老年期抑郁症的单光子发射计算机断层扫描研究

目的 了解老年期抑郁症(ED)的脑血流灌注特点,为相关神经科学理论提供实验室数据。方法 对26名健康老人、22例ED及26例阿尔茨海默病(Alzheimer’s disease,AD)患者作脑血流灌注检查。结果 与健康老人相比,ED存在右顶叶、双侧额叶和双侧枕叶低灌注(P<0.05),与AD相比,ED的扣带回、双侧颞叶、双侧基底节和双侧丘脑灌注明显较高(P<0.05)。ED在颞叶、额叶、枕叶和丘脑处的双侧灌注不对称(P<0.05),除丘脑灌注为左侧高于右侧外,其余均为左侧低于右侧。判别分析结果为右顶叶、左颞叶、左额叶、左枕叶和扣带回进入判别方程,ED的判别方程对ED诊断的敏感性和特异性分别为100％和94.2％。结论 ED脑血流灌注兼具一般抑郁症和本身的特点,右顶叶、左颞叶、左额叶、左枕叶和扣带回灌注对ED的诊断有重要意义,支持额叶、边缘系统及其它相关区域共同构成情绪调节回路的假设。

SPECT study on elderly depression

Objective To understand the features of brain blood flow perfusion in elderly depressive patients, in an effort to supplj experimental evidence for the related neuroscientific assumptions. Methods 26 normai aged, 22 elderly depressive patients ( KD) and 26 patients with Alzheimer's disease (AD) were recruited and conducted with SPECT for brain blood flow perfusion. Re-sults ED showed significantly lower perfusion in right parietai lobe, bilateral frontal lobes and bilateral occipital lobes compared with normai aged, but obviously higher perfusion in cingulate, bilateral temporal lobes, bilateral basai ganglia and also bilateral ihalamus eompared vvith AD. Bilateral perfusion asymmetry was found in ED at following areas, including bilateral temporal lobes, bilateral (rontal lobes and bilateral occipital lobes with their left-side perfusion lower than right-side, and bilateral thalarnus as well vvith its higher left-side perfusion compared to the right. Discriminant analysis found 5 perfusion indes of corresponding areas were rhosen to enter into discriminant function, they vvere right parietai lobe, left temporal lobe, left prontal lobe, left occipital lobe and cingulate. The sensitivity and specificity of the discriminant function in diagnosing ED were 100% and 94.2%, respectively. Conclusions ED appears to have certain perfusion characleristics either of general depression or of its own. Those areas which perfusion indiees entering into discriminant function are thought to be supportive to the assumption for mood regulatory circus to cer-lain exlent, in which frontal lobe, limbic system and other related cortex are supposed to be involved.