抑郁症患者额叶、前扣带回、海马N-乙酰天冬氨酸磁共振质子波谱研究

目的 探讨抑郁症患者额叶、前扣带回皮质、海马N-乙酰天冬氨酸(NAA)的相对含量.方法 对13例未服药的抑郁症患者及13位健康志愿者前扣带回行多体素磁共振氢质子波谱(1H-MRS)扫描,抑郁症患者经6周抗抑郁治疗后再次作1H-MRS扫描,测定的生化物质为NAA和肌酸(Cr).结果 抑郁症组左侧和右侧额前皮质、左侧和右侧海马NAA/Cr值分别为(1.29±0.18),(1.33±0.23),(0.93±0.21),(0.96±0.19)]低于正常对照组,差异有显著性(均P ＜0.01),双侧前扣带回皮质NAA/Cr值与正常对照组差异无显著性( P >0.05).抗抑郁治疗后,左侧额前皮质NAA/Cr值(1.63±0.42)较治疗前(1.29±0.18)升高( P =0.010);右侧额前皮质、双侧海马、右侧前扣带回皮质NAA/Cr值较治疗前均有所升高,但无统计学意义( P >0.05);双侧额前皮质、双侧前扣带回皮质、左侧海马NAA/Cr值治疗后与正常对照组无显著差异( P >0.05).结论 额前皮质和海马N-乙酰天冬氨酸的含量改变与抑郁症的发生和抗抑郁剂的疗效有关.

N-acetylaspartate levels in the prefrontal cortex,anterior cingulate cortex and hippocampus of major depressive patients:A proton magnetic resonance spectroscopy study

Objective To measure the levels of N-acetylaspartate (NAA) in the prefrontal cortex,anterior cingulate cortex and hippocampus of major depressive patients. Methods Multi voxel proton magnetic resonance spectroscopy (1H-MRS) was performed to assess NAA levels in 13 unmedicated patients with major depressive disorder and 13 healthy controls. The patients underwent 1H-MRS again after six weeks of antidepressant treatment. The compounds measured were NAA and creatine (Cr). Results Depressive patients had significantly lower NAA/Cr ratios in left and right prefrontal cortex,and left and right hippocampus (1.29±0.18,1.33±0.23,0.93±0.21,0.96±0.19,respectively)than healthy controls( P =0.00). No significant difference was found in the N-acetylaspartate levels in bilateral anterior cingulate cortex between depressive patients and healthy controls( P >0.05). After antidepressant treatment,N-acetylaspartate level in left prefrontal cortex(1.63±0.42) was increased significantly compared with that (1.29±0.18) before treatment( P =0.010),and N-acetylaspartate levels in right prefrontal cortex ,bilateral hippocampus and right prefrontal cortex were increased but did not reach statistically significance. No significant differences were found in the N-acetylaspartate levels in bilateral prefrontal cortex,bilateral anterior cingulate cortex and left hippocampus. Conclusion The findings suggest that N-acetylaspartate alterations in prefrontal cortex and hippocampus may be implicated in the pathogenesis of depressive disorder and are related to the efficacy of antidepressants.