静息态fMRI对抑郁症伴嗅觉功能减退患者功能连接的研究

The Application of fMRI at Resting State to Study the FC of Depression Patients with Hyposmia

目的:应用功能连接(FC)分析方法探讨抑郁症伴嗅觉功能减退患者的双侧杏仁核功能连接情况。方法:纳入37例抑郁症患者(MDD组)和38例性别年龄及受教育程度相匹配的健康人(NC组)进行70%异丙醇吸入测试法进行嗅觉测试,根据嗅觉测试结果将抑郁症组分为伴嗅觉减退的抑郁症a组和不伴嗅觉减退的抑郁症b组,然后均接受脑静息态fMRI检查,选取双侧杏仁核做全脑FC分析。结果:抑郁症伴嗅觉减退患者嗅觉减退程度与HDRS-24得分(r=-0.519,P=0.033)存在负相关关系。以左侧杏仁核为种植点,抑郁症组较正常组在右侧梭状回、左侧颞下回、左侧中央后回、左侧中央前回、双侧内侧旁扣带回功能连接减弱,抑郁症a组在右侧丘脑、右侧内侧旁扣带回功能连接减弱,与左侧距状回、右侧岛叶、左侧颞上回、右侧中央沟盖、左侧楔叶、左侧内侧旁扣带回、双侧中央前回、右侧额中回、左侧补充运动区、Cerebelum_Crus1_R功能连接增强。以右侧杏仁核为种植点,抑郁症组较正常组在右侧颞下回、左侧颞上回、左侧三角部额下回、左侧内侧旁扣带回、左侧中央前回、左侧中央后回、右侧中央旁小叶功能连接减弱,左侧海马功能连接增强。抑郁症a组在右侧内侧旁扣带回功能连接增强。抑郁症a组左侧杏仁核与左侧颞上回(r=-0.603,P=0.038)、左侧楔叶(r=-0.671,P=0.017)以及Cerebelum_Crus1_R(r=-0.608,P=0.036)功能连接与嗅觉测试距离呈负相关。结论:抑郁症伴嗅觉减退的患者双侧杏仁核功能连接存在改变,这些改变可能提示了抑郁症患者嗅觉减退和情绪调节失控之间的关系。

Purpose： To explore the functional connectivity （FC） of bilateral amygdala in depression patients with byposmia through the resting state fMRI. Methods： Major depression disorder group （MDD group） and normal control goup （NC group） included 37 subjects with depression and 38 healthy subjects respectively with matching gender, age and educational background. Both groups received 70% isopropyl alcohol inhaled test. According to the test results, MDD group was subsequently divided into MDDa group of subjects with hyposmia and MDDb group of those without hyposmia. All patients were then examined by fMRI at resting state. Their bilateral amygdala was selected for FC analysis throughout their brains. Results： There was negative correlation between the severity of hyposmia and the score of HDRS-24 （r = -0.519, P=- 0.033） of MD patients with hyposmia. Setting left amygdala as the seed region, MDD group showed lower functional connectivity than NC group at right fusiform, left inferior temporal gyrus, left posteentral gyrus, left precentral gyrus and bilateral medial cingulate gyrus, whereas MDDa group showed weakened functional connectivity at right thalamus, right medial cingulate gyrus, but enhanced connectivity at left calcarine, right insula, left superior temporal gyms, right rolandic operculum, left cuneus, left medial cingulate gyms, bilateral precentral gyrus, right middle frontal gyms, left supplementary motor area, and right cerebellum crus. Setting right amygdala as the seed region, MDD group showed lower functional connectivity than the NC group at right inferior temporal gyrus, left superior temporal gyms, left triangular inferior frontal gyri, left medial cingulate gyrus, left precentral gyms, left postcentral gyrus, and right the paracentral lobule, but higher functional connectivity at left hippocampus. MDDa group showed enhanced functional connectivity at right medial cingulate gyrus. For MDDa group, the functional connectivity between left amygdala and other regions such as left superior temporal gyrus （r=-0.603, P=-0.038）, left cuneus（r=-0.671, P=0.017） and right cerebelum crus （r=-0.608, P=-0.036） were negatively correlated with the distance recorded in olfactory test. Conclusion： There is a significant change of FC at bilateral amygdala of MD patients with hyposmia, which may reveal the relationship between olfactory dysfunction and emotional disorder of MD patients.