不同类型抑郁障碍患者静息态功能磁共振成像下前扣带回功能变化及鉴别诊断价值

Changes of anterior cingulate function in patients with different types of depressive disorders under resting-state functional magnetic resonance imaging and its differential diagnosis value

目的探讨不同类型抑郁障碍患者静息态功能磁共振成像下前扣带回功能变化及鉴别诊断价值。方法回顾性选取广州医科大学附属脑科医院单相(UD)与双相抑郁障碍(BD)患者的临床资料各50例,分别设为UD组和BD组,并选取同期进行体检的50例健康人群作为对照组,对三组进行静息态功能磁共振成像扫描,比较三组前扣带回功能连接特征。结果UD组左侧前扣带回与左侧三角额下回、左侧顶下缘角回之间及右侧前扣带回与左侧三角额下回之间的连接强于对照组,差异有统计学意义(P<0.05);BD组左侧前扣带回与右侧颞中回连接及右侧前扣带回与左侧中央后回、右侧颞上回、右侧颞中回之间的连接弱于对照组,差异有统计学意义(P<0.05);UD组左侧前扣带回与左侧三角部额下回、右侧三角部额下回连接及右侧前扣带回与左侧三角部额下回、左侧顶下缘角回、右侧顶下缘角回之间的连接强于BD组,差异有统计学意义(P<0.05)。结论与正常人比较,UD与BD患者静息态下前扣带回功能明显改变,前者主要表现为前扣带回功能连接增强,后者前扣带回功能连接减弱,对鉴别UD与BD具有一定参考价值,有助于指导医师的治疗与用药。

Objective To investigate the changes of anterior cingulate function in patients with different types of depressive disorders under resting-state functional magnetic resonance imaging(fMRI),and its differential diagnosis value.Methods The clinical data of 50 patients with unipolar depression(UD)and bipolar depression(BD)from the Affiliated Brain Hospital of Guangzhou Medical University were retrospectively analyzed.Meanwhile,a total of 50 healthy individuals were selected as the control group.The three groups all received resting-state functional magnetic resonance imaging scan,and the functional connectivity characteristics of anterior cingulate were compared among the three groups.Results The connectivity between left anterior cingulate and left triangle inferior frontal gyrus as well as left top-inferior angular gyrus,and the connectivity between right anterior cingulate and left triangle inferior frontal gyrus in UD group were stronger than those in the control group,the differences were statistically significant(P<0.05).The connectivity between left anterior cingulate and right middle temporal gyrus,the connectivity between right anterior cingulate and left central posterior gyrus,right superior temporal gyrus,and right middle temporal gyrus in BD group were weaker than those in the control group,the differences were statistically significant(P<0.05).The connectivity between left anterior cingulate and left triangle inferior frontal gyrus as well as right triangle inferior frontal gyrus,the connectivity between right anterior cingulate and left triangle inferior frontal gyrus,left top-inferior angular gyrus,and right top-inferior angular gyrus in UD group were stronger than those in BD group,the differences were statistically significant(P<0.05).Conclusion Compared with normal people,there are obvious changes of anterior cingulate function in patients with UD and BD in resting state.Patients with UD mainly manifest as enhanced functional connectivity of anterior cingulate,and patients with BD have weakened functional connectivity of anterior cingulate,which provides reference for distinguishing UD from BD and helps to guide treatment and medication of physicians.