伴与不伴抑郁的早泄患者静息态脑功能特征差异分析

Difference of resting-state brain activity between premature ejaculation patients with and without depression

目的探讨从脑功能角度分析早泄患者伴发抑郁的中枢机制。方法选取96例早泄患者,其中48例伴抑郁的早泄患者(HAMD-17>7分)、48例不伴抑郁的早泄患者(HAMD-17≤7分),另选取40例健康对照者(HCs)(HAMD-17≤7分)的静息态功能磁共振成像(rs-fMRI)数据。计算AAL模板中90个脑区局部一致性值(ReHo)。对脑区ReHo值进行方差分析与双样本t检验,使用AlphaSim方法进行多重比较校正。结果1)与HCs相比,不伴抑郁的早泄患者表现出左距状裂、左枕上回、左枕中回ReHo值下降;左脑岛、左尾状核、右脑岛、右中央后回、右直回ReHo值上升;2)与HCs相比,伴抑郁的早泄患者左楔前叶、左距状裂、左枕上回、左枕中回、右颞中回、右枕上回、右枕中回、右楔叶ReHo值下降;左楔前叶、左脑岛、左壳核、左补充运动区、左旁中央小叶、左中央后回、左罗兰多壳盖、右中央后回、右罗兰多壳盖、右尾状核、右壳核ReHo值上升;3)与不伴抑郁的早泄患者相比,伴抑郁的早泄患者左顶下回ReHo值下降;左扣带回前部ReHo值上升。结论早泄患者的抑郁情绪可能与左顶下回活动同步性下降以及左扣带回前部上升相关,导致对负面情绪感受与识别能力上升,对与情绪相关的外界刺激注意与调控能力下降。

Objective To explore the central mechanism of depression in PE patients from the perspective of neuroimaging.Methods The resting functional magnetic resonance imaging(rs-fMRI)data of 48 PE patients with depression(HAMD-17>7),48 PE patients without depression(HAMD-17≤7)and 40 healthy controls(HCs)(HAMD-17≤7)were collected.Reagional homogeneity(ReHo)values of 90 brain regions in the AAL template were calculated.The differences of ReHo values were compared by ANOVA and two sample t‑test.The results were corrected by the AlphaSim program.Results(1)Compared with HCs,PE patients without depression showed decreased ReHo values in the left calcarine fissure,left superior occipital gyrus and left middle occipital gyrus;and increased ReHo values in the left insula and left caudate,the right postcentral gyrus and right gyrus rectus.(2)Compared with HCs,PE patients with depression showed decreased ReHo values in the left precuneus,left calcarine fissure,left superior occipital gyrus,left middle occipital gyrus,right middle temporal gyrus,right superior occipital gyrus,right middle occipital gyrus and right cuneus;and decreased ReHo values in the left precuneus,left insula,left putamen,left supplementary motor area,left paracentral lobule,left postcentral gyrus,left rolandic operculum,right postcentral gyrus,right rolandic operculum,right caudate and right putamen.(3)Compared with PE patients without depression,PE patients with depression showed the decreased ReHo values in the left inferior parietal gyrus;and increased ReHo values in the anterior cingulate gyrus.Conclusion In PE patients,depression may be related to the decreased synchronicity of activity in the left inferior parietal gyrus and the increase in the left anterior cingulate gyrus,which lead to increased ability to feel and recognize negative emotions,and decreased ability to pay attention to and regulation of emotional external stimuli.