青少年抑郁症脑血流改变与临床特征评分的相关性

Correlation between cerebral blood flow changes and clinical feature scores in adolescents with depression

目的:采用三维动脉自旋标记(3D-ASL)成像技术探讨首诊青少年抑郁症患者静息状态下脑血流(CBF)改变及其与抑郁程度之间的相关性。方法:将2020年1月-2022年6月在本院就诊的43例首发未治疗的青少年抑郁症患者(抑郁症组)及在性别、年龄及受教育程度相匹配的34例健康青少年(对照组)纳入本研究。所有被试行3D-ASL-PWI扫描,经后处理得到脑血流(CBF)图,基于全脑体素分析方法对两组被试CBF值存在差异的脑区进行分析。使用17项汉密尔顿抑郁量表(HAMD-17)对抑郁症患者进行抑郁严重程度的评估,采用Pearson相关性分析对患者组差异脑区的CBF值与HAMD-17得分进行相关性分析。结果:对照组和抑郁症组的左侧三角部额下回的CBF值分别为(33.83±3.83)和(29.80±3.33)mL/(100g·min),右侧中央前回的CBF值分别为(35.62±3.96)和(42.10±5.48)mL/(100g·min),抑郁症组左侧三角部额下回的CBF值显著降低(P<0.001),右侧中央前回的CBF值显著升高(P<0.001)。抑郁症患者左侧三角部额下回的CBF值与其抑郁评分呈负相关(r=-0.38,P=0.010)。结论:3D-ASL成像技术能够为青少年抑郁症患者的病情评估提供影像学依据。左侧三角部额下回CBF值的改变可能是青少年抑郁症易感性的潜在生物学标志物。

Objective:To investigate the changes of resting cerebral blood flow(CBF)in patients with first-episode untreated adolescents with depression and its correlation with depression severity using three-dimensional arterial spin labeling(3D-ASL)imaging technique.Methods:From January 2020 to June 2022,43 first-episode untreated adolescents with depression(depression group)in our hospital and 34 healthy adolescents as controls(HC group)who were matched in sex,age and education level were recruited in this study.All subjects underwent MRI scan using 3D-ASL sequence and CBF maps were obtained by post-process.The CBF maps were analyzed based on the whole-brain voxel analysis method for the brain regions with difference between the two groups.The severity of depression in the depression group was evaluated using the 17-item Hamilton Depression Scale(HAMD-17),and its correlation with the CBF values of the brain regions with statistical difference was evaluated using Pearson correlation analysis.Results:There were differences in blood perfusion in the left triangular part of the inferior frontal gyrus[(33.83±3.83)vs.(29.80±3.33)mL/(100g·min)]and right precentral gyrus[(35.62±3.96)vs.(42.10±5.48)mL/(100g·min)]between HC group and depression group.Compared with the HC group,the CBF value of the left triangular inferior frontal gyrus in the depression group was significantly decreased(P<0.001),and the CBF value of the right precentral gyrus was significantly increased(P<0.001).The CBF value of the left triangular part of the inferior frontal gyrus in depression group was negatively correlated with depression score(r=-0.38,P=0.010).Conclusion:3D-ASL technique can provide useful imaging evidence for adolescents with depression.CBF values in the left triangular part of the inferior frontal gyrus may be a potential biomarker of susceptibility to adolescents with depression.