DTI观察难治性抑郁症患者不同脑区微观结构改变

目的 采用DTI观察难治性抑郁症（TRD）患者不同脑区微观结构改变。方法 对18例TRD患者（TRD组）和18名性别、年龄、受教育程度匹配的健康志愿者（对照组）行常规MR和DTI扫描，测量胼胝体压部、体部和膝部厚度和不同脑区的FA值及ADC值，比较2组间的差异。结果 所有受试者常规MRI均未见异常。对照组侧脑室和第三脑室大小正常；TRD组16例侧脑室和第三脑室大小正常，2例略扩大。TRD组与对照组间胼胝体各部的厚度差异均无统计学意义（P均> 0.05）。2组间各脑区ADC值差异均无统计学意义（P均> 0.05）；TRD患者双侧额下回和额中回、前扣带回、双侧海马、胼胝体膝部和压部的FA值低于对照组，差异均有统计学意义（P均< 0.05）。结论 DTI参数FA值可定量反映TRD患者多个脑区的微观结构改变，后者可能与抑郁症的抗药性有关。

DTI observation on different brain regions in patients with treatment-resistant depression

Objective To explore the microstructural changes in different brain regions of treatment-resistant depression (TRD) patients with DTI. Methods Totally 18 TRD patients (TRD group) and 18 gender, age and education-matched healthy volunteers (control group) underwent conventional MRI and DTI. The thickness of genu, body and pressure of corpus callosum were measured, and the FA value and ADC value of different brain regions were measured and compared between the two groups. Results No abnormality was found on routine MRI of all subjects. In control group, the size of the lateral ventricle and the third ventricle were both normal. In TRD group, the size of the lateral ventricle and the third ventricle in 16 patients were normal, while in 2 patients slightly enlarged. There was no significant difference in thickness of corpus callosum (all P>0.05), nor in ADC values between the 2 groups (all P>0.05). FA value of bilateral lower frontal gyrus and middle frontal gyrus, anterior cingulate gyrus, bilateral hippocampus, the genu and pressure part of the corpus callosum of TRD group were lower than those of conntrol group (all P<0.05). Conclusion DTI parameter FA value can quantitatively reflect the microstructural changes in multiple brain regions of TRD patients, which may be related to the drug resistance of depression.