发作期抑郁症患者脑动脉血流速度与注意力、执行功能关系

目的探讨发作期抑郁症患者脑动脉血流速度及其与注意力、执行功能的关系。方法 70例发作期抑郁症患者及65名健康对照纳入研究。采用24项汉密尔顿抑郁量表(24 items Hamilton depression scale,HAMD-24)评估抑郁症患者抑郁情绪,划销测验(cancellation test,CT)、威斯康星卡片分类测验(Wisconsin card sorting test,WCST)评估的认知功能,采用经颅多普勒超声(transcranial Doppler,TCD)检测脑动脉血流速度。结果与对照组比较,发作期抑郁症患者基底动脉、左侧大脑中动脉、右侧大脑中动脉、左大脑前动脉与右大脑前动脉平均血流速度均减慢,差异具有统计学意义(P0.05)。患者组CT各阶段净分及总净分低于对照组,而WCST总应答数、错误应答数、持续性错误数、完成第一个分类所需应答数均高于对照组,差异具有统计学意义(P0.01)。发作期抑郁症患者大脑基底动脉(r=0.25)、左中动脉(r=0.46)、右中动脉(r=0.25)、右后动脉(r=0.26)平均血流速度与CT总净分呈正相关(P0.05),各大脑动脉平均血流速度与WCST总应答数、持续性错误数呈负相关(P0.05),基底动脉、左右后动脉与错误应答数、完成第一个分类所需应答数呈负相关(P0.05)。结论发作期抑郁症患者大脑动脉平均血流速度普遍降低,注意力与执行功能受损。认知功能受损可能与脑动脉平均血流速度的改变有关。

The relationship between cerebral blood flow velocity and attention and execution function in patients with major depressive episode

Objective To find out the cerebral blood flow velocity and its relationship with attention and execu?tion function in patients with major depressive episode. Methods A total of 70 patients with major depressive episode and 65 healthy controls were included. The 24 items Hamilton depression scale (HAMD-24) was adopted for patients' depressive symptoms assessment. The Cancellation Test (CT) and Wisconsin Card Sorting Test (WCST) were adopted for cognitive function assessment. And the blood flow velocity of cerebral arteries were detected by transcranial Doppler ul?trasonography (TCD). Results Compared with the controls, the patients showed significantly slower average blood flow ve?locity in basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery and right ante?rior cerebral artery (P<0.05). Compared with those in the controls, the net score of each stage and the total net score of CT were significantly lower in the patients, while the total number of responses, response errors, perseverative errors and the necessary response number to complete the first category of WCST were significantly higher (P<0.01). The blood flow velocity in the cerebral basilar artery (r=0.25), left middle cerebral artery (r=0.46), right middle cerebral artery (r=0.25) and right posterior cerebral artery (r=0.26) showed positive correlations with total net score of CT (P<0.05), and the cere?bral artery average blood flow velocity showed negative correlations with the total number of responses, response errors and perseverative errors of WCST in the patients (P<0.05). Conclusions Compared with healthy controls, patients with major depressive episode suffer from lower average cerebral artery blood flow velocity, bad attention and executive func?tion. The change of average cerebral artery blood flow velocity may be responsible for impaired cognitive function in epi?sode major depression patients.