首发抑郁障碍伴躯体疼痛患者的感觉运动区功能改变

Functional changes of sensorimotor areas in first-episode major depressive disorder with somatic pain

目的利用静息态功能磁共振成像(resting-state functional MRI,rs-fMRI)技术,探索伴有躯体疼痛的抑郁症患者异常脑功能活动区域及抑郁症状与躯体疼痛症状的关系。方法对32例首发抑郁障碍患者(16例伴有躯体疼痛、16例不伴有躯体疼痛)进行rs-fMRI扫描。使用局部一致性(regional homogeneity,ReHo)方法分析ReHo在伴有躯体疼痛的抑郁障碍组与不伴有躯体疼痛的抑郁障碍组之间差异。结果抑郁障碍伴有躯体疼痛的左侧中央后回和左侧中央前回(感觉运动区)ReHo显著高于不伴有躯体疼痛患者(t左侧中央后回=4.93,P左侧中央后回<0.001;t左侧中央前回=4.57,P左侧中央前回<0.001),且简明疼痛量表(BPI)平均疼痛分与左侧中央后回脑区ReHo值呈正相关(r=0.544,P<0.001)、与左侧中央前回脑区ReHo值呈正相关(r=0.550,P<0.001)。结论感觉运动区局部一致性改变在伴有躯体疼痛的抑郁症患者中起重要作用。

Objective Our study is to explore abnormal brain activity areas in first-episode depressed patients with somatic pain by using resting-state functional magnetic resonance imaging(rs-fMRI)and the relationship between depressive symptoms and somatic pain. Methods Thirty-two depressed patients(sixteen with somatic pain and sixteen without somatic pain)diagnosed MDD by the criteria of DSM-IV were scanned by rs-fMRI. ReHo was used to analyze the difference between depressed patients with somatic pain and without somatic pain. Results(1)ReHo values in the Left postcentral gyrus and the left precentral gyrus(sensorimotor area)of depressed patients with somatic pain were significantly higher than those without somatic pain(tleft postcentral gyrus=4.93,P left postcentral gyrus<0.001;tleft precentral gyrus=4.57,P left precentral gyrus<0.001).(2)The mean pain score of BPI was positively correlated with ReHo value in the left postcentral gyrus(r=0.544,P=0.001)and the left precentral gyrus(r=0.550,P=0.001). Conclusion ReHo changes in sensorimotor area play an important role in depressed patients with somatic pain.