早发抑郁患者功能磁共振成像对下脑区静息态自发活动与疾病严重程度的相关性研究

A relevant research between spontaneous activity of resting state of brain area and severity of illness of patients with EOD under functional magnetic resonance imaging

目的:探索早发性抑郁症(EOD)患者脑区自发活动与疾病严重程度的关系。方法:选取20例EOD患者纳入观察组,另选20名健康受检者纳入健康对照组,对两组分别进行3.0T磁共振成像(MRI)静息态扫描,比较分析两组受检者脑区的低频振幅以及比率低频振幅特征,将对比所得差异性脑区的均值与汉密尔顿抑郁量表(HAMD)总分做相关性分析,观察其临床严重程度与差异性脑区活动的相关性。结果:观察组患者的右侧颞中回、背外侧额上回、右侧岛叶、左侧枕上回及右侧扣带回的低频振幅(ALFF)值随着HAMD-17评分增加而逐渐增强,而在右侧颞上回颞级、左侧颞中回颞级及左侧海马区域随着HAMD-17评分增加而减弱;观察组患者的右侧岛叶、左侧扣带回、右侧扣带回、左侧眶部额中回以及左侧额中回的比率低频振幅(fALFF)值随着HAMD-17评分增加而逐渐增强,在右侧距状裂、右侧舌回、右侧梭状回及右侧缘上回区域随着HAMD-17评分增加而逐渐为减弱,与健康对照组比较差异均有统计学意义(AlphaSim校正,P<0.05,cluster size>405 mm^3,蒙特卡罗校正)。结论:早发性抑郁患者在前额叶、扣带回、部分枕以及颞叶脑区自发活动的改变与抑郁症的严重程度存在相关性。

Objective： To discusses the relationship between the spontaneous activity of brain area and the severity of illness of patients with early-onset depression（EOD）. Methods： 20 patients with EOD were divided into observation group and 20 healthy subjects were divided into health control group, and all of them were implemented resting-state scan of 3.0 T MRI. The characteristics of amplitude low frequency fluctuation（ALFF） and fractional amplitude of low frequency fluctuation（fALFF） were compared and analyzed. And then the mean of different brain area and the total scores of Hamilton depression scale（HAMD） were applied to carry out correlation analysis, and the correlation between clinical severity degree and activity of different brain area was observed. Results： In the observation group, the ALFFs of gyrus temporalis medius of right side, superior frontal gyrus of outside of back, lobus insularis of right side, gyri occipitales superiores of left side and gyrus cinguli of right side were strengthened with the increasing of the scores of HAMD-17, while the ALFFs of gyrus temporalis superior of right side, gyrus temporalis medius of left side and hippocampus region of left side were weakened with the increasing of the scores of HAMD-17. Besides, for these patients, the fALFFs of lobus insularis of right side, gyrus cinguli of left side, gyrus cinguli of right side, middle frontal gyrus of left pars orbitalis and middle frontal gyrus of left side were gradually strengthened with the increasing of scores of HAMD-17, while the fALFFs of calcarine fissure of right side, gyrus lingualis of right side, gyrus fusiformis of right side and supramarginal gyrus of right side were gradually weakened with increasing of the scores of HAMD-17. And the differences between them and that of control group were significant（AlphaSim rectification, P〈0.05, cluster size〉405 mm3, Monte Carlo rectification）. Conclusion： For patients with EOD, there are correlation between the changes of spontaneous activity of some brain regions, include preforntal lobe, gyrus cinguli, a part of gyri occipitales superiores and temporal lobe, and severity degree of depression.