抑郁症快速动眼期特征对执行功能损害的诊断价值研究

Diagnostic value of rapid eye movement in executive function in depressed patients:a pilot study

目的初步分析抑郁症的快速动眼期(rapid eye movement,REM)特征与执行功能相关性,探索REM作为客观指标评估抑郁症执行功能损害的诊断价值。方法本研究为横断面研究,纳入64例抑郁症患者,使用便携式睡眠呼吸监测仪对其进行睡眠监测,监测指标包括REM占比、潜伏期及持续时间等,并采用Stroop色词测试评估执行功能。结果抑郁症患者REM持续时间与色词测试中双色时间(r=-0.29,P=0.02)、反映干扰量(Stroop interference effects,SIE)耗时数(r=-0.30,P=0.02)间呈负相关。REM持续时间对SIE耗时数,即执行功能损害,具有一定诊断价值(AUC=0.70,P<0.01);REM持续时间为94.5 min时,是SIE耗时数最佳诊断点,此时约登指数为0.41。结论 REM持续时间与执行功能间呈正相关,REM持续时间对抑郁症患者执行功能存在一定诊断作用,但其价值较低。

Objective To explore the correlation between the characteristics of rapid eye movement and executive function in depression, and to explore the diagnostic value of rapid eye movement(REM) as an objective index in evaluating executive function in depression.Methods This study was a cross-sectional study.The Mini-International Neuropsychiatric Interview and the 17-item Hamilton Depression Scales(HAMD) were used to screen the participants.A total of 64 depressed patients were enrolled in the study.Sleep was monitored by a portable sleep-respiratory monitor,including the proportion of REM, latency and duration.Executive function was evaluated using Stroop test.Results REM duration in depressed patients was negatively correlated with Color-word time(r =-0.29, P =0.02) and Stroop interference effects(SIE)(r=-0.30, P=0.02).REM duration had diagnostic value for SIE, i.e.executive function(AUC=0.70, P<0.01).After exploring the SIE of REM duration in depressed patients, i.e.the sensitivity, specificity and Yoden index of executive function, REM duration at 94.5 minutes was the best diagnostic point in which Yoden index was 0.41.Conclusion REM duration is positively correlated with executive function.REM duration has certain diagnostic value for executive function of depressive patients, but its value is low.