首、复发抑郁症患者额颞叶神经纤维偏侧化与疾病严重程度的相关研究

The correlation study between lateralization of the frontal lobe and disease severity in patients with first-onset and recurrent major depression

目的:探讨首、复发抑郁症患者额颞叶神经纤维是否存在偏侧化改变,以及与认知、疾病严重程度的相关性。方法:入组首发抑郁症患者25例、复发抑郁症患者27例及健康对照者24名,入组者均进行弥散张量成像扫描(DTI)及威斯康辛卡片分类测试(WCST);抑郁患者同时进行汉密尔顿抑郁量表(HAMD)评分。结果:首、复发抑郁组,在右额中回、右额下回、右颞下回的各向异性(FA)值较左侧显著性降低(P<0.05),复发抑郁组右侧海马回FA值较左侧显著性升高(P<0.01),健康对照组未发现左右脑FA值差异有统计学意义(P>0.05);对照组左额叶中回、左额下回FA值与持续错误数正相关,右额下回FA值与完成第一分类所需应答数正相关,首发抑郁组的左额叶中回FA值与持续错误数相关,右额下回FA值与完成第一分类所需应答数相关(P均<0.05);复发抑郁组右额下回FA值与HAMD评分呈负相关(P<0.05)。结论:首、复发抑郁症患者均存在右侧颞叶、额叶的偏侧化,且与认知功能的改变存在一定的相关性,反复发作、病程迁延的复发患者偏侧化程度进一步加重,且右侧额叶下回的纤维完整性与疾病严重程度呈负相关。

Objective:To investigate the hemispheric asymmetries of the white matter micro structural changes in first-onset and recurrent major depression,and its correlation with cognition and severity of illness.Method:25 patients with unipolar major depressive disorders and 27 with recurrent depression were recruited,and 25 matched healthy controls were also enrolled.There were no significant differences in general demographic data among the three group.All the subjects were right handedness,scanned by diffusion tensor imaging(DTI)and tested by Wisconsin Card Sorting Test(WCST).Results:The self-control analysis showed that the right brain made significant decreased fractional anisotropy(FA)in the middle,inferior frontal gyrus and temporal lobe than left brain in first-onset depressed patients(P<0.05).The FA value of the right hippocampus in the recurrent depression group was significantly higher than that on the left side(P<0.01).There was no significant difference of the right and left self-control analysis in the healthy control group(P>0.05).Correlation were found in first episode depression and healthy controls,no significant association were found in recurrent patients.Conclusion:The lateralization of the frontal and temporary lobe are found both in patients with first-onset and recurrent patients,the damage associated with cognitive dysfunction,and the lateralization is further aggravated in recurrent patients.The white matter integrity of the right frontal lobe is negatively correlated with the severity of disease in patients with recurrent major depression.