首发重性抑郁障碍患者脑白质微结构弥散张量成像研究

发布时间：2018-12-08 18:18

【摘要】：目的:利用磁共振弥散张量成像(diffusion tensor imaging，DTI)技术，研究首发重性抑郁障碍(major depressive disorder，MDD)患者脑白质微结构的改变，探讨重性抑郁障碍患者的病程、疾病严重程度和发病年龄与弥散张量各向异性的关系。 方法:收集了71例首发重性抑郁障碍患者以及45例同地区正常人群的DTI数据分为两组进行比较，控制性别和年龄因素后，MDD患者和正常对照进行一一配对，共41对(22对男性，19对女性)，用DSM--IV--TR轴I障碍定式临床检查（the struetured cliniealinterview for DSM—IV axis1disorders for patient，SCID—I/P)对MDD进行筛查诊断，用汉密尔顿抑郁量表(Hamilton Depression scale,HAMD)（17项）、汉密尔顿焦虑量表(Hamilton Anxiety scale,HAMA)（14项）、抑郁自评量表(Self-Rating Depression Scale,SDS)评定临床症状。要求MDD组符合HAMD评分大于17分，，HAMA评分小于14分;正常对照组符合HAMD评分低于7分，SDS评分标准分小于30分,HAMA评分小于7分.对两组被试进行磁共振弥散张量成像扫描，用部分各向异性(fractionalanisotropy，FA)作为组织扩散特征的指标。用FSL(FMRIB Software Library，http://www.fmrib.ox.ac.uk/fsl)软件包中基于纤维的空间统计方法（Tract-Based Spatial Statistics，TBSS）对弥散张量图像进行分析，首先对图像进行头动校正和涡流校正、全脑mask后,形成个体FA图像，通过非线性变换方法将个体FA图配准到MNI152标准空间，得到一个平均的FA像，该图像被浓缩产生一个模板骨架（mean FA skeleton image），界定FA的阈值≥0.2以排除周围组织的干扰，最后，采用TFCE（Threshold-Free Cluster Enhancement）方法进行多重校正比较，以校正后p值小于0.01作为显著性标准，把每个抑郁障碍患者的平均FA值与患者的病程、症状严重程度、首次发病年龄进行相关分析。 结果:l)与正常对照比较，MDD患者平均FA值升高，升高的位点位于左上纵束（校正后p0.01）；2)MDD患者平均FA值与HAMD评分、病程、首次发病年龄无显著相关； 结论:1）首发青中年重性抑郁障碍患者存在脑白质微结构的改变。 2）首发青中年重性抑郁障碍患者可能存在神经纤维代偿性再生。 3）首发青中年重性抑郁障碍患者脑白质微结构的改变和疾病的严重程度、病程及发病年龄无关。
[Abstract]:Objective: to study the changes of white matter microstructure in patients with first-episode depressive disorder (major depressive disorder,MDD) by using magnetic resonance diffusion Zhang Liang (diffusion tensor imaging,DTI) technique, and to explore the course of disease in patients with severe depressive disorder. Relationship between severity and age of disease and anisotropy of dispersive Zhang Liang. Methods: the DTI data of 71 patients with first-onset depression disorder and 45 normal controls were divided into two groups. After sex and age factors were controlled, 41 pairs (22 male) of MDD patients and normal controls were matched. In 19 women, MDD was screened and diagnosed with DSM--IV--TR axis I disorder (the struetured cliniealinterview for DSM-IV axis1disorders for patient,SCID-I/P) and Hamilton Depression scale (Hamilton Depression scale,HAMD) (17 items). Hamilton anxiety scale (Hamilton Anxiety scale,HAMA) (14 items) and self-rating Depression scale (Self-Rating Depression Scale,SDS) were used to assess clinical symptoms. The compliance score of MDD group was more than 17 points and HAMA score was less than 14 points, while that of normal control group was less than 7 points, SDS score was less than 30 points, HAMA score was less than 7 points. Diffusion Zhang Liang imaging was performed in two groups, and partial anisotropy (fractionalanisotropy,FA) was used as the index of tissue diffusion characteristics. The dispersion Zhang Liang image is analyzed by using the fiber based spatial statistical method (Tract-Based Spatial Statistics,TBSS) in the FSL (FMRIB Software Library, http://www.fmrib.ox.ac.uk/fsl) software package. First, the head moving correction and eddy current correction of the image are carried out. After the whole brain mask, the individual FA image is formed. The individual FA image is registered into the MNI152 standard space by nonlinear transformation method, and an average FA image is obtained. The image is condensed to produce a template skeleton (mean FA skeleton image),. The threshold value of FA was defined as 鈮

本文编号：2368792