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.

A diffusion tensor imaging study in patients with first-episode treatment-naive major depression

Objective To explore the white matter integrity via diffusion tensor imaging(DTI)in first-episode treatment-naive major depressive patients and their correlations with the course and severity of depression.Methods Seventeen first-episode treatment-naive young adult major depressive patients Hamilton Rating Scale for Depression._( 17) (HAMD-_(17))＞17]and seventeen healthy subjects(HAMD-_(17)＜7)matched in gender.age and education underwent clinical assessment and DTI scan.Voxel-based analysis was used to examine the fractional anisotropy(FA)difference of whole brain white matter between the patients and healthy subjects.Clinical association of the average FA value of identified clusters with the course and severity of depression was examined by using bivariate correlation analysis.Results The patients with major depression exhibited significantly lower FA than healthy subjects in the white matter of bilateral middle frontal gyrus,left cingulate gyrus and left inferior temporal gyrus.The illness course,but not HAMD scores,was significantly negatively correlated to FA of the right middle frontal gyrus(r=-0.732,P=0.001).Conclusion Brain white matter integrity abnormalities may be a biological traits of major depression disorder and may be affected by the illness course.