难治性与非难治性抑郁症的静息态脑功能磁共振ReHo特征初步比较

Preliminary study on comparing the Re Ho features of resting-state functional MRI between the treatment-resistant and non-treatment-resistant depression

目的通过静息态脑功能磁共振成像采集脑功能数据,行脑局部一致性ReHo(regional homogeniety)分析,探讨难治性抑郁症(treatment-resistant depression,TRD)和非难治性抑郁症(non treatment-resistant depression,nTRD)的脑功能差异及其与临床症状的相关性。材料与方法招募27例TRD患者、22例nTRD、22例健康对照组,评估抑郁、焦虑、冗思等临床症状,均进行静息态磁共振脑功能扫描,采用DPARSF 5.0处理核磁数据,SPSS软件包(单因素方差分析)one way ANOVA检验三组ReHo差异脑区与临床量表积分的相关性。结果两组抑郁症患者的人口统计学资料和临床症状评分均无显著差异。然而,与nTRD组比较,TRD组在左侧颞上回、右侧小脑后ReHo值更高,右侧眶额回的ReHo值更低。相关性分析显示,TRD组右侧额上回/额中回、眶额回ReHo值分别与冗思量表(Ruminative Response Scale,RRS)评分呈正相关(P=0.015,r=0.46),(P=0.018,r=0.44)。结论难治与非难治性抑郁症在临床表现相似及量表积分无明显差异时,脑功能ReHo存在明显差异,难治性抑郁症累及更多的脑区,涉及到情感、认知、初级感觉中枢等,与临床症状明显相关。

Objective:To explore the brain function difference between the treatment-resistant depression(TRD)and non-treatment-resistant depression(nTRD),the local consistency ReHo(regional homogeniety)method was used to analyze the resting state functional magnetic resonance imaging data,and then the result of functional brain imaging was correlated with the scores of the clinical symptoms’scales.Materials and Methods:The study was recruited with 27 TRD patients,22 nTRD and 22 healthy controls.All subjects were conducted with the resting state fMRI.The fMRI data was processed by DPARSF 5.0.The clinical symptoms were also collected and evaluated with the scales of Depression,Anxiety,and Rumination Response.The one way ANOVA(analysis of variance)was used to test the differences in ReHo among the three groups.The ReHo values of brain areas were correlated with the clinical scales’scores.Results:There was no significant difference in demographic data and clinical symptom scores between the two groups of depression patients.However,significant differences in ReHo values were found in the left superior temporal gyrus and multiple brain areas on the right cerebrum.Compared with the nTRD group,the TRD group showed higher Re Ho values in the left superior temporal gyrus and the right posterior cerebellum,and lower in the right orbitofrontal gyrus.The ReHo values of the right upper/middle frontal gyrus and orbital frontal gyrus in the TRD group were positively correlated with the RRS scale scores,respectively(P=0.015,r=0.46),(P=0.018,r=0.44).Conclusions:Even though there are the similar scale scores of the symptoms between the TRD and non-TRD,an apparent difference exists of brain function ReHo value.Therefore,the physiopathology of TRD involves more brain regions,including emotion,cognition,primary sensory center,etc.,which are significantly related to clinical symptoms.