抑郁症家族史阳性首发患者和健康者脑血流灌注的变化

Changes of brain perfusion in first-episode depressive patients and healthy people with family history of depression

目的:应用磁共振动脉自旋标记(ASL)技术探究家族史阳性的首发抑郁患者和健康者脑血流灌注的变化。方法:对50例首发抑郁患者(家族史阳性21例、家族史阴性29例)和52例健康受试者(家族史阳性22例、家族史阴性30例)进行ASL灌注扫描,以SPM12软件进行脑血流量(cerebral blood flow,CBF)灌注图像的预处理及统计分析。结果:①与家族史阴性健康者相比,家族史阴性首发抑郁患者存在CBF显著降低的区域(左侧额中回、左侧枕上回、左侧丘脑及右侧尾状核)和CBF显著增加的区域(左侧扣带回、右侧豆状核及右侧海马);②与家族史阳性健康者相比,家族史阳性首发抑郁患者只存在CBF显著降低的区域(左侧额中回、左侧枕上回及右侧杏仁核);③与家族史阴性首发抑郁患者相比,家族史阳性首发抑郁患者右侧杏仁核及左侧脑岛的CBF显著降低;④与家族史阴性健康者相比,家族史阳性健康者右侧杏仁核CBF明显降低。结论:家族史阳性首发抑郁患者和健康者脑血流灌注存在异常,其中右侧杏仁核为主要受累脑区。

Objective:To investigate the brain perfusion in first-episode depressive patients and healthy people with family history of depression by application of arterial spin labeling(ASL).Methods:Fifty first-episode depressive patients(21 patients with family history of depression and 29 without family history of depression)and 52 healthy subjects(22 subjects with family history of depression and 30 without family history of depression)underwent ASL-MRI scanning.The preprocessing and statistical analysis of CBF perfusion maps were based on SPM12.Results:Compared with healthy subjects,first-episode depressive patients without family history of depression displayed significantly reduced CBF in the left middle frontal gyrus,the left superior occipital gyrus,the left thalamus as well as the right caudate nucleus and increased CBF in the left cingulate gyrus,the right lenticular and the right hippocampus.In contrast,first-episode depressive patients with family history of depression had significant reduced CBF in the left middle frontal gyrus,the superior occipital gyrus and the right amygdala.Compared with patients without family history of depression,patients with family history had reduced CBF in the right amygdala and the left insula.Moreover,compared with healthy subjects without family history,healthy subjects with family history showed reduced CBF in the right amygdala.Conclusion:The brain perfusion changed in first-episode depressive patients and healthy subjects with family history of depression,decline of CBF in the right amygdala was most remarkable.