近红外脑功能成像对卒中后抑郁神经机制的研究

Neural Mechanism of Post-stroke Depression: A Functional Near-infrared Spectroscopy Study

目的观察卒中后抑郁(PSD)患者在认知加工期间前额叶氧合血红蛋白(Oxy-Hb)相对浓度变化值,初步探讨PSD的神经机制和工作记忆功能变化。方法 2017年2月至8月,20例PSD患者(PSD组)及20例卒中非抑郁患者(对照组),应用NIRSport便携式近红外脑功能成像系统,分别采用情绪面孔性别判断任务和"1-back"工作记忆任务,观察前额叶Oxy-Hb相对浓度变化值。结果在负性情绪面孔图片呈现后,PSD组前额叶Oxy-Hb相对浓度变化值显著低于对照组(t=3.872,P<0.001)。在"1-back"工作记忆任务时,PSD组左侧前额叶Oxy-Hb相对浓度变化值低于对照组(t=2.475,P=0.018),两组右侧前额叶Oxy-Hb相对浓度变化值无显著性差异(t=1.773,P=0.084)。结论 PSD患者在负性情绪面孔图片呈现后,前额叶激活程度降低,并且左侧前额叶工作记忆功能受损,PSD患者前额叶有氧代谢功能失调。

Objective To observe the change of the relative concentration of oxygenated hemoglobin in the frontal cortex during cognitive processing in patients with post-stroke depression(PSD),and to discuss the neural mechanism and changes of working memory function of PSD preliminarily.Methods From February to August,2017,20 patients with PSD(PSD group)and 20 patients with non-depressive(control group)were recruited.NIRSport portable functional near-infrared spectroscopy system was used to observe the change of the relative concentration of hemoglobin in the frontal cortex during the emotional face gender judgment task and"1-back"working memory task.Results Compared with the control group,the change of the relative concentration of oxygenated hemoglobin in the prefrontal cortex was significantly lower after the negative emotion faces were presented in PSD group(t=3.872,P<0.001).In the implementation of the"1-back",the change of the relative concentration of oxygenated hemoglobin in the left prefrontal cortex was significantly lower in PSD group than in the control group(t=2.475,P<0.05),however,there was no significant difference in the change in the right prefrontal cortex between two groups(t=1.773,P=0.084).Conclusion The prefrontal cortex activity decrease in patients with PSD after the negative emotion faces were present-ed.The left prefrontal working memory function is impaired.The patients with PSD have disorder of oxygen metabolism in the prefrontal lobe.