双相情感障碍患者抑郁和缓解状态脑功能稳定性的比较

Comparison of brain functional stability in patients with bipolar disorder in depressive and euthymic mood states

目的分析处于双相情感障碍(BD)缓解期的患者(EP)和BD抑郁期的患者(DP)脑功能稳定性的特点。方法选取2009年2月至2016年6月于首都医科大学附属北京安定医院就诊的56例BD患者为研究组,并根据患者所处的情绪状态分为EP组(n=30)和DP组(n=26)。招募与研究组患者匹配的71名健康对照者作为健康对照组。采用17项汉密尔顿抑郁量表(HAMD-17)比较EP组、DP组、健康对照组之间的抑郁程度。采集所有受试者的静息态功能性磁共振成像数据,采用DPABI软件对数据进行预处理和功能稳定性指标的计算并比较3组功能稳定性差异,变换不同窗宽、步长和窗的类型进行重复验证。采用Pearson相关分析患者右侧小脑后叶的功能稳定性与HAMD-17总分之间的相关性。结果EP组、DP组、健康对照组受试者HAMD-17总分比较[2.00(0,4.00)分比14.00(10.75,19.50)分比0(0,1.00)分],差异有统计学意义(P<0.01)。不同窗宽/步长/窗类型的3组受试者右侧小脑后叶功能稳定性比较,差异均有统计学意义(均P<0.05);EP组患者右侧小脑后叶的功能稳定性低于DP组和健康对照组,差异有统计学意义(P<0.05);DP组和健康对照组功能稳定性比较,差异无统计学意义(P>0.05)。研究组、EP组和DP组右侧小脑后叶的功能稳定性与HAMD-17总分无相关性(P>0.05)。结论EP、DP患者表现出不同的脑功能活动模式,仅EP患者表现出右侧小脑后叶的功能稳定性降低。

Objective To analyze the difference of brain function stability among patients with bipolar disorder(BD) in remission(EP),patients with BD depression(DP) and healthy controls.Methods A total of56 patients with BD treated in Beijing Anding Hospital Affiliated to Capital Medical University from February2009 to June 2016 were selected as the study group,and were divided into EP group(n=30) and DP group(n=26)according to their emotional state.Another 71 healthy controls matched with patients in the study group were recruited as the healthy control group.The degree of depression among EP group,DP group and healthy control group were compared by Hamilton Depression Scale(HAMD-17).Resting state functional magnetic resonance imaging(fMRI) data of all subjects were collected.DPABI software was used to preprocess the data and calculate the functional stability index,to compare the differences of the three groups of functional stability.Repeated verification was carried out using different window width,step size and window type.Pearson correlation was used to analyze the correlation between the functional stability of the right posterior cerebellar lobe and the total score of HAMD-17.Results The total score of HAMD-17 in the EP group,the DP group,and the healthy control group was [2.00(0,4.00) points vs 14.00(10.75,19.50) points vs 0(0,1.00) points],and the difference was statistically significant(P <0.01).The functional stability of the right posterior cerebellar lobe of the three groups of subjects with different window width/step size/window type was compared,and the difference was statistically significant(P <0.05).The functional stability of the right posterior cerebellar lobe in EP group was significantly lower than that in DP group and healthy control group(P <0.05).There was no statistical significance in the difference of functional stability between DP group and healthy control group(P> 0.05).There was no correlation between the functional stability of the right posterior cerebellar lobe and the total score of HAMD-17 in the study group,EP group and DP group(P> 0.05).Conclusions EP and DP patients show different brain function activity patterns,only EP patients show decreased functional stability of the right posterior cerebellar lobe.