女性抑郁障碍患者脑静息功能磁共振局部一致性与低频振幅研究

Study regional homogeneity and low frequency amplitude of brain resting state functional magnetic resonance imaging in patients with depression

目的利用静息功能磁共振成像技术，探讨女性抑郁障碍患者异常活动的脑区及与症状严重程度的相关性。方法对32例女性抑郁障碍患者组与40例相匹配的正常对照组进行3．0T静息功能磁共振扫描，计算其全脑的局部一致性（ReHo）值与低频振幅（ALFF）值，将差异有统计学意义脑区的ReHo均值、ALFF均值与症状严重程度进行相关分析。结果患者组较对照组ReHo值减低的脑区有左楔前叶／左楔叶（MNI：-18，-81，45）、双侧中央前回（MNI：-58，-5，35和57，-6，33）、左顶下小叶（MNI：-42。-36，45）和右颞下回（MNI：60，-45，-18），两组之间差异有统计学意义（P〈O．05，AlphaSim校正）；患者组较对照组ALFF值减低的脑区有左楔叶（MNI：-3，-87，30）、右颞下回（MNI：60，-48，-18）和左中央前回（MNI：-63，-3，26），两组之间差异有统计学意义（P〈0．05，AlphaSim校正）。相关分析显示右颞下回ReHo均值分别与HAMD-17总分和阻滞因子分呈负相关（r=-0．484，P=0．017；r=-0．408，P=0．048），右颞下回ALFF均值与体重因子分呈正相关（r=0．574，P=0．003），与发作次数呈负相关（r=-0．416，P=0．043）。结论女性抑郁障碍患者在静息态下存在多个脑区功能活动的异常，其损害程度与症状严重程度相关，结合ReHo和ALFF两种数据分析方法有助于全面探讨抑郁障碍的病理生理机制。

Objective To explore the abnormally functional brain regions of female patients with depression by resting state functional magnetic resonance imaging （fMRI） , and analyze the correlation with the severity of depressive symptoms. Methods 32 female patients diagnosed with depressive disorder and 40 matched healthy controls completed resting state fMRI scans. The whole brain＇ s regional homogeneity （ReHo） and amplitude of low-frequency fluctuation（ALFF） were calculated, and the correlation analysis be- tween ReHo and ALFF of brain regions with significant difference and the severity of depressive symptoms was conducted. Results Compared with control group,the left precuneus/left cuneus（MNI：-lS,-81,45） , bilateral precentral gyrus （ MNI ： - 58, - 5,35 and 57, - 6,33 ） , left inferior parietal lobule （ MNI ： - 42, - 36, 45 ） and right inferior temporal gyrus（ MNI：60,-45,-18） （P〈0.05, corrected by AlphaSim）in the case group showed significantly decreased ReHo, with statistical significance. Compared with control group, the left cune- us （ MNI ： - 3, - 87,30 ）, right inferior temporal gyrus （ MNI ： 60, - 48, - 18 ） and left precentral gyrus （ MNI ： -63,-3,26） （P〈O.05, corrected by AlphasSim）in the case group showed significantly decreased ALFF. The ReHo in the right inferior temporal gyrus was negative correlated with the HAMD-17 total score and retarda- tion factor（ r=-0.484, P= 0.017; r=-0.408, P= 0.008）, the ALFF in the right inferior temporal gyrus was positively correlated with weight factor（ r= 0.574, P= 0.003 ）, and negative correlated with the number of depressive episodes（ r=-0.416, P=0.043）. Conclusion Female with depression in resting state have several abnormally functional brain regions and the extent of damage is correlated with the severity of depressive symptoms.Combination of the two parameters may yield a more comprehensive pathophy-siological mechanism for depressive disorder.