扣带束和钩束的微观结构变化与白质疏松相关性抑郁

Association between altered microstructures of cingulum bundle and uncinate fasciculus and depression with leukoaraiosis

目的通过弥散张量成像(diffusion tensor imaging,DTI)技术研究白质疏松(leukoaraiosis,LA)患者扣带束和钩束的白质微观结构改变,并探讨其与抑郁障碍的关系。方法前瞻性纳入60例Fazekas评分为2~3级的LA患者及30例对照组。LA组分为伴有抑郁(n=33)和不伴有抑郁(n=27)2个亚组。所有被研究对象均进行抑郁评估、3.0T头部MRI常规检查及DTI检查。使用PANDA软件处理DTI数据,提取双侧扣带束和钩束的部分各向异性(fractional anisotropy,FA)数值。结果 LA组双侧钩束及扣带束的FA值均显著低于对照组(P<0.05);LA伴抑郁亚组双侧扣带束和右侧钩束的FA值显著低于不伴抑郁亚组(P<0.05);LA不伴抑郁亚组和对照组双侧扣带束、钩束之间的FA值无显著性差异(P>0.05)。双变量相关分析发现抑郁程度与右侧钩束(r=-0.27,P=0.037)、扣带束(左侧r=-0.329,P=0.01;右侧r=-0.259,P=0.046)FA值呈负相关,与左侧钩束FA变化无明显相关性。结论钩束和扣带束白质微观结构变化与LA相关性抑郁存在关联性,但相关程度较弱(r<0.4),提示LA相关性抑郁的发生存在多元化的病理生理基础。

Objective To investigate the association between altered microstructures of the cingulum bundle and uncinate fasciculus and depressive disorder in leukoaraiosis（ LA） patients by diffusion tensor imaging（ DTI）. Methods In this prospective study,60 LA patients with Fazekas score of 2 to 3 and 30 controls were recruited. LA patients were divided into depression group（ n = 33） and non-depression group（ n = 27）. All the subjects were received depression assessment,routine cranial MRI and DTI examination. The values of fractional anisotropy（ FA） in bilateral cingulum bundles and uncinate fasciculi were determined with PANDA software. Results In LA group,the FA values in bilateral cingulum bundle and uncinate fasciculus were significantly lower than that in control group（ P 0. 05）. In LA patients without depression,the FA values of bilateral cingulum bundle and uncinate fasciculus were similar to that in control group（ P 0. 05）. In LA patients with depression,the FA values of bilateral cingulum bundles and right uncinate fasciculus were significantly lower than that in LA patients without depression（ P 0. 05）. The severity of depression was negatively related to the FA values of right uncinate fasciculus（ r =-0. 27,P = 0. 037） and bilateral cingulum bundles（ left： r =-0. 329,P = 0. 01; right： r =-0. 259,P = 0. 046）,but had no relationship with the FA value of left uncinate fasciculus. Conclusion Altered white matter microstructures in cingulum bundle and uncinate fasciculus are associated with the depression in LA patients,but the related degree is not strong. It may indicate that depression with leukoaraiosis has diverse pathophysiological basis.