首次发病未用药老年抑郁症患者脑白质完整性的弥散张量成像研究

目的 使用弥散张量成像探讨首次发病未用药老年抑郁症患者的脑白质完整性.方法 15例首次发病未用药的老年抑郁症患者和15例正常对照组接受脑弥散张量成像扫描,用基于体素的分析方法对脑内所有体素的各向异性分数(FA)逐一进行组间比较.结果 与正常对照组相比,首次发病未用药老年抑郁症患者左侧前扣带(丛集体积=106体素,t=3.21)、右侧前扣带(丛集体积=60体素,t=2.71)、右侧膝下扣带(丛集体积=63体素,t=3.37)、左侧脑干(丛集体积=62体素,t=3.25)白质FA值显著降低(检验水准为未校正的单侧P＜0.01,体素集阈值＞50体素).结论 老年抑郁症发病早期存在双侧前扣带及右侧膝下扣带白质完整性下降,经由该脑区的神经通路损害可能与老年抑郁症的病理机制有关.     

首次发病未用药老年抑郁症患者脑白质完整性的弥散张量成像研究

Objective To explore the white matter integrity by using diffusion tensor imaging (DTI) in first-episode, medication-naive geriatric patients with major depressive disorder.Methods Fifteen first-episode, medication-naive depressive patients and fifteen healthy controls underwent DTI scan.Fractional anisotropy (FA) of white matter was compared between the two groups using voxel-based approach.Results Compared with healthy controls, geriatric depressive patients showed significantly lower FA in left anterior cingulate (cluster size = 106 voxels, t = 3.21 ), right anterior cingulate ( cluster size =60 voxels, t = 2.71 ), right subgenual cingulate ( cluster size = 63 voxels, t = 3.37 ) and left brainstem ( cluster size = 62 voxels, t = 3.25 ) ( level of significance was uncorrected single-tailed P ＜ 0.01, threshold of cluster size ＞ 50 voxels).Conclusion Decrease of white matter integrity in bilateral anterior cingulate and right subgenual cingulate are present in the early stage of geriatric depression.Lesions of neural pathways by way of these regions may be involved in the pathophysiology of geriatric depression.     

首次发病未用药老年抑郁症患者脑白质完整性的弥散张量成像研究

Objective To explore the white matter integrity by using diffusion tensor imaging (DTI) in first-episode, medication-naive geriatric patients with major depressive disorder.Methods Fifteen first-episode, medication-naive depressive patients and fifteen healthy controls underwent DTI scan.Fractional anisotropy (FA) of white matter was compared between the two groups using voxel-based approach.Results Compared with healthy controls, geriatric depressive patients showed significantly lower FA in left anterior cingulate (cluster size = 106 voxels, t = 3.21 ), right anterior cingulate ( cluster size =60 voxels, t = 2.71 ), right subgenual cingulate ( cluster size = 63 voxels, t = 3.37 ) and left brainstem ( cluster size = 62 voxels, t = 3.25 ) ( level of significance was uncorrected single-tailed P ＜ 0.01, threshold of cluster size ＞ 50 voxels).Conclusion Decrease of white matter integrity in bilateral anterior cingulate and right subgenual cingulate are present in the early stage of geriatric depression.Lesions of neural pathways by way of these regions may be involved in the pathophysiology of geriatric depression.     

未经治疗的抑郁症首次发病患者脑弥散张量成像的研究

目的 通过对未经治疗的抑郁症首次发病(以下简称首发)患者进行弥散张最成像(DTI)检查,探讨抑郁症患者脑门质的完整性及其与病程和抑郁严重程度的相关性.方法 对17名首发末服药抑郁症患者(以下简称患者组)和17名年龄、性别和文化程度相匹配的健康对照(以下简称对照组)进行全脑DTI扫描.以基于体素的分析比较两组受试者脑白质的分数各向异性(FA)的差异.提取差异有统计学意义的脑区的FA绝对值,将其与汉密尔顿抑郁量表(17项,HAMD)总分和患者病程进行相关分析.结果 患者组的双侧额中回、左侧扣带回和颞下回白质的FA值显著低于对照组(P＜0.01,cluster＞100).右侧额中回的FA值与病程呈显著负相关(r=-0.732,P=0.001).未发现各脑区的FA值与HAMD总分存在相关.结论脑白质完整性异常可能是抑郁症的生物学特征之一,抑郁症病程对脑白质的完整性有明显影响.     

