抑郁症患者脑白质变化初步研究

目的：利用能够提示脑白质纤维完整性的磁共振弥散张量成像（DTI）探讨首发和复发重性抑郁症患者脑白质纤维的变化及其差异。方法：20例重性抑郁症患者（首发9例，复发11例）和20名正常对照者均经常规磁共振成像（MRI）平扫，未发现异常者继续进行DTI和结构MRI（3D）扫描，基于像素的全脑分析技术对DTI数据进行分析。结果：与对照组相比较，抑郁症组白质纤维结构在双侧额中回、右顶下小叶及双侧脑岛等区域白质的各向异性值（FA）显著降低（各脑区P均〈0.001，cluster〉30像素）;与首发抑郁症患者相比较，复发抑郁症患者右侧额上回、右顶叶、中央前回、中央后回及右顶下小叶等区域FA值降低更为显著（各脑区P均〈0.001，cluster〉10像素）。结论：重性抑郁症患者存在脑白质异常，抑郁反复发作会导致脑白质损害进一步加重。

The alterations of brain white matter in depressed patients:a preliminary study

Objective: To investigate the changes of white mater fiber in first-episode and recurrent major depressive disorders(MDDs) and their differences by diffusion tensor imaging(DTI) which can show white mater integrity. Method:20 depressed patients(9 first episode,11 recurrent patients) and 20 matched healthy controls all underwent conventional magnetic resonance imaging(MRI) and,DTI and 3D scan were for those no abnormality in MRI.DTI data were analyzed by using voxel-based analysis method. Results:Compared to the healthy controls,the MDDs patients showed significant decrease fractional anisotropy(FA) of white matter in the bilateral middle frontal lobe,right middle temporal lobe,right inferior parietal lobe and bilateral insula(P<0.001,cluster>30 pixel).Compared to the first-episode patients,the recurrent depressed patients showed significant decrease FA in the right precentral lobe,inferior parietal lobule,postcentral gyrus and superior frontal gyrus(P<0.001,cluster>10 pixel). Conclusion:This study suggested that the white matter abnormalities were presented in the patients with major depressed disorder.The white mater integrity will be damaged further with recurrent depressive attacks.