双相抑郁患者及健康同胞的额叶皮质、基底节、丘脑核磁共振波谱研究

发布时间：2018-06-19 13:00

本文选题：双相障碍 + 健康同胞　；参考：《暨南大学》2015年硕士论文

【摘要】：研究目的:采用核磁共振波谱(Magnetic resonance spectroscopy,MRS)比较双相抑郁(Bipolar depressive disorder,BDD)患者、患者的健康同胞(Healthy unaffected siblings,SIB)、健康对照者(Healthy controls,HC)三组间额叶皮质、基底节和丘脑内的脑生化代谢物差异,探讨双相障碍在在额叶皮质、基底节和丘脑代谢物上可能的内表型。对象和方法:拟入组受试者经简明国际神经精神障碍访谈(M.I.N.I.)行结构化临床会晤,使用美国《精神疾病的诊断和统计手册》第四版(DSM-IV)进行疾病诊断。共入组17例BDD患者、14例SIB和14例HC。受试者入组后接受量表测评、一般体格检查和血液检查,采用GE 3.0T Discovery MRI进行大脑额叶皮质、基底节和丘脑区静息状态下核磁共振波谱扫描,采集三个部位左右两侧的N-乙酰天门冬氨酸(N-acetylasparte,NAA)、胆碱复合物(Choline compounds,Cho)、肌醇(Myo-inositol,m I)、乳酸(Lactate,Lac)和肌酸(Creatine,Cr)水平。研究数据使用SPSS13.0统计分析软件进行统计分析。结果:1、HC组和SIB组的右侧额叶皮质区NAA/Cr水平显著高于BDD组(F右=2.419,P右=0.000);2、HC组的左侧额叶皮质区NAA/Cr水平显著高于BDD组和SIB组(F左=3.839,P左=0.029)3、SIB组及BDD组的左侧额叶皮质的Lac/Cr水平显著高于HC组(F=4.797,P=0.013);4、BDD组及SIB组的左侧基底节NAA/Cr水平显著低于HC组(F=3.973,P=0.026);5、BDD组的左侧基底节Lac/Cr水平与HAMD24项目呈正相关(r=0.590,P=0.013);6、BDD组年龄与右侧丘脑区的Lac/Cr水平呈正相关(r=0.526,P=0.034);7、BDD组发作次数与左侧丘脑m I/Cr水平呈负相关(r=-0.572,P=0.016);8、BDI组的右侧基底节NAA/Cr水平显著低于BDII组(t=-3.026,P=0.004)。结论:1、静息状态下,SIB的左侧基底节和额叶存在NAA的下降和Lac的升高,可能可以参考为BD遗传相关的内表型标记。2、BDD患者在左侧基底节、双额叶皮质具有神经元功能紊乱。3、BDI患者较BDII患者的基底节神经损害更为严重。
[Abstract]:Objective: to compare the differences of brain biochemical metabolites in frontal cortex, basal ganglia and thalamus among patients with bipolar depressive disorder (BDD), healthy unaffected (healthy controls) and healthy controls (healthy controls) by magnetic resonance spectroscopy (MRSs). To investigate the possible endophenotypes of bipolar disorder in the frontal cortex, basal ganglia and thalamus metabolites. Participants and methods: participants in the proposed group underwent brief international interviews with neuropsychiatric disorders (M.I.N.I.) A structured clinical meeting was conducted to diagnose the disease using the fourth edition of the US Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). There were 14 cases of SIB and 14 cases of HCH in 17 patients with BDD. The subjects were assessed with the scale, general physical examination and blood examination. GE 3.0T Discovery MRI was used to scan the cerebral frontal cortex, basal ganglia and thalamus resting state. The levels of N-acetylasparteine NAAn, choline complex Choline compoundsChoo, Myo-inositol Ion, lactate Lactate Lacs and creatine Cr were collected from the left and right sides of the three sites. The data were analyzed by SPSS 13.0 software. Results NAA / Cr levels in the right frontal cortex of the HC and SIB groups were significantly higher than those in the left frontal cortex of the BDD group (2.419P 0.000) and the left frontal cortex of the BDD and SIB groups (3.839P, 0.0293C, SIB) and the left frontal cortex (Lacr / Cr) of BDD group, BDD group and BDD group were significantly higher than those of BDD group and SIB group, and the level of NAA / Cr in left frontal cortex of BDD group was significantly higher than that of BDD group and SIB group. The level of NAA-Cr in left basal ganglia of HC group was significantly higher than that of HC group (4.797 7) and SIB group (P < 0.05). It was significantly lower than that in HC group (F3.973P ~ (0.026) group and HAMD24 item. There was a positive correlation between the age of HMD24 group and the right thalamic area of Lacar P _ (Cr) level and the number of episodes in the right thalamic region of the BDD group (r 0.526 ~ 0. 034 ~ 0. 034 ~ 0. 034) BDD group (P < 0. 05 26). There was a positive correlation between the level of Lacr / Cr in the left basal ganglia and the item of HAMD24 in the left basal ganglia of BDD group. There was a negative correlation between the left thalamic MI / Cr level and the level of NAA / Cr in the right basal ganglia of the BDI group. The level of NAA / Cr in the right basal ganglia was significantly lower than that in the BDII group (P 0.004). Conclusion at 1: 1, NAA decreased and Lac increased in the left basal ganglia and frontal lobe of SIB at rest, which may be referred to as an internal marker of BDD associated with BD in the left basal ganglia. The lesion of basal ganglia was more serious in the patients with BDI than in the patients with BDII.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R749.4

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