首发早发性抑郁症患者脑自发活动改变与临床特征及认知功能的相关性

目的:探讨首发早发性抑郁症(EOD)患者神经元静息态自发活动的强度特征与其临床特征、认知功能的相关性。方法:对60例首发未用药EOD患者(EOD组)及年龄、性别、受教育年限相匹配的64例健康志愿者(对照组)行3.0T MR静息态功能MRI检查。对EOD患者临床特征的评估采用汉密尔顿抑郁量表(HAMD)-17,认知功能的评估采用威斯康星卡片分类测验(WSCT)和连线测试(TMT)。采用独立样本t检验比较两组被试的大脑低频振幅(ALFF)、低频振幅分数(fALFF)间是否存在差异,采用Spearman秩相关法分析组间差异有统计学意义的脑区的ALFF、fALFF与HAMD-17评分、认知功能评分的相关性。结果:与对照组相比,EOD组中右侧额中回MNI坐标:44,50,7;体素大小(k)=42;t=-4.146]的ALFF值减低,右侧额中回(MNI坐标:40,47,8;k=37;t=-4.011)和右侧楔前叶(MNI坐标:3,-57,63;k=29;t=-4.526)的fALFF值减低(P值均<0.05,GRF校正)。右侧额中回的ALFF值与HAMD-17评分中抑郁情绪得分呈负相关(r=-0.255,P=0.049),与WSCT中完成第一个分类应答数呈负相关(r=-0.304,P=0.018)。结论:首发EOD患者部分脑区的局部神经元自发神经活动受损,且与抑郁情绪的严重程度和认知功能改变具有相关性。功能MRI可用于客观评价抑郁症患者疾病早期脑功能活动受损情况。

Correlation between brain spontaneous activity and clinical features and cognitive function in patientswith first episode of early-onset depression

Objective:The purpose of this study was to investigate the amplitude features of resting-state spontaneous activity of neurons in the patients with first episode of early-onset depression(EOD)and the correlation with clinical features as well as cognitive function.Methods:A total of 60 patients with untreated EOD and 64 healthy controls matched for age,gender and educational background underwent resting-state functional MRI(rs-fMRI)scan.Clinical features was evaluated using HAMD-17 items.Cognitive function was evaluated using Wisconsin card sorting(WSCT)and trail marking test(TMT).The difference of amplitude of low frequency fluctuations(ALFF)and fractio-nal ALFF(fALFF)between the two groups was compared using the t-test.Spearman correlation analysis was used to evaluate the correlation between functional changes and the scores of HAMD-17 items as well as cognitive test.Results:Compared with the control group,ALFF values in the right middle frontal gyrus of EOD patients were reducedMNI(x,y,z):44,50,7;voxel size(k)=42;t=-4.146];fALFF values in the right middle frontal gyrus were reduced(MNI(x,y,z):40,47,8;k=37;t=-4.011);as well as in the right precuneus(MNI(x,y,z):3,-57,63;k=29;t=-4.526);there were significantly differences(all P<0.05,corrected by GRF).Significant negative correlations were observed between the abnormal ALFF values in the right middle frontal gyrus and the scores of depressed mood item of HAMD-17(r=-0.255,P=0.049)as well as the number of completion of the first classification response in WSCT(r=-0.304,P=0.018).Conclusion:The spontaneous activity of local neurons was disturbed in the right middle frontal gyrus and precuneus in untreated patients with EOD,and that the abnormal functional changes in the right middle frontal gyrus may be associated with severity of depressed mood and cognitive abnormality.The right middle frontal gyrus and precu-neus may be the biomarkers to evaluate abnormal brain activity in depression patients in early stage.