抑郁症首次发病中年女性患者的弥散张量成像研究

目的 运用基于纤维束示踪的空间统计学方法(tract-based spatial statistics,TBSS)探索首次发病抑郁症中年女性患者脑白质微观结构的损害.方法 对20例首次发病抑郁症中年女性患者(患者组)和15名与患者组性别、年龄、受教育程度相匹配的健康志愿者(对照组)进行全脑弥散张量成像扫描.应用TBSS方法对患者组和对照组的部分各向异性(fractional anisotropy,FA)值进行组间比较.结果 与对照组相比,患者组左侧前额叶、左侧内囊、右侧楔前叶白质的FA值显著降低(P ＜0.005,簇＞40).结论 脑白质病变在抑郁症发病的早期即已存在,异常脑区涉及与认知和情感调节关系较密切的前额叶-子皮质神经环路和默认网络的纤维束.     

精神分裂症首次发病患者的脑扩散张量成像研究

目的 利用磁共振扩散张量成像(DTI)技术研究未经药物治疗的精神分裂症首次发病(以下简称首发)患者主要脑区白质纤维束的异常.方法 选取26例首发精神分裂症患者(患者组)和20名健康志愿者(对照组)行脑DTI扫描(两组均为右利手),测量胼胝体膝部、压部、双侧额叶白质、扣带束前部及海马头的部分各向异性(FA)值.结果 (1)对照组左侧扣带束FA值(0.428±0.067)大于右侧(0.375±0.079;P＜0.05).(2)患者组两侧相对应感兴趣区FA值差异均无统计学意义(P＞0.05).(3)患者组左右侧胼胝体压部FA值(均为0.734±0.085)、左右侧扣带束前部FA值(0.300±0.068和0.306 4±0.062)均低于对照组(0.785±0.045,0.428±0.067,0.375±0.079;均P＜0.05).结论 首发精神分裂症患者存在双侧扣带束、胼胝体压部白质纤维束的受损,支持脑内连接异常假说.     

高功能孤独症患儿全脑白质纤维的弥散张量成像研究

目的 分析高功能孤独症患儿的全脑白质纤维的完整性.方法 对18例高功能孤独症患儿(病例组)以及10名年龄、性别、智商与病例组相匹配的健康儿童(对照组)进行全脑弥散张量成像(DTI)测量;应用基于体素的分析方法,比较两组全脑各向异性分数(FA)的差异.使用Spearman相关分析,分析病例组各感兴趣区FA值与儿章期孤独症评定表(CARS)总分及各项目之间的关系.结果 与对照组相比,病例组右侧额下回、左侧额中回及右侧颞下回邻近白质的FA值低(分别为0.67±0.10、0.57±0.09、0.50 ±0.12),左顶上小叶邻近白质的FA值高(0.55±0.15;P<0.001).病例组左额中回邻近白质的FA值与CARS中的与非生命物体的关系的得分呈负相关(r=-0.63,P=0.005).结论 高功能孤独症患儿多个部位的脑白质纤维的完整性受到破坏.     

