老年抑郁症首次发病与复发患者脑结构的磁共振研究

Magnetic resonance imaging study of brain structure in first-episode and recurrent elderly depressive patients

目的:基于磁共振探讨首发与复发老年抑郁症患者脑结构特点。方法:对首发与复发老年抑郁症患者30例(首发组20例,复发组10例)和正常人30名(正常对照组)进行脑磁共振成像检查并运用弥散张量成像(DTI)扫描,比较首发与复发抑郁症患者与正常对照组的异常脑区以及首发与复发患者脑白质、灰质容量及白质各向异性分数(FA)值的差异。结果:与正常对照组比较,患者组双侧额叶、右顶叶、左楔叶、左海马回灰质以及左颞上回白质T1信号强度减低;右扣带回灰质T1信号及白质T1信号强度升高(P<0.01,像素集合>30)。首发组和复发组患者脑白质容量未发现显著差异脑区,但复发组右海马区灰质容量较首发组明显减小(P<0.01,像素集合>30)。与首发组比较,复发组右额中回、左颞中回白质FA值减低(P均<0.01,像素集合>30)。结论:首发与复发老年抑郁症患者可能存在前额叶及右扣带回功能缺陷;双侧海马区灰质容量可能与临床症状有关。

Objective：Using magnetic resonance imaging（ MRI） to explore the brain structure features of first-episode and recurrent late-onset depressive patients.Method：Thirty depressive patients（ 20 first-episode and 10 recurrent late-onset patients） and 30 healthy people were enrolled and diffusion tensor imaging（ DTI）was performed.Abnormal brain regions,white matter volume,gray matter volume and frational anisotropy（ FA）were compared among healty people,first-episode and recurrent late-onset patients.Results：Compared to healthy people,depressive patients showed T1 signal intensity decrease in bilateral frontal,right parietal,left cuneus,left hippocampus gray matter,while showed T1 signal intensity increase in right cingulate gyrus gray matter and white matter（ P〈0.01,voxels 〉30）.There was no significant brain area difference on white matter volume between first-episode and recurrent late-onset patients,but the recurrent patients had fewer right hippocampus gray matter volume than first-episode patients（ P〈0.01,voxels 〉30）.Compared to the first-episode patients,the white matter FA values of right middle frontal gyrus and left middle temporal gyrus was reduced in late-onset patients（ P〈0.01,voxels〉 30）.Conclusion：Patients with first-episode and recurrent late-onset depression may have function deficiency in cingulate gyrus and right prefrontal lesions,and bilateral hippocampal gray matter volume may be associated with clinical symptoms.