多系统萎缩伴抑郁症状的静息态脑功能低频振幅研究

Amplitude of low-frequency fluctuations of resting-state functional MRI in multiple system atrophy patients with depression

目的探讨多系统萎缩(multiple system atrophy,MSA)患者伴抑郁症状自发脑活动的改变。材料与方法收集多系统萎缩伴抑郁症状的患者32例,不伴抑郁症状的患者26例和健康对照组39例,所有的被试进行功能磁共振序列扫描。利用双样本t检验的方法比较三组全脑低频振幅(amplitude of low-frequency fluctuations,ALFF)值的差异,进一步将差异的脑区和汉密尔顿抑郁评分做相关性分析。结果与健康对照组相比,MSA伴抑郁症状较MSA不伴抑郁症状的患者全脑ALFF损伤的范围更加广泛,主要集中在右侧颞下回、双侧壳核、右侧额上回、左侧额中回、双侧枕中回、左侧楔前叶和左侧中扣带皮层,直接对比两组病例组,MSA伴抑郁症状患者右侧颞中回,右侧枕中回ALFF激活增强。其中右侧颞中回ALFF值异常与临床汉密尔顿抑郁评分量表(Hamilton Depression Scale,HAMD-24)评分成负相关(r=-0.511,P=0.003)。结论多系统萎缩伴抑郁症状患者存在更加广泛的脑区活动改变,右侧颞中回ALFF活动增强可能是患者抑郁症状的潜在神经生物标记。

Objective:To investigate the changes of resting-state spontaneous brain activity in multiple system atrophy patients with depression.Materials and Methods:Thirty-two MSA patients with depression symptom,twenty-six patients without depression and thirtynine health controls were enrolled.All the participants underwent 3.0 T MRI resting-state blood oxygen level dependence sequence scan.Two sample t-test was used to compare the differences of the whole brain amplitude of low-frequency fluctuations(ALFF)among the three groups,and the correlation between the different brain areas and Hamilton depression score was analyzed.Results:Compared with the HC groups,MSA-D(MSA patients with depressive symptoms)shows more widely brain areas dysfunction which included right inferior temporal gyrus,bilateral putamen,right superior frontal gyrus,left middle frontal gyrus,bilateral middle occipital gyrus,left precuneus and left middle cingulate cortex than MSA-ND(MSA-no depressive symptoms).A directly comparison of the two patient groups,MSA-D shows increase ALFF in right middle temporal gyrus and right middle occipital gyrus.There was a positive correlation between the ALFF value of right middle temporal gyrus and clinical HAMD-24 score(r=-0.511,P=0.003).Conclusions:There is a wide range of resting state brain activity in MSA patients with depressive symptoms,and increased ALFF activity in the right middle temporal gyrus may be a potential biomarker for depressive symptoms in MSA.