精神分裂症患者全脑白质纤维弥散张量成像的初步研究

目的运用能够提示白质纤维(white matter,WM)完整性的弥散张量成像(diffusion tensor imaging,DTI)技术,探讨精神分裂症患者全脑白质纤维是否受到损害。方法对21例精神分裂症患者(患者组)和21名健康人(对照组)进行全脑DTI扫描,用SPM2(Statistical Parametric Maps,SPM)软件对图像进行处理,采用以像素为基础的分析方法(voxel-based analysis,VBA)对两组的分数各向异性(fractional anisotropy,FA)值进行组间比较。结果患者组下列脑区的FA值显著低于对照组(P<0·001):左侧额眶区和右侧额中回的白质、双侧颞下回白质、双侧顶叶内侧白质、右侧前扣带、双侧海马、双侧大脑脚、双侧岛叶、右侧放射冠和右侧小脑上脚。结论精神分裂症多个部位脑白质纤维的完整性受到破坏。     

高功能孤独症患儿全脑白质纤维的弥散张量成像研究

Objectlve To analysis the changes of white matter fiber in autistic disorder.Methods Diffusion tensor imaging(DTI)data were obtained from 18 autistic children and 10 age-,sex-and intelligent quotient matched normal controls.Voxel-based analysis Was applied to assess the fractional anisotropy(FA)in cerebral tissues.Results Compared with the controls,the FA values in autistic children were significantly decreased in the white matter of right inferior frontal gyrus,left middle frontal gyrus and right inferior temporal gyms,and increased in the white matter of left superior parietal lobule(P＜0.001).Furthermore.the white matter changes on left middie frontal gyrus were significandy correlated with the scores of Childhond Autism Rming Scale(CARS)in autistic children(r=-0.63,P=0.005).Conclusion The white matter integrity is probably disconnected in many brain regions in children with autistic disorder.     

高功能孤独症患儿全脑白质纤维的弥散张量成像研究

Objectlve To analysis the changes of white matter fiber in autistic disorder.Methods Diffusion tensor imaging(DTI)data were obtained from 18 autistic children and 10 age-,sex-and intelligent quotient matched normal controls.Voxel-based analysis Was applied to assess the fractional anisotropy(FA)in cerebral tissues.Results Compared with the controls,the FA values in autistic children were significantly decreased in the white matter of right inferior frontal gyrus,left middle frontal gyrus and right inferior temporal gyms,and increased in the white matter of left superior parietal lobule(P＜0.001).Furthermore.the white matter changes on left middie frontal gyrus were significandy correlated with the scores of Childhond Autism Rming Scale(CARS)in autistic children(r=-0.63,P=0.005).Conclusion The white matter integrity is probably disconnected in many brain regions in children with autistic disorder.     

White matter lesions in euthymic patients with bipolar disorder

Objective: We aimed to quantify both load and regional distributions of hyperintensities on magnetic resonance imaging (MRI) in prospectively verified euthymic bipolar patients and matched controls. Method: Cerebral hyperintensities on T2, proton density and fluid‐attenuated inversion recovery (FLAIR) MRI were compared between 48 bipolar and 47 control subjects using semi‐quantitative rating scales. Results: Bipolar subjects had more severe frontal deep white matter lesions (DWML). Hyperintensity load was independent of age in bipolar patients but increased with age in controls. Global prevalence and severity of hyperintensities did not differ between groups. Exploratory analysis showed DWML in excess in the left hemisphere in bipolar subjects but not in controls. Conclusion: Findings are consistent with clinical, particularly some neurocognitive, features of bipolar disorder and implicate fronto‐subcortical circuits in its neurobiology. They more probably reflect a trait abnormality or illness scar rather than a mood state‐dependent finding. Processes other than ageing and vascular factors may underlie their development.     

