脑卒中后抑郁合并认知损害的磁共振扩散张量成像研究

目的 探讨脑卒中后抑郁(PSD)合并卒中后认知功能损害(PSCI)患者的磁共振扩散张量成像(DTI)表现及脑卒中后抑郁合并认知功能损害的发病机制。方法 选取武汉大学中南医院2014年10月～2015年12月首发急性脑卒中患者52例,进行汉密尔顿抑郁量表(HAMD)、简明精神状态检查量表(MMSE)、蒙特利尔认知评估(MoCa)量表评分,分为PSD合并PSCI组13例(A组),PSD组(B组)11例,PSCI组(C组)12例,单纯脑卒中组16例(D组)。进行磁共振平扫及DTI扫描,比较各组不同部位FA值的差异。结果 A组与D组比较,双侧额叶、双侧半卵圆中心、左侧颞叶、左侧丘脑、右侧壳核FA值减低,差异有统计学意义(P<0.05)。结论 PSD合并PSCI患者可能具有相对独立的发病机制,与双侧额叶、双侧半卵圆中心、左侧颞叶、左侧丘脑及右侧壳核损害有关。

A diffusion tensor imaging study in patients with post-stroke depression combined with cognitive impairmentWang

ObjectiveTo study the characteristics of MR diffusion tensor imaging(DTI)in patients with post-stroke depression(PSD)and post-stroke cognitive impairment(PSCI), and to explore the pathogenesis of depression and cognitive impairment after stroke.Methods We chose 52 patients who are hospitalized in Zhongnan Hospital of Wuhan University due to acute stroke from October 2014 to December 2015. We examined Hamilton Depression Scale(HAMD)、mini-mental state examination(MMSE)、Montreal cognitive assessment scale(MoCa).All patients were divided into PSD combined PSCI group(A, n=13), PSD group(B, n=11), PSCI group(C, n=12), non-PSD and non-PSCI group(D, n=16).We detected fractional anisotropy(FA)values in different regions using DTI,and compared the values between different groups.Results Compared with group D, FA values decreased significantly in Group A in bilateral middle frontal lobes, bilateral centrum ovale, left temporal lobe, left thalamus and right putamen.Conclusion PSD combined with PSCI has an independent pathogenesis which probably related to the damage of bilateral frontal lobes, bilateral centrum ovale, left temporal lobe, the left thalamus and right putamen.