分析未治疗抑郁症患者丘脑及基底核微观结构和血流灌注

Analysis of microstructure and blood perfusion in thalamus and basal ganglia in patients with untreated depressive disorder

目的采用扩散峰度成像(DKI)和三维动脉自旋标记灌注技术(3D ASL)分析未治疗抑郁症患者丘脑和基底核微观结构和血流灌注的改变。方法收集未治疗抑郁症患者21例(病例组)及健康志愿者32名(对照组),均接受DKI、3D ASL及常规MR扫描,测量并比较2组间双侧丘脑、尾状核头、壳核的DKI参数[平均扩散峰度(MK)、轴向峰度(Ka)和径向峰度(Kr)]和扩散参数[各向异性分数(FA)、平均扩散率(MD),轴向扩散系数(Da)和径向扩散系数(Dr)],以及3D ASL参数[脑血流量(CBF)]的差异。结果与对照组比较,病例组左侧尾状核头Ka值增高、Kr值减低(P均<0.05),右侧壳核Ka值增高(P均<0.05),左侧尾状核头及双侧壳核CBF显著减低(P均<0.05)。结论未治疗抑郁症患者存在基底核DKI参数及血流灌注的异常,提示基底核区微观结构完整性受损、血流灌注减低,可能是抑郁症的神经影像学特征之一。

Objective To investigate the changes of microstructure and blood perfusion of thalamus and basal ganglia in patients with untreated depressive disorder using diffusion kurtosis imaging （DKI） and three-dimensional arterial spin labeling （313 ASL） perfusion imaging. Methods Totally 21 untreated patients with depressive disorder （disease group） and 32 healthy volunteers （control group） underwent DKI, 3D ASL and routine MR scanning were enrolled. DKI parameters （mean kurtosis [MK], axial kurtosis [Ka], radial kurtosis [Kr], fractional anisotropy [FAJ, mean dif{usivity EMD], axial diffusivity [Da] and radial diffusivity EDr]） and 3D ASL parameters （cerebral blood flow [CBF]） of bilateral heads of caudate nucleus, thalamus and putamens were measured and compared between the 2 groups. Results Compared with control group, Ka of left caudate head in disease group was significantly higher, while Kr was significantly lower （both P~ 0.05）. Ka of right putamens in disease group was significantly higher than that in control group （P^0.05）. Compared with control group, CBF of left caudate head and bilateral putamens decreased significantly in disease group （all P^0.05）. Conclusion Untreated depressed patients show abnormal DKI parameters and blood perfusion in basal ganglia, which indicating that microstructure integrity is impaired and blood perfusion decreases. The abnormalities in basal ganglia microstrueture and blood perfusion may serve as one of the neuroimaging features of depressive disorders.