双相障碍Ⅱ型患者豆状核的磁共振波谱特征及其与认知功能的关系

Magnetic resonance spectroscopy in lenticular nucleus of Bipolar Ⅱ disorder and its relation with cognitive function

目的 探讨双相障碍Ⅱ型患者豆状核的磁共振波谱特点及其与认知功能的相关性.方法 收集2012年9月至2013年4月住院的双相障碍Ⅱ型患者30例作为患者组,以20名健康人为健康对照组,采用多体素磁共振波谱技术检测所有受试者豆状核的代谢物质,包括N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）、肌醇（MI）.采用Stroop色词测验评估患者的注意功能,采用威斯康星卡片分类测验（WCST）评估患者的执行功能.结果 双相障碍Ⅱ型患者右豆状核NAA、Cho、Cr浓度（289±63、215±61、185±48）和左豆状核Cr浓度（173±60）与健康对照组（337±45、257±46、211±24、206±32）相比明显下降（P＜0.05）.在Stroop测试上,患者组的各项因子成绩包括字、色、色词[（84±21）个、（55±14）个、（34±12）个]与健康对照组[（104±18）个、（71±19）个、（41±11）个]相比明显下降（P＜0.05）.双相障碍患者的WCST正确数、完成分类数[（27.0±9.0）个、（3.2±1.8）个]均差于健康对照组[（36.4±4.8）个、（4.9±1.0）个]（P＜0.01）,WCST持续错误数、随机错误数[（12.8±5.7）个、（8.3±4.9）个]多于健康对照组[（7.3±3.0）个、（4.3±2.8）个]（P＜0.01）.患者右豆状核的NAA和Stroop-色词阅读正确数成正相关.结论 双相障碍Ⅱ型患者右豆状核神经元受损,且会影响到注意功能.双侧豆状核的细胞能量代谢率下降.

Objective To explore the magnetic resonance spectroscopy characteristics of lenticular nucleus in Bipolar Ⅱ disorder and its relation with cognitive function.Methods Thirty Bipolar Ⅱ disorder patients in hospital from 2012 September to 2013 April and twenty healthy controls were evaluated with Multi-Voxel 1H-MRS scans on lenticular nucleus to assess the NAA,Cho,Cr and MI.All subjects were assessed for attention using the Stroop Test and executive function by Wisconsin card sorting test.Results NAA,Cho,Cr in right lenticular nucleus and Cr in left lenticular nucleus were lower than healthy controls （P 〈 0.05）.The patients showed significant cognitive impairment in all aspects of Stroop Test and Wisconsin card sorting test （P 〈 0.05）.NAA in right lenticular nucleus was positively correlated with correct number of Stroop-CW.Conclusions Neural dysfunction in right lenticular nucleus of Bipolar Ⅱ disorder may influence attention function.Cellular energy metabolism rate was reduced in bilateral lenticular nucleus,