强迫症患者脑结构异常的多模态研究

目的探讨强迫症患者脑灰质和白质结构改变是否在同一样本中反映了相同环路的异常。方法对54例强迫症患者(强迫症组)和54名健康对照(对照组)进行3D结构磁共振成像扫描和弥散张量成像扫描。基于SPM分析软件,采用基于体素的形态学分析方法分析强迫症组全脑灰质体积与对照组的差异;基于FSL软件,采用基于纤维束示踪的空间统计学探讨强迫症组各向异性分数(fractional anisotropy,FA)与对照组的差异。结果与对照组相比,强迫症组左侧额中回、左侧前扣带和旁扣带脑回、左侧中央前回及右侧颞下回灰质体积减小(P<0.05,Alphasim校正),胼胝体体部和胼胝体膝部FA值减小(P<0.05,FWE校正)。结论强迫症患者的灰质体积和白质完整性均存在异常,且异常区域多位于皮质-纹状体-丘脑-皮质环路相关脑区,强迫症的灰、白质结构异常可能同时出现。     

基于形变的形态学测量对首次发病未服药抑郁症患者大脑灰质异常的研究

目的:探讨首次发病未服药抑郁症患者（major depressive disorder）大脑灰质结构改变以及抑郁症早期诊断的影像学指标。方法:对38例抑郁症患者（抑郁症组）和65名年龄、性别相匹配的健康对照（对照组）进行3D T 1加权结构像磁共振成像扫描,采用基于形变的形态学测量（deformation-...     

White matter abnormalities in first-episode, treatment-naive young adults with major depressive disorder

OBJECTIVE: The aim of this study was to explore the microstructural integrity of whole-brain white matter by diffusion tensor imaging in first-episode, treatment-naive young adults with major depressive disorder. METHOD: Diffusion tensor imaging scans were obtained from 14 first-episode, treatment-naive young adult patients with major depressive disorder and 14 healthy comparison subjects. A voxel-based method was used to analyze the scans. RESULTS: The patient group exhibited significantly lower fractional anisotropy values than healthy comparison subjects in the white matter of the right middle frontal gyrus, the left lateral occipitotemporal gyrus, and the subgyral and angular gyri of the right parietal lobe. There were no regions of significantly higher fractional anisotropy values in patients compared with healthy comparison subjects. CONCLUSIONS: These findings suggest that abnormalities of brain white matter may be present early in the course of major depressive disorder. They also support the idea that white matter lesions may disrupt the neural circuits involved in mood regulation and thus contribute to the neuropathology of major depressive disorder.     

White matter abnormalities in children with and at risk for bipolar disorder

OBJECTIVES: Diffusion tensor magnetic resonance imaging (DT-MRI) assesses the integrity of white matter (WM) tracts in the brain. Children with bipolar disorder (BPD) may have WM abnormalities that precede illness onset. To more fully examine this possibility, we scanned children with DSM-IV BPD and compared them to healthy peers and children at risk for BPD (AR-BPD), defined as having a first-degree relative with the disorder. METHODS: Ten children with BPD, eight healthy controls (HC), and seven AR-BPD, similar in age, had MRI scans on a 1.5 Tesla GE scanner, including a standard DT-MRI sequence (T2-EPI) with 25 axial slices. Fractional anisotropy (FA) values were compared between groups to determine regions of significant difference (p < 0.05). RESULTS: Compared to HC, children with BPD had decreased FA in right and left superior frontal tracts, including the superior longitudinal fasciculus I (SLF I) and the cingulate-paracingulate WM (CG-PAC(WM)). In addition, the BPD group had reduced FA in left orbital frontal WM and the right corpus callosum body. Compared to AR-BPD, children with BPD showed reduced FA in the right and left CG-PAC(WM). Both the BPD and AR-BPD groups showed reduced FA relative to HC in bilateral SLF I. CONCLUSIONS: The bilateral SLF I finding in both the BPD and AR-BPD groups may represent a trait-based marker or endophenotype of the disorder. The finding of decreased FA in the right and left CG-PAC(WM) in children with BPD compared to the other two groups may represent a disease-state related finding.     

