卒中后抑郁患者静息态局部脑活动与默认网络功能连接改变的磁共振成像研究

采用静息态fMRI并基于局部一致性（regional homogeneity，ReHo）和独立成分分析（independentcomponent analysis，ICA）方法研究卒中后抑郁患者（post-stroke depression，PSD）局部自发脑活动和默认网络（default mode network，DMN）功能连接变化模式。方法 纳入自2017年1月-2019年1月期间新乡医学院第一附属医院收治的20例PSD患者（PSD组），以及年龄、性别和受教育程度等均匹配的单纯缺血性卒中未抑郁患者19例（对照组）。分别采用MMSE、汉密尔顿抑郁量表17项（Hamilton depression scale-17，HAMD-17）测试受试者的认知功能和抑郁情绪；然后采集静息态fMRI数据，图像预处理后计算ReHo值并提取两组DMN成分。比较组间ReHo值和DMN功能连接差异，并提取差异脑区的ReHo值和功能连接值与PSD组患者HAMD-17评分进行相关性分析。结果 与对照组相比，PSD组右侧海马旁回和左侧小脑脚2区ReHo值升高（P <0.001，体素值>20 mm3，未校正），并且在DMN中左侧楔前叶功能连接增强[P =0.011，校正错误发现率（false discovery rate，FDR）]、右侧楔叶功能连接减弱（P =0.006，校正FDR）。右侧海马旁回的ReHo值与HAMD-17评分呈正相关（r =0.556，P =0.011）；右侧楔叶功能连接值与HAMD-17评分呈负相关（r =-0.574，P =0.008）。结论 PSD患者存在局部自发脑活动以及DMN功能连接异常并与患者的抑郁情绪相关。

Magnetic Resonance Imaging Changes of Resting-state Regional Brain Activity and Functional Connection in the Default Mode Network in Patients with Post-stroke Depression

Objective To investigate the patterns of change in regional spontaneous brain activity and
functional connection in the default mode network (DMN) in patients with post-stroke depression
(PSD) using resting-state functional magnetic resonance imaging based on regional homogeneity
(ReHo) and independent component analysis (ICA).
Methods From January 2017 to January 2019, twenty inpatients with PSD (PSD group) and 19
age-, gender ratio-, and education level-matched no-depression inpatients with ischemic stroke
(control group) were enrolled in this analysis. The mini-mental state examination (MMSE)
and Hamilton depression scale-17 (HAMD-17) were used to assess the cognitive function
and depressive symptoms, respectively. The resting-state fMRI data were acquired, after data
preprocessing, the ReHo values were calculated and the components of DMN were extracted in
both groups. The differences of the ReHo values and functional connections in the DMN between
the two groups were compared, and the correlations between the ReHo values and DMN function
connection values in the regions showing significant difference and the HAMD-17 scores in PSD
group were analyzed.
Results Compared with the control group, ReHo values of the right parahippocompal gyrus andthe left cerebellar peduncle-2 (P <0.001, cluster threshold>20mm3, unadjusted) increased, and the
left precuneus functional connection increased in PSD group [P =0.011, adjusting for false discovery
rate (FDR)] and the right cuneus functional connection decreased (P =0.006, adjusting for FDR), and
the ReHo value of the right parahippocampal gyrus was positively correlated with HAMD-17 score.
(r =0.556, P =0.011). The functional connection value of the right cuneus was negatively correlated
with HAMD-17 score (r =-0.574, P =0.008).
Conclusions The PSD patients had regional spontaneous brain activity and abnormal DMN
functional connection, which were related to depression.