抑郁症首次发病患者脑白质的弥散张量成像研究

目的 探讨抑郁症首次发病（以下简称首发）患者全脑白质纤维的完整性是否受到损害。方法 对14例未接受过治疗的首发抑郁症患者（抑郁症组）和14名与抑郁症组按性别、年龄匹配的正常人（正常人组）进行全脑弥散张量成像扫描，使用以像素为基础的分析方法比较两组各向异性分数（FA）。结果 抑郁症组的右侧额中回（x=36，y=49．x=10；t=4．89，像素集合=258）、左侧枕颞外侧回（x=-42，y=-56，z=-1；t=5．00，像素集合=96）、右侧顶叶的角回（x=24，y=-47，z=41；t=5．23，像素集合=120）和深部（x=42，y=-65，z=27；t=4．56，像素集合=76）白质FA值低于正常人（未校正，P〈0．001），上述FA值差异有统计学意义的区域与抑郁症组的症状严重程度（BDI和HAMD评分）以及病程之间无显著相关性。未发现抑郁症组比正常人组FA值高的脑区。结论 白质病变在抑郁症发病早期即已存在，其完整性的损害可能破坏了调节心境的神经环路。     

Manic depressive illness and EEG abnormalities.

In evaluating 40 manic-depressive (bipolar) patients who had clinical electroencephalograms, there was a significant relationship between abnormal EEG findings and a negative family history for affective disorder when a comparison was made between patients with various classes of family history.     

Grey matter volume abnormalities in patients with bipolar I depressive disorder and unipolar depressive disorder:a voxelbased morphometry study

Bipolar disorder and unipolar depressive disorder(UD) may be different in brain structure. In the present study,we performed voxel-based morphometry(VBM) to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder(BP1) and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls(HCs) using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.     

Melatonin. Chronobiologic peripheral endocrine index in depressive states

The chronobiological studies with melatonin constitute valid arguments to consider melatonin as a peripheral index of depressive disorders. In a group of patients with major depression, we reported a lowering of melatonin nocturnal plasma levels, associated with cortisol hypersecretion. A similar lowering of melatonin was observed in a group of patients with cluster headaches, but without quantitative modification of cortisol secretion. Other studies are necessary in order to determine wether melatonin may be considered as a "state marker" of depression itself or a marker of the genetic vulnerability to depression.     

Brief depressive affect]

A 59-year-old patient suffered during three months from depressive episode. Thereafter he developed depressive attacks of 30 to 60 minutes duration, reoccurring weekly to every third week. The patient could be treated successfully with Carbamacepine.     

The spouses of depressive and schizophrenic patients

Summary The personality structures and the well-being of the partners of a representative sample of 103 married depressive or schizophrenic hospitalised patients were examined. As a means of examination we used a semi-structured interview, the Giessen-test (Beckmann and Richter 1972, 1979) and the Eigenschaftswörterliste (Janke and Debus 1978).Concerning personality, the comparison of self-image of the partners with the patient's estimation of his or her spouse resulted in good mutual agreement. The spouses of schizophrenic and depressive patients differed neither as far as the average profiles were concerned nor according to the cluster-analysis findings. In addition to this, both groups differed only to a minor extent from a representative sample of the general population. Whereas personal attitude and the well-being of the marital partners were for the most part independent of the depressive or schizophrenic kind of illness, personality and well-being of the spouses correlated with the course of the illness. The more phases of illness the spouses had witnessed, the more unattractive, self-controlled and uncommunicative they proved to be and the less irritated and sensitive they were when the patient was hospitalised. These findings are discussed in the light of further research.     

基于形变的形态学测量对首次发病未服药抑郁症患者大脑灰质异常的研究

目的:探讨首次发病未服药抑郁症患者（major depressive disorder）大脑灰质结构改变以及抑郁症早期诊断的影像学指标。方法:对38例抑郁症患者（抑郁症组）和65名年龄、性别相匹配的健康对照（对照组）进行3D T 1加权结构像磁共振成像扫描,采用基于形变的形态学测量（deformation-...     

