高血压共病抑郁障碍患者静息态功能磁共振成像低频振幅研究

Amplitude of low frequency fluctuation on patients with hypertension comorbid depression：a resting-state functional magnetic resonance imaging study

目的 探讨高血压共病抑郁障碍患者静息态脑功能改变特点.方法 选取性别、年龄及受教育程度相匹配的高血压共病抑郁障碍患者（共病组）及高血压患者（高血压组）和健康对照者（对照组）各30例,收集3组一般人口学资料和临床特征,所有被试者经静息状态全脑功能磁共振扫描检查,采用方差分析比较3组低频振幅（amplitude of low frequency fluctuations,ALFF）值的差异.结果 3组被试者ALFF值差异有统计学意义的脑区为左小脑、右丘脑、左颞上回、左额中回（F=14.99、15.90、11.52、12.64,均P〈0.05,AlphaSim校正）.高血压组与对照组相比,右丘脑[MNI坐标（x,y,z）：6,-15,12;F=-3.96]ALFF值减低;共病组与对照组比较,左小脑[MNI坐标（x,y,z）：-48,-63,-27;F=-4.87]和右丘脑[MNI坐标（x,y,z）：6,-15,9;F=-5.20]ALFF值降低,左额中回[MNI坐标（x,y,z）：-24,36,42;F=5.08]ALFF值升高;共病组与高血压组相比,左颞上回[MNI坐标（x,y,z）：-54,-12,12;F=-4.32]ALFF值降低,右额上回[MNI坐标（x,y,z）：18,36,48;F=3.99]和左额上回[MNI坐标（x,y,z）：-15,48,42;F=3.57]ALFF值升高;差异均有统计学意义（P〈0.05,AlphaSim校正）.结论 高血压共病抑郁障碍患者静息态局部脑区功能活动异常,且较单纯高血压患者更明显,早期积极有效控制高血压可能有助于减轻脑功能损害.

Objective To explore the features of resting state brain activity of hypertension and hypertension co-morbid depression by resting state functional magnetic resonance imaging （fMRI） technology based on the amplitude of low frequency fluctuation （ALFF）. Methods Thirty patients with hypertension co-morbid depression group （HD）, 30 patients with hypertension group （H）, and 30 normal controls group （NC） were selected. The demographic data and clinical features of all groups were collected. All participants underwent the fMRI and the resting state data of whole brain were analyzed by ALFF method. Results Four clusters with statistically significant differences in one-way analysis of variance in ALFF between the three groups including the left cerebellum, right thalamus, left superior temporal gyrus, and left superior medial frontal gyrus （F=14.99,15.90,11.52,12.64,all P〈0.05, AlphaSim corrected）. Group H showed more decreased ALFF in right thalamus than group NC（MNI coordinates （x, y, z）：6,-15, 12;F=-3.96）. Compared group HD with group NC, decreased ALFF was found in left cerebellum （MNI coordinates （x, y, z）：-48,-63,-27;F=-4.87）, right thalamus（MNI coordinates （x, y, z）：6,-15, 9;F=-5.20） and increased ALFF in left superior medial frontal gyrus（MNI coordinates （x, y, z）：-24, 36, 42, F=5.08）. Compared group HD with group H, decreased ALFF was found in the left superior temporal gyrus（MNI coordinates （x, y, z）：-54,-12, 12; F=-4.32）, increased ALFF in right superior frontal gyrus（MNI coordinates （x, y, z）：18, 36, 48;F=3.99）and left superior frontal gyrus（MNI coordinates （x, y, z）：-15, 48, 42;F=3.57;all P〈0.05, AlphaSim corrected）. Conclusion Abnormal resting-state brain activity emerge in regulatory areas in patients with hypertension co-morbid depression,which is more seriously than ones with hypertension, and early positive and effective control of blood pressure may alleviate damage to brain function.