老年抑郁症恢复期患者认知损害与全脑白质纤维完整性的相关性研究

目的 探讨恢复期老年抑郁症患者全脑白质纤维完整性是否受损,并进一步分析其与认知损害是否关联.方法 对16例恢复期老年抑郁症患者(患者组)和14名健康老年人(对照组)进行汉密尔顿抑郁量表(HAMD)、简易智力状态检查(MMSE)和神经心理学评估后,行全脑弥散张量成像扫描,用SPM2软件处理图像,采用基于体素的分析方法进行组间比较分数各向异性(FA)值.结果 (1)HAMD、MMSE评分和神经心理学测试:患者组HAMD和MMSE评分与正常对照组的差异无统计学意义(P>0.05),但在听觉言语测验[(5.9±2.6)分]、连线测验A[(146±127)s]和B[(264±196)s]成绩均差于正常对照组[分别为(9.3±1.6)分,(73±25)s和(121±35)s;P<0.01～0.05].(2)FA值:患者组低于对照组的脑区主要包括:右侧额上回、左侧额下回、左侧颞中回、右侧顶下回、右侧枕中回、左侧舌回、右侧壳核和右侧尾状核(未校正,P<0.001).(3)患者组右侧额上回FA值与连线B测验成绩呈显著负相关(r=-0.556,P=0.049).结论 恢复期老年抑郁症患者多部位脑白质纤维的完整性受损,这可能是该类患者认知损害的神经病理基础.     

首发抑郁症青少年患者的大脑功能——静息态功能磁共振成像的病例对照研究(英文)

背景:青少年抑郁症对患者及其家庭成员会产生长期严重的痛苦,但这种致残状况的潜在机制仍不清楚。目的:比较未经药物的青少年首发抑郁症患者和匹配的对照者之间的大脑功能静息状态。方法 :使用3T磁共振扫描仪对15名青少年抑郁症患者和16名对照者进行功能磁共振静息状态扫描。采用低频振荡振幅(amplitude of low frequency fluctuation,ALFF)来评估脑功能静息态。结果 :青少年抑郁症患者的儿童抑郁量表评分的均值(标准差)高于对照组(22.13[9.21]与9.37[5.65])。与对照组相比,青少年抑郁症患者在扣带回后部、左颞下回、右颞上回、右岛叶、右侧顶叶和右侧梭状回具有较高的ALFF;而在双侧楔叶、左枕叶和左内侧额叶表现出较低的ALFF。结论 :青少年抑郁症与大脑多个区域的显著功能变化有关。     

青壮年重症抑郁障碍的磁化传递成像研究

目的探讨青壮年重症抑郁障碍患者磁化传递率(MTR)值的改变及其与病程的相关性。方法根据美国精神障碍诊断与统计手册,选择临床晤谈诊断明确并且17项汉密尔顿抑郁量表评分≥18分的30例重症抑郁障碍患者,以及按照年龄、性别、利手性、受教育程度相匹配原则征集的30例正常对照者。采用3.0T MRI扫描仪采集磁化传递成像数据,统计参数图软件对所得MTR参数图进行标准化和平滑等预处理,再行基于体素的分析。MTR值的组间比较行双样本t检验,与病程的相关性分析采用Pearson相关分析。结果在统计参数图中,以团簇水平P<0.05作为统计显著性阈值。与正常对照组相比,重症抑郁障碍组患者未发现MTR值差异有统计学意义的脑区;相关分析显示,其在左侧前额叶、顶叶、颞叶部分区域,以及双侧前扣带回等脑区与病程呈显著负相关。进一步亚组分析显示,长病程(>60周)重症抑郁障碍患者MTR值在左侧额中回、双侧中扣带回、右侧小脑前叶低于与之相匹配的正常对照者;而短病程(≤60周)患者,MTR值则在左侧额中回、颞枕交界区、双侧前扣带回及邻近白质较正常对照者升高。结论不同病程重症抑郁障碍患者脑MTR值呈现不同改变模式,提示对重症抑郁障碍患者长期纵向随访的必要性,尤其是长期抗抑郁治疗对脑结构及功能的影响应作为重点研究课题。