经历童年虐待抑郁症患者静息态功能磁共振成像研究

A study of resting functional magnetic resonance in depressive patients with childhood maltreatment

目的探讨经历童年虐待抑郁症患者基础状态下特征性脑功能改变,并评价其与临床症状相关性。方法对50例抑郁症患者(经历童年虐待组和未经历童年虐待组各25例)行静息态磁共振成像扫描并计算低频波动振幅(ALFF),对两组ALFF值行双样本t检验比较,并行Alphasim多重比较校正;提取经历童年虐待组差异脑区平均ALFF值与临床症状行Pearson相关分析。结果(1)与未经历童年虐待组相比,经历童年虐待组在左额中回(t=4.14)、右额中回(t=4.11)、左顶下缘角回(t=4.12)ALFF值升高,在右楔前叶(t=-3.68)、右角回(t=-4.34)ALFF值降低。(2)经历童年虐待组右角回(r=-0.47)、左顶下缘角回(r=0.53)ALFF值与HAMD绝望感因子分相关。结论经历童年虐待抑郁症患者静息状态下可能存在额中回、默认脑网络相关脑区的自发神经活动异常,且部分脑区的异常可能与绝望感有关。

Objective To explore the characteristics of spontaneous neural activity of resting-state brain function in depressive patients who also suffered childhood maltreatment (CM) by comparing low frequency fluctuation amplitude (ALFF). The relationship between the ALFF changes and the clinical depressive symptoms was also explored. Methods Fifty adult patients with depression were separated to CM group (twenty-five depressive patients with CM history) and non-CM group (twenty-five depressive patients without CM history).All of them were given a resting functional magnetic resonance scan of the brain. ALFF values of each subject were calculated to estimate the spontaneous activities of different brain regions. A two-sample t-test was performed on the ALFF values of different brain regions between CM group and non-CM group, corrected by an AlphaSim multiple comparison.A Pearson correlation analysis was performed to explore whether the ALFF values were correlated to the clinical depressive symptoms. Results (1) The patients with CM showed higher ALFF values in the left middle frontal gyrus (t=4.14),the right middle frontal gyrus (t=4.11), and the left inferior parietal gyrus (t=4.12);while the lower ALFF values were found in the right precuneus (t=-3.68) and the right angular gyrus (t=-4.34).(2) The ALFF values of both right angular gyrus(r=-0.47) and the left inferior parietal gyrus (r=0.53) in the CM group were correlated with the HAMD despair coefficient. Conclusions Depressive adult patients with childhood maltreatment may have abnormal rest spontaneous neural activities in the middle frontal gyrus and those default mode network-related brain regions. These abnormalities may be closely correlated with a sense of despair.