Coping with depressive disorders]

Coping behavior was assessed in 40 depressed patients during their hospitalization and 2 months later. Patients completed an antidepressive activity questionnaire and were interviewed. External assessment and patient self-assessment showed significant differences between patients with monopolar or bipolar depressive disorders and those with neurotic/reactive disorders. Patients treated with antidepressants reported more frequent and effective coping behaviors. There is a fundamental difficulty in distinguishing differentiate between symptoms of depression and certain coping behaviors (eg withdrawal). Only a longitudinal analysis of individual cases could help us to differentiate.     

The influence of light therapy in depressive patients

Our study investigated the effects of light therapy on mainly endogenously depressive patients. We applied white fluorescent light of 1500-2000 lux for a length of 4-6 hours daily. For 10 days no antidepressants or sleeping pills were given. We observed a quick and substantial improvement of depressive symptoms within 3 to 5 days. 9 patients showed a very good and 5 patients a good remission of symptoms. This corresponds to an improvement of 65% and is comparable to the effects of antidepressants. The improvement however with light is more rapid and more intensive, the main improvement is to be seen until the 5th day of treatment. No influence was found on vital signs or laboratory values. The rare side-effect was an increase in general drive and activity, which was perceived as agreeable however, and did not take the character of restlessness. Two times an increase of sexual drive was reported. The patients' self-rating concerning vital energy and concentration improved along with the values of the HDRS and CGI as with the quality of sleep. In general patients found light therapy to be agreeable. 1 patient only minimally improved (295.7). No improvement was to be seen in 5 patients (4 x 296.1, 309.1). From our findings we can conclude that light therapy in our patients had the same therapeutic efficacy as tricyclics. In our study the antidepressive effect of light could be maintained with Amitriptylin. Unlike other authors we did not observe a relapse into depression in the responders after ending light therapy.     

Serum concentrations of amitriptyline and its metabolites and clinical effect in depressive patients]

The serum concentrations of amitriptyline and its 3 metabolites--nortriptyline, 10-hydroxy-amitriptyline and 10-hydroxy-nortriptyline were determined in 18 depressive patients treated with amitriptyline for 6 weeks. The relationships between the serum concentrations and the clinical effects were statistically analyzed and showed significant correlations. The authors suggest that the total TAD serum concentration (280 ng/ml) can be used as the index for clinical efficacy, so far as the above data are concerned.     

Cortical thickness abnormalities associated with depressive symptoms in temporal lobe epilepsy

Depression in patients with temporal lobe epilepsy (TLE) is highly prevalent and carries significant morbidity and mortality. Its neural basis is poorly understood. We used quantitative, surface-based MRI analysis to correlate brain morphometry with severity of depressive symptoms in 38 patients with TLE and 45 controls. Increasing severity of depressive symptoms was associated with orbitofrontal cortex (OFC) thinning in controls, but with OFC thickening in TLE patients. These results demonstrate distinct neuroanatomical substrates for depression with and without TLE, and suggest a unique role for OFC, a limbic region for emotional processing strongly interconnected with medial temporal structures, in TLE-related depressive symptoms.     

Functional brain abnormalities in major depressive disorder using the Hilbert-Huang transform

Major depressive disorder is a common disease worldwide, which is characterized by significant and persistent depression. Non-invasive accessory diagnosis of depression can be performed by resting-state functional magnetic resonance imaging (rs-fMRI). However, the fMRI signal may not satisfy linearity and stationarity. The Hilbert-Huang transform (HHT) is an adaptive time–frequency localization analysis method suitable for nonlinear and non-stationary signals. The objective of this study was to apply the HHT to rs-fMRI to find the abnormal brain areas of patients with depression. A total of 35 patients with depression and 37 healthy controls were subjected to rs-fMRI. The HHT was performed to extract the Hilbert-weighted mean frequency of the rs-fMRI signals, and multivariate receiver operating characteristic analysis was applied to find the abnormal brain regions with high sensitivity and specificity. We observed differences in Hilbert-weighted mean frequency between the patients and healthy controls mainly in the right hippocampus, right parahippocampal gyrus, left amygdala, and left and right caudate nucleus. Subsequently, the above-mentioned regions were included in the results obtained from the compared region homogeneity and the fractional amplitude of low frequency fluctuation method. We found brain regions with differences in the Hilbert-weighted mean frequency, and examined their sensitivity and specificity, which suggested a potential neuroimaging biomarker to distinguish between patients with depression and healthy controls. We further clarified the pathophysiological abnormality of these regions for the population with major depressive disorder.