抑郁对颅脑创伤患者认知功能影响的fMRI研究

The Effect of Depression on the Cognitive Function in Patients with Traumatic Brain Injury: a fM RI Study

目的:探讨抑郁对颅脑创伤(TBI)患者认知功能的影响。方法:对2012年1月-2014年10月间,在华山医院门诊或住院的颅脑创伤患者进行筛查,入组伴及不伴抑郁的颅脑创伤患者共80例。所有患者在f MRI扫描下完成反应抑制任务。一般人口学及行为学数据采用SPSS 16.0进行统计学分析,f MRI数据使用SPM8软件进行分析。结果:80例患者均完成行为学认知实验及情绪评估,3例头动明显患者的功能磁共振数据被剔除。伴抑郁TBI组患者执行反应抑制任务时,激活的脑区明显多于不伴抑郁TBI的患者,主要集中在前额叶皮质、前扣带回吻部、背外侧前额叶皮质。结论:伴抑郁TBI患者执行认知任务时,需要激活更多脑区,可能与管理认知脑区的代偿参与有关。

Purpose： To explore the effect of depression on the cognitive function in patients with traumatic brain injury（TBI）. Methods： We screened the patients with TBI when they came to the department of neurosurgery in Huashan hospital,Fudan University during Jan. 1,2012 to Oct.30,2014. Totally 80 participants were recruited into the study. There were 40 participants in each group of TBI patients with depression or without depression,respectively. All participants performed the response inhibition task when they were undergone f MRI exam. SPSS16.0 was used to analyze the behavioral data and demographic data. In addition,functional imaging data was processed by SPM8.Results： All participants finished the behavioral task and the evaluation of the depression. The functional data of 3 participants were moved out of the analysis due to the head movement. The result demonstrated that the total scores of HAMD were much higher in the group with depression（21.60±2.49）than that in the group without depression（5.90±1.23）. But there was no statistically difference in age,sex,education and the severity of brain injury between the two groups. Compared with patients without depression,the reaction time was much longer in patients with depression,no matter the stimuli were compatible or incompatible. More brain areas were activated when performing cognitive task in the group with depression,compared with the group without depression. The activated regions mainly located on the prefrontal cortex,anterior cingulated gyrus and dosal lateral prefrontal cortex. Conclusion： Depression has effect on the cognitive function of patient with traumatic brain injury. The effect was not only responded by the longer reaction time,but also the more activated brain regions when performing cognitive functional task. The activated regions mainly located on prefrontal cortex and anterior cingulated gurus. The higher activation might be a kind of compensation.