regions of interest. Two-sample t-test and partial correlation analysis was used for statistical analysis. Results Compared with the non-PSD patients, the PSD group showed significantly lower gray matter volume in bilateral ACC （P 〈 0. 001, voxel 〉 200 ） and bilateral hippocampus （ P 〈 0. 001, voxel 〉 200 ）, and had no region with increased gray matter volume. In the PSD patients, there was no correlation of the decreased volumes of gray matter with the scores of Hamilton depression scale （HAMD） （ r = 0. 343, 0. 356, 0. 240 for bilateral ACC, and left and right hippocampus respectively, P 〉 0.05 ） and illness duration （ r = 0.379, 0. 452, 0.413 for bilateral ACC, and left and right hippocampus respectively, P 〉0.05）. Conclusion Similar with primary depression, PSD patients have decreased gray matter volumes in the ACC and hippocampus, but the decreases have no correlation with depression severity.