围绝经期抑郁女性前额叶皮质激活的近红外脑功能成像研究

Prefrontal cortex activation in women with perimenopausal depression: a functional near-infrared spectroscopy study

目的探究围绝经期抑郁女性在情绪面孔识别任务期间前额叶皮质(prefrontal cortex,PFC)的氧合血红蛋白(oxygenated hemoglobin,Oxy-Hb)相对浓度变化以及脑区激活情况。方法2023年2—4月招募围绝经期女性40人,其中围绝经期抑郁女性(试验组)20人,围绝经期非抑郁女性(对照组)20人。使用改良Kupperman评分、24项汉密尔顿抑郁量表(24 items Hamilton depression scale,HAMD-24)和患者健康问卷抑郁量表(patient health questionnaire,PHQ-9)对所有被试进行评估。采用近红外脑功能成像(functional near-infrared spectroscopy,fNIRS)设备测量两组被试在情绪面孔识别任务下的PFC的Oxy-Hb相对浓度。统计分析使用SPSS 26.0软件。数据统计采用t检验、秩和检验和Pearson相关分析。结果试验组和对照组改良Kupperman评分[(23.20±3.66)分,(18.10±1.28)分]、HAMD-24[(15.95±5.47)分,(3.35±1.84)分]、PHQ-9[7.00(5.00,10.75)分,1.50(1.00,3.00)分]量表得分均差异有统计学意义(P<0.05)。试验组的改良Kupperman评分与HAMD-24评分之间呈正相关(r=0.685,P=0.01)。试验组在识别负性情绪面孔和中性情绪面孔的反应时间比对照组长,差异有统计学意义(t=4.01,4.80,均P<0.05)。与识别中性情绪相比,在识别负性情绪时试验组和对照组的PFC激活增强(P<0.05)。在识别负性情绪时试验组比对照组的PFC激活增强(P<0.05)。在识别中性情绪时两组激活程度均差异无统计学意义(P>0.05)。结论围绝经期抑郁女性存在情绪处理的特异性,在识别负性情绪时PFC激活程度增强,PFC的情绪处理功能受损并且有氧代谢功能失调。

Objective To explore the relative concentration changes of oxygenated hemoglobin(Oxy Hb)in the prefrontal cortex(PFC)and brain region activation during emotional face recognition tasks in women with perimenopausal depression.Methods From February to April 2023,forty perimenopausal women were recruited,including 20 women with perimenopausal depression(experimental group)and 20 women with non-perimenopausal depression(control group).All participants were evaluated by the modified Kupperman score,24-item Hamilton depression scale(HAMD-24),and patient health questionnaire(PHQ-9).Functional near-infrared spectroscopy(fNIRS)equipment was used to measure the relative concentration of Oxy-Hb in the PFC in two groups under the emotional face recognition task.Statistical analysis was performed by SPSS 26.0 software.Data were analyzed by a t-test,rank sum test,and Pearson correlation.Results There were statistically significant differences in the results of the modified Kupperman score((23.20±3.66),(18.10±1.28)),HAMD-24((15.95±5.47),(3.35±1.84)),and PHQ-9(7.00(5.00,10.75),1.50(1.00,3.00))scales between the the experimental group and control group(P<0.05).There was a positive correlation between the modified Kupperman score and the HAMD-24 score in the experimental group(r=0.685,P=0.01).The reaction time of the experimental group in identifying negative and neutral emotional faces was statistically significant compared to the control group(t=4.01,4.80,both P<0.05).Compared with identifying neutral emotions,PFC activation was stronger in the experimental group and control group when identifying negative emotions(P<0.05).The PFC activation in the experimental group was stronger than that in the control group when identifying negative emotions(P<0.05).There was no statistically significant difference in the activation level between the two groups when identifying neutral emotions(P>0.05).Conclusion Women with perimenopausal depression exhibit specificity in emotional processing,with increased PFC activation when identifying negative emotions,impaired emotional processing function of PFC,and dysfunction of aerobic metabolism.