磁共振低频振幅对青少年与成年抑郁症患者静息态功能变化的研究

目的 分别研究首发未用药的青少年抑郁症患者和成年抑郁症患者脑活动性改变情况,探索两者的共性和差异,进一步明确青少年抑郁症与成年抑郁症病理生理学基础和发病机制上的差异,以期为青少年抑郁症的准确诊断及特异性治疗提供依据。 方法 选取2009年7月—2017年12月中国医科大学附属第一医院精神医学科和沈阳市精神卫生中心就诊的抑郁症患者,通过广告招募、门诊推荐等方式收集受试者,在进行人口学资料收集及量表评估诊断后,对30名首发未用药的青少年抑郁症患者及其28名青少年健康对照,以及31名首发未用药的成年抑郁症患者及其34名成年健康对照,进行头部静息态功能磁共振扫描,再对得出的青少年2组及成年2组标准ALFF脑图分别进行两样本t检验,以获得组间显著差异的脑区,再比较青少年组与成年组差异脑区的异同性。 结果 与健康对照相比,青少年抑郁症患者在右侧背外侧额上回、右侧额中回、右侧内侧额上回、右侧眶部额上回的ALFF值显著升高,未发现ALFF值显著降低的脑区;成年抑郁症患者与其健康对照相比,在双侧岛盖部额下回、双侧脑岛、双侧豆状壳核、右侧中央沟盖、右侧中央前回的ALFF值显著升高,未发现ALFF值显著降低的脑区。 结论 青少年抑郁症患者和成年抑郁症患者均存在脑功能异常,并且均表现为活动性增高,而未发现活动性降低的脑区,但两者发生改变的脑区存在差异,提示青少年抑郁症的神经生物学基础以及发病机制可能会区别于成年抑郁症。 

Amplitude of low-frequency fluctuation(ALFF) in adolescent and adult major depression:a resting-state functional MRI study

Objective To study the changes of brain activity in adolescent and adult patients with major depressive disorder(MDD), and to explore the commonness and difference of pathophysiological basis and pathogenesis between them for providing basis for accurate diagnosis and specific treatment of adolescent depression. Methods The volunteers were collected by means of advertisement recruitment, outpatient recommendation, and so on. After the demographic data collection and the evaluation and diagnosis of the scale, 30 first untreated adolescent depressive patients and 28 healthy controls, as well as 31 first untreated adult depressive patients and 34 healthy controls, were scanned for head resting state functional magnetic resonance(fMRI), and two samples of t test(GRF correction, P<0.05) were performed on 2 groups of adolescents and 2 adult groups of standard ALFF brain maps, respectively. The brain regions with significant difference were compared. Results Compared with the adolescent health control, the ALFF of Frontal_Sup_R(aal), Frontal_Sup_Medial_R(aal), Frontal_Mid_R(aal), Frontal_Sup_Orb_R(aal) were significantly increased in the adolescent depressive patients, no regions decreased. Compared with the adult health control, the ALFF of Insula(aal), Frontal_Inf_Oper(aal), Rolandic_Oper_R(aal),Precentral_R(aal), Putamen(aal) were significantly increased in adult depressive patients, no regions decreased. Conclusion Both Adolescents depression and adult depression have their own specific brain dysfunction, which showed increased activity, but no decreased activity. However, there still have some difference between them, suggesting that the neurobiological basis and pathogenesis of adolescent depression may be different from adult depression.