首发抑郁症患者及抑郁易感者静息态脑功能磁共振的研究

发布时间：2018-03-11 18:48

本文选题：抑郁症　切入点：抑郁易感　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:应用静息态功能磁共振成像技术(resting-state functional magnetic resonance imaging,rs-fMRI),首先对比观察首发未服药抑郁症患者及抑郁易感者基础状态下的脑功能活动,其次研究抑郁症患者异常脑功能活动区与临床症状的相关性,探索抑郁易感及抑郁症发病的病理生理学机制,为今后抑郁症的诊断、治疗和抑郁易感人群的预防提供科学参考及客观依据。方法:对23例首发未服药抑郁症患者、26例抑郁易感者和与之年龄、性别相匹配的15例健康志愿者完成rs-fMRI扫描。首先采取低频振幅(amplitude of low frequency fluctuation,ALFF)、低频振幅比率(fractional amplitude of low-frequency fluctuation,fALFF)和局部一致性(regional homogeneity,ReHo)等多种分析方法对三组人群的影像学数据进行统计学处理,得出各组间的差异脑区;然后将抑郁症患者组脑ALFF、fALFF和ReHo均值与抑郁总严重度(HAMD总分)和各临床因子分进行相关分析。结果:1.ALFF分析:抑郁症患者组相比对照组ALFF值显著增大的脑区在左小脑前叶、中央后回、顶下小叶、额上回及双侧中央前回,显著减小的在双侧小脑后叶;抑郁易感组ALFF值显著增大的脑区在右小脑后叶,显著减小的在右额上回。易感组相对患者组ALFF值显著增大的脑区在双侧小脑后叶、右舌回,显著减小的为右丘脑及左顶下小叶、楔前叶。患者组左小脑前叶ALFF值与抑郁严重度和焦虑正相关(P=0.015、0.010);额上回ALFF值与认知障碍正相关(P=0.012);中央前回ALFF值与绝望感正相关(P=0.009);颞上回ALFF值与体重减轻正相关(P=0.014);右前扣带回ALFF值与睡眠障碍正相关(P=0.015)。2.fALFF分析:与对照组对比,抑郁症患者组左额下回、中央后回及右中央前回fALFF值显著增大,双侧小脑后叶及右颞中回显著减小;抑郁易感组右小脑后叶fALFF值显著增大,左颞中回及额上回显著减小。与患者组相比,易感组双侧小脑后叶、左颞中回及舌回fALFF值显著增大。抑郁症患者的抑郁严重度和焦虑与左小脑后叶fALFF值负相关(P=0.015、0.007);绝望感与右小脑后叶fALFF值负相关(P=0.008);日夜变化与左丘脑fALFF值正相关(P=0.012)。3.ReHo分析:与对照组对比,抑郁症患者组右额上回、双侧前扣带回及左中央后回局部一致性增强,右壳核、小脑后叶及颞上回局部一致性减弱;抑郁易感组左壳核及右前扣带回局部一致性增强,左舌回、额上回及右颞上回局部一致性减弱。易感组相对患者组右壳核、小脑后叶、颞上回及扣带回局部一致性增强,左楔前叶及额上回局部一致性减弱。患者组抑郁严重度与左小脑后叶ReHo值负相关(P=0.010);绝望感与右小脑后叶ReHo值负相关(P=0.013);日夜变化与左扣带回ReHo值负相关(P=0.014),与左丘脑ReHo值正相关(P=0.048)。结论:与健康人群对比分析,抑郁症患者和抑郁易感者基础状态下均存在异常脑功能区,主要分布在额叶、颞叶、顶叶、枕叶、小脑和边缘系统,同时抑郁症患者的部分异常活动脑区与抑郁严重度和临床症状群存在线性关联。因此,证明抑郁症是一个涉及多脑区、多系统的疾病,且这些异常活动脑区可能是抑郁易感和发病的潜在神经病理机制。
[Abstract]:Objective: the application of resting state functional magnetic resonance imaging (resting-state functional magnetic resonance imaging, rs-fMRI), the first observation of first-episode patients with depression and depression susceptible brain function activities under basal conditions, followed by the study of depression in patients with different brain function areas often associated with clinical symptoms, to explore the pathophysiology of susceptible and depression the incidence of depression of the mechanism for the future diagnosis of depression, and provide scientific reference and objective basis for prevention of susceptible population and treatment of depression. Methods: 23 patients with first-episode depression patients, 26 cases of depression susceptible and 15 healthy volunteers were age, gender matched rs-fMRI. First take low frequency scanning (amplitude of low frequency fluctuation amplitude, ALFF amplitude, low frequency ratio (fractional) amplitude of low-frequency fluctuation, fALFF) and local uniform Of (regional homogeneity, ReHo), statistical data processing and other analysis methods of the three group images, showed that the differences in brain regions between each group; then the depression group of brain ALFF, fALFF and ReHo mean and depression severity (HAMD score) and the clinical factors of correlation analysis. Results: 1.ALFF analysis: depression group compared group ALFF significantly increased the value of brain regions in the left anterior lobe of cerebellum control, postcentral gyrus, inferior parietal lobule, superior frontal gyrus and bilateral precentral gyrus, significantly decreased in bilateral posterior lobe; depression susceptible group ALFF values significantly increased the brain areas in the right posterior lobe of cerebellum. Significant decreases in the right superior frontal gyrus. The susceptible