首发与复发中青年重性抑郁症患者脑结构差异的影像学研究

目的 利用弥散张量成像(DTI)及三维结构磁共振成像(3D)技术,探讨重性抑郁症首复发患者脑容量及脑白质神经纤维差异状况.方法 40例重性抑郁症患者(首发20例,复发20例)及年龄、性别及教育年限相匹配的20例健康对照者,均经DTI及3D扫描,数据处理采用基于像素的全脑分析技术及基于体素的形态学测量方法,全脑范围内探讨脑结构状况.结果 复发抑郁症组右额中层、左颞中回及左脑岛区域的白质各向异性值较首发抑郁症组降低( P <0.005,像素集合>30);白质容量未发现差异脑区( P <0.005,像素集合>30);灰质容量方面,复发抑郁症组的右侧海马体积较首发减小( P <0.005,像素集合>30).结论 复发较首发抑郁症患者部分区域白质纤维排列紊乱加重,但尚未涉及白质容量的减少;灰质容量则有部分降低.

Structural brain difference between first-onset and recurrent major depression:an MRI study

Objective By diffusion tensor imaging (DTI) and three dimensional structure MRI (3D),the brain concentration and white matter fiber difference between first-onset and recurrent major depression was explored.Methods 40 patients (first depressive episode 20 cases,recurrent major depression 20 cases) metted with CCMD-3 criteria for major depression disorder and 20 age-,gender-,education-matched healthy controls were scanned DTI and 3D.Voxel-based methods were used to analyze the imaging data in whole brain.Results Compared with the first-onset patients,recurrent patients showed reduced fractional anisotropy (FA) in the right medial frontal gyrus,the left middle temporal gyrus and the left insula ( P <0.005,voxels>30).No differences were found in white matter volume (WMV),but reduced gray matter volume (GMV) was found in the right hippocampus in recurrent patients ( P <0.005,voxels>30).Conclusion Recurrent major depressive patients exsit more white matter abnormalities than first episode patients,but has not involves WMV changes,GMV showes some atrophy.