重度抑郁症患者脑灰质体积性别差异的3D高分辨MRI研究

High resolution 3D MRI study of gender differences of gray matter volume in major depression disorderpatients

目的:基于3D-T_(1)WI高分辨MRI,探讨重度抑郁症(MDD)患者脑灰质体积的性别差异及有性别差异脑区的灰质体积与临床指标的相关性。方法:将25例男性、36例女性MDD患者及25例男性、36例女性健康志愿者纳入本研究,所有被试行3D-T_(1)WI高分辨MRI扫描。建立双因素方差分析模型,获得4组间灰质体积有性别差异的脑区,将男、女性MDD患者之间有性别差异脑区的灰质体积与临床指标[17项汉密尔顿抑郁量表(HAMD)评分、病程及发病年龄]进行相关性分析。结果:四组之间双因素方差分析主效应结果显示男性灰质体积小于女性的脑区包括左侧额中回、左侧中央后回、右侧额叶内侧回、右侧舌回、双侧额上回、双侧中央前回、双侧颞中回和双侧丘脑。Post-hoc法组间两两比较结果显示,与女性MDD组比较,男性MDD组的左侧额中回、左侧中央前回、右侧额叶内侧回、双侧额上回、双侧中央前回及双侧丘脑的灰质体积减小(P<0.05,Alphasim校正)。相关性分析结果显示仅男性MDD患者的左侧颞中回和左侧额中回的灰质体积与HAMD评分呈负相关(r=-0.418,P=0.042;r=-0.498,P=0.013);女性MDD患者的有差异脑区的灰质体积与临床指标间均无显著相关性(P>0.05)。结论:MDD患者存在性别特异性灰质体积改变,这些改变可能与临床症状有关。

Objective:The purpose of this study was to explore the gender differences of cerebral gray matter volume(GMV)in major depressive disorder(MDD)and the correlation between these differences and clinical manifestations.Methods:Twenty five male and 36 female unmedicated MDD patients and 25 male and 36 female healthy controls were recruited in the current study.All subjects underwent high-resolution 3D-T_(1) and conventional MRI exams on 3.0T MR scanner.Analysis of variance(ANOVA)was used to compare the gender differences among four groups.Correlation analysis was made between the group difference of GMV values and the scores of Hamilton Depression Scale(HAMD)-17 as well as the illness duration in MDD patients.Results:The major effect result of ANOVA among the four groups revealed that the GMV in males were smaller than that in females,including left middle frontal gyrus,left posterior central gyrus,right lingual gyrus,right medial frontal gyrus,bilateral middle temporal gyrus,bilateral thalamus,bilateral superior frontal gyrus,and bilateral anterior central gyrus.Further post-hoc comparisons revealed the GMV of left middle frontal gyrus,left anterior central gyrus,right medial frontal gyrus,bilateral superior frontal gyrus,bilateral anterior central gyrus and bilateral thalamic in male MDD group were decreased when compared with female MDD group(P<0.05,corrected for Alphasim).The GMV values of left middle frontal gyrus and left middle temporal gyrusin male MDD patients were negatively correlated with the scores of HAMD(r=-0.418,P=0.042;r=-0.498,P=0.013);there were no statistical correlation between the GMV with gender statistical difference in female MDD group and the clinical indexes.Conclusion:The diffe-rence of specific brain gray matter volume alterations in different gender may associate with the diffe-rent clinical characteristics in male and female MDD patients.