group relative to patients in group ALFF were significantly increased in value of brain regions of bilateral posterior lobe, right lingual gyrus, right thalamus was significantly reduced and left inferior parietal lobule, precuneus. Patients with left anterior lobe of cerebellum ALFF value and depression severity and anxiety Positive correlation (P=0.015,0.010); superior frontal gyrus ALFF value was positively correlated with cognitive impairment (P=0.012); the precentral gyrus ALFF value and hopelessness positive correlation (P=0.009); temporal gyrus ALFF value was positively correlated with body weight loss (P=0.014); right anterior cingulate ALFF value was positively correlated with sleep disorders (P=0.015) and.2.fALFF analysis. The control group, depression group left inferior frontal gyrus, postcentral gyrus and right precentral gyrus fALFF value increased significantly, bilateral posterior lobe and right middle temporal gyrus decreased significantly; the susceptible group of right cerebellar depression leaf fALFF values increased significantly, the left middle temporal gyrus and superior frontal gyrus was significantly decreased. Compared with the patients. The susceptible group of bilateral posterior lobe of cerebellum, left middle temporal gyrus and lingual gyrus. The value of fALFF increased significantly in patients with depression and anxiety and depression severity of left behind small leaf fALFF was negatively correlated (P=0.015,0.007); a sense of despair and leaf fALFF value of right cerebellum posterior negative correlation (P= 0.008); diurnal and left thalamus fALFF values Positive correlation (P=0.012).3.ReHo analysis: compared with the control group, depression group right superior frontal gyrus, bilateral anterior cingulate and left postcentral gyrus local consistency enhancement, right putamen, temporal lobe gyrus weakened local consistency after cerebellar; depression susceptible group and left putamen and right anterior cingulate local consistency increased, left lingual gyrus, superior frontal gyrus and right superior temporal gyrus local consistency decreased. The susceptible group relative to patients with right posterior lobe of cerebellum, putamen, temporal gyrus, cingulate regionalhomogeneity enhancement, left precuneus superior frontal gyrus and local consistency weakened. Patients with depression severity and left posterior lobe of cerebellum was negatively correlated (ReHo P=0.010); a sense of despair and leaf ReHo value of right cerebellum posterior negative correlation (P=0.013); diurnal variation and left cingulate ReHo negative correlation (P=0.014), positive correlation with left thalamus ReHo values (P=0.048). Conclusion: analysis and comparison of healthy people, suffering from depression susceptible state and depression under There were abnormal brain functional areas, mainly in the frontal lobe, temporal lobe, parietal lobe, occipital lobe, cerebellum and limbic system, while part of abnormal brain activity and severity of depression in patients with depression and clinical symptoms there is a linear correlation. Therefore, evidence that depression is involved in a number of brain regions, multi system disease, and these abnormal brain activity may be a potential neural pathological mechanism of susceptibility and incidence of depression.

【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R749.4

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