抑郁症患者认知功能与前额叶、海马质子波谱特点及其相关性

Correlation of cognitive function,prefrontal lobe,and hippocampus ~1H-magnetic resonance spectroscopy(~1H-MRS)among depression sufferers

目的探讨抑郁症患者认知功能与前额叶、海马氢质子磁共振波谱(1H-MRS)特点及其之间的相关性。方法研究对象为2010-12—2012-11在我院住院的51例抑郁症患者(研究组)及附近社区的46例正常对照(对照组)。入组24 h内应用事件相关电位P300(P300)和威斯康星卡片分类测验(WCST)评估认知功能,采用多体素1H-MRS检测前额叶和海马N-乙酰基天门冬氨酸(NAA)、胆碱复合物(Cho)与肌酸复合物(Cr)。结果与对照组比较,研究组N2、P3潜伏期均延长,N2、P3波幅均降低,差异有高度统计学意义(t值分别为3.258、5.834、4.707和-4.968,P<0.01);Re、Rpe、Rf均高,Cc和Rf%均低,差异有高度统计学意义(t值分别为4.969、5.682、3.001、-3.649和-4.269,P<0.01)。研究组NAA/Cr值左侧和右侧前额叶、左侧海马均低于对照组,差异有统计学意义[(1.74±0.28)vs(1.87±0.16),t=2.767,P=0.007;(1.73±0.32)vs(1.89±0.15),t=2.315,P=0.023;(1.75±0.33)vs(1.87±0.27),t=2.641,P=0.001]。研究组左侧前额叶、左侧海马的NAA/Cr值与P3波幅、Cc、Rf%等均呈正相关(r=0.352,0.324,0.337;0.344,0.312,0.334,P<0.05),与P3潜伏期、Re、Rpe、Rf等均呈负相关(r=-0.354,-0.353,-0.370,-0.296;-0.352,-0.356,-0.364,-0.302,P<0.05)。结论抑郁症患者存在认知功能损害,可能与前额叶、海马的神经元低水平表达有关。

Objective To explore the relationship betw een cognitive function,prefrontal lobe,and hippocam pus 1H-m agnetic resonance spectroscopy (1H-M R S )am ong depression sufferers.Methods 51 depression sufferers adm itted to our hospital from D ecem ber 2010 to N ovem ber 2012 w ere chosen to be the research group ,w hile 46 norm al cases w ere chosen to be the control group .E vent-related potential (ERP)P30 andWisconsinCardSortingTest(WCST)wereadoptedtoassesscognitivefunctionwithin24hoursofadmission,andmulti-vox-el 1H-M R S w as adopted to detect prefrontal lobe,hippocam pus N-acetyl-aspartate (N A A ),C ho and C r.Results C om pared w ith the control group,the research group show ed prolonged latency of N 2 and P3,shortened am plitude of N 2 and P3,w ith differences of high statistical significance(t=3.258,5.834,4.707,-4.968,P<0.01).And they also dem onstrated high Re,Rpe,and Rf,and low Cc and Rf% ,with differences of high statistical significance (t=4 .969 ,5 .682 ,3 .001 ,-3 .649 ,-4 .269 ,P<0 .01 ).T he N A A/C r ratios in left and right pre-frontal lobes[(1.74±0.28)vs(1.87±0.16),t=2.767,P=0.007;(1.73±0.32)vs(1.89±0.15),t=2.315,P=0.023]and left hip-pocam pus[(1 .75 ± 0 .33 )vs(1 .87 ± 0 .27 ),t=2 .641 ,P=0 .001 )]in the research group w ere low er than the control group w ith differences of high statistical significance.T he N A A/C r ratios in both left prefrontal lobe and left hippocam pus in the research group w ere positively related to the am plitude of P3,C c,and R f% (r=0.352,0.324,0.337;0.344,0.312,0.334,P<0.05),and negatively related to the latency of P3, R e,R pe,and R f (r=-0.354,-0.353,-0.370,-0.296;-0.352,-0.356,-0.364,-0.302,P<0.05).Conclusions C ognition dys-function in depression sufferers is perhaps related to the low level expression of nerve cells in prefrontal lobe and hippocam pus.