舍曲林对抑郁症患者静息态脑功能的影响

Effect of sertraline on resting state brain function in the patients with depression

目的探讨舍曲林对抑郁症患者静息态下脑功能磁共振影像的影响。方法本研究对象为2021年2月~2022年10月50例抑郁症患者,设为抑郁组,所有患者采用舍曲林治疗,选择30名一般资料配对的健康志愿者,设为对照组。对照组以及抑郁组治疗前后均进行静息状态下功能成像扫描,记录抑郁组与对照组以及抑郁组治疗前后比率低频振荡振幅(fALFF)、局部一致性(ReHo)差异显著的脑区。评价治疗前后汉密尔顿焦虑、抑郁量表(HAMA、HAMD)。结果抑郁组右侧颞中回、左侧额中回、右侧楔前叶fALFF高于对照组,左侧小脑半球、左侧枕中回fALFF低于对照组,左侧额中回ReHo高于对照组,右侧中央前回、左侧中央后回ReHo显著低于对照组,P均<0.05;抑郁组治疗后其左侧小脑半球、左侧枕中回fALFF升高,左侧额中回ReHo升高,P均<0.05;抑郁组治疗后HAMA评分、HAMD评分均显著降低(P<0.05)。结论抑郁症患者治疗前存在多个脑区的fALFF、ReHo改变,舍曲林治疗抑郁症近期疗效显著,且能改变部分脑区的静息态下脑功能。

Objective To explore the effect of sertraline on resting state functional magnetic resonance imaging in patients with depression.Methods Fifty patients with depression from February 2021 to October 2022 were selected as the study subjects,and they were divided into the depression group.All patients were treated with sertraline,and 30 healthy volunteers matched with general information were selected as the control group.Both the control group and the depression group underwent functional imaging scans in a resting state before and after treatment.The brain regions with significant differences in low-frequency oscillation amplitude(fALFF)and local consistency(ReHo)between the depression group and the control group,as well as the depression group before and after treatment were recorded.The Hamilton Anxiety and Depression Scale(HAMA,HAMD)before and after treatment were evaluated.Results The fALFF of right middle temporal gyrus,left middle frontal gyrus and right anterior cuneiform lobe in depression group was higher than that in control group.The fALFF in the left cerebellar hemisphere and left middle occipital gyrus was lower than that in the control group,the ReHo in the left middle frontal gyrus was higher than that in the control group,and the ReHo in the right precentral gyrus and left posterior central gyrus were significantly lower than that in the control group(P<0.05).After treatment,fALFF in the left cerebellar hemisphere and left occipital gyrus increased,while ReHo in the left frontal gyrus increased(P<0.05).The HAMA score and HAMD score of the depression group were significantly reduced after treatment(P<0.05).Conclusion Depression patients have changes in fALFF and ReHo in multiple brain regionst.Sertraline has shown significant short-term efficacy in treating depression and can alter fALFF and ReHo in some brain regions of depression patients.