大脑静息葡萄糖代谢改变与情绪障碍的相关性

目的前瞻性分析大脑静息葡萄糖代谢改变在初诊肺癌患者情绪障碍发病中的临床意义。方法实验组来自临床拟诊肺癌并拟行全身(脑+躯干)18F-氟脱氧葡萄糖(18F-FDG)正电子发射断层显像/计算机体层摄影(PET/CT)检查的患者,对照组来自健康体格检查者。所有被试者在18F-FDG PET/CT检查前接受哈密尔顿抑郁量表(HAMD)及焦虑量表(MAS)评定,对比分析大脑静息葡萄糖代谢改变、情绪障碍评分以及两者之间的相关性。结果最终纳入155例肺癌患者(实验组)及152例健康体检者(对照组),实验组HAMD评分及MAS评分均高于对照组(t=1.020.P=0.04;t=0.09,P=0.03);实验组脑PET显像存在以双侧额、颞叶为主的多个脑区葡萄糖代谢减低,且受累脑区平均标准化摄取值(SUV)在双侧额叶及左侧颞叶分别与HAMD评分呈负相关(r=0.68、0.60、0.55),在左侧额叶及左侧颞叶分别与MAS评分呈负相关(r=0.59、0.58)。结论大脑静息葡萄糖代谢改变与情绪障碍在肺癌患者中具有显著相关性,且以额叶为著。脑葡萄糖代谢改变可能是肺癌患者情绪障碍发病的神经病理基础,有望作为神经生物学标记用于临床评估。

Correlation between brain glucose metabolism and emotional disorder

Objective To explore clinical significance of brain glucose metabolic changes to emotional disorders in patients with lung cancer.Methods The experiment subjects consisted of patients with clinically diagnosed lung cancer in our hospital,while healthy individuals formed the control group.All subjects answered inquiries with Hamilton depression scale(HAMD)and manifest anxiety scale(MAS)prior to undergoing whole body 18F-fluorodeoxyglucose(18F-FDG)positron emission tomography and computed tomogra?phy(PET/CT)examination.Brain glucose metabolic changes,emotional disorder scores and their relations were then statistically ana?lyzed.Results Finally,155 lung cancer patients and 152 healthy subjects were respectively enrolled in this study.There were no statisti?cally significances between two groups in respect to ages and genders(both P<0.05).The Hamilton scores both of HAMD and MAS in the research group were higher than those in the controls with statistical significance(t=1.020,P=0.04;t=0.09,P=0.03,respectively).The brain PET imaging in the research group showed relative reductions of cerebral resting glucose metabolism in multiple cerebral regions,mainly located in bilateral frontal and temporal lobes.The significant negative correlations were observed between the standardized uptake value(SUVs)of cerebral glucose metabolism and HAMD scores in the bilateral frontal and the left temporal regions(r=0.68,0.60,0.55,respectively),and the SUVs and MAS scores in the left frontal and temporal regions(r=0.59,0.58,respectively).Conclusion There are significant correlations between SUVs and HAMD/MAS scores in the patients with lung cancer,especially in fron?tal lobes.It implies that brain glucose metabolic change is possibly a neuropathological basis underlying the emotional disorder.The brain glucose metabolic changes can hopefully be regarded as a clinical neurobiological label to evaluate emotional disorder for lung cancer pa?tients.