基于静息态MRI观察比率低频振幅下产后抑郁症患者脑自发神经活动

目的 采用静息态功能MRI（fMRI）观察产后抑郁症（PPD）患者在比率低频振幅（fALFF）下大脑自发神经活动。方法 对23例产后抑郁症患者（PPD组）、28名健康产妇（HPW组）及20例女性重性抑郁障碍患者（MDD组）采集静息态fMRI数据，以fALFF技术观察各组脑自发神经活动，提取PPD组与HPW组差异脑区的fALFF值，与爱丁堡产后抑郁量表（EPDS）评分进行相关性分析。结果 相比HPW组，PPD组左侧后扣带回、左侧楔前叶、左侧枕中回、左侧枕下回及右侧距状裂周围皮质fALFF值增高（AlphaSim校正，P均<0.05），右侧眶部额下回、右侧脑岛、右侧嗅皮质、右侧海马fALFF值减低（AlphaSim校正，P均<0.05）。相比MDD组，PPD组右侧舌回、右侧小脑fALFF值增高（AlphaSim校正，P均<0.05），右侧背外侧前额叶、右侧楔前叶、左侧顶上回、左侧角回、右侧内侧旁扣带回、右侧颞下回fALFF值减低（AlphaSim校正，P均<0.05）。PPD组右侧眶部额下回fALFF值与EPDS评分呈负相关（r=-0.53，P=0.01）。结论 静息态下PPD患者与情绪、认知相关脑区存在自发神经活动异常，其右侧眶部额下回fALFF值与抑郁严重程度密切相关；PPD与MDD患者脑fALFF表现并不完全一致，PPD可能存在特征性神经功能改变。

FunctionaI MRI observation on spontaneous neuraI activity based on resting-state fractionaI ampIitude of Iow-frequency fIuctuation in patients with postpartum depression

Objective To explore spontaneous neuronal activity in patients with postpartum depression (PPD) under fractional amplitude of low frequency fluctuation (fALFF) with resting-state functional MRI (fMRI). Methods Resting-state fMRI data of 23 PPD patients (PPD group), 28 healthy postpartum women (HPW group) and 20 women with major depressive disorder (MDD group) were collected. fALFF technology was used to observe spontaneous neural activity of all subjects. fALFF values were extracted from different regions in PPD group and HPW group, and their correlations with Edinburgh postnatal depression scale (EPDS) score were analyzed. Results Compared with HPW group, fALFF values of left posterior cingulate gyrus, left precuneus, left middle occipital gyrus, left inferior occipital gyrus and right calcarine cortex increased (AlphaSim correction, all P<0.05), whereas of right orbital inferior frontal gyrus, right insula, right olfactory cortex and right hippocampus decreased in PPD group (AlphaSim correction, all P<0.05). Compared with MDD group, fALFF values of right lingual gyrus and right cerebellum increased (AlphaSim correction, both P<0.05), but of the right dorsolateral prefrontal cortex, right precuneus, left superior parietal gyrus, left angular gyrus, right medial lateral cingulate gyrus and right inferior temporal gyrus decreased in PPD group (AlphaSim correction, all P<0.05). fALFF value of right orbital inferior frontal gyrus was negatively correlated with EPDS score in PPD group (r=-0.53, P=0.01). Conclusion Abnormal spontaneous activities exist in brain regions related with emotional and cognitive function in PPD patients, and fALFF value of right orbital inferior frontal gyrus is closely related to the severity of depression. fALFF expression of PPD is not completely consistent with that of MDD patients, and the neurological changes of PPD may have some characteristics.