磁共振三维伪连续动脉自旋标记技术分析初诊早发型抑郁症患者脑血流灌注

doi:10.16098/j.issn.0529-1356.2024.04.016

摘要/Abstract

摘要： 目的使用磁共振三维伪连续动脉自旋标记(3D-pCASL)技术，分析初诊早发型抑郁症（EOD）患者脑血流灌注改变，并探究其与临床表型之间的关系。方法收集65例初诊EOD患者（EOD组）和55名健康志愿者（HC组）的汉密尔顿抑郁（HAMD）评分及童年创伤量表（CTQ）评分，采集两组被试者的颅脑3D T1WI和3D-pCASL图像，采用SPM 12、DPABI_V7.0软件对两组图像进行预处理及统计学分析，用Xjview 10.0软件对两组进行全脑水平的脑血流（CBF）值分析，用SPSS 25.0软件评估脑血流值与HAMD评分及CTQ评分的相关性。结果 EOD组与HC组相比，CBF值明显减低［P<0.05,团块>50,经错误发现率（FDR）校正］的区域有右岛盖部额下回（t=5.87）及右颞顶枕交界区(TPO)（t=6.49），CBF值明显增加（P<0.05,团块>50,经FDR校正）的区域有左侧额上回（t=5.31）和左侧岛叶（t=4.70）。结论 EOD患者中伴有童年创伤经历者占比较大，CBF改变表现为同时存在CBF减少区与CBF增加区，其中右侧TPO区域的CBF值与HAMD评分成负相关关系；左侧额上回CBF值与CTQ量表的总得分及其中的躯体忽视指标成正相关关系。与不区分早发型与晚发型抑郁症的研究结果有所不同。

关键词:

早发型抑郁症, 血流灌注, 童年创伤, 磁共振成像, 三维伪连续动脉自旋标记, 人

Abstract:

Objective To analyze the cerebral blood flow changes in patients with newly diagnosed untreated early-onset depression (EOD), using three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL), and to explore its relationship with clinical phenotypes. Methods The Hamilton Depression Scale (HAMD), Childhood Trauma Questionnaire (CTQ) scores, 3D T1WI, and 3D-pCASL brain images of 65 untreated EOD patients and 55 healthy volunteers(HC group) were collected. SPM 12 and DPABI_V7.0 software were used to preprocess and analyze the whole brain images in two groups. Xjview software was used to analyze the value of cerebral blood flow (CBF) at the whole brain level of the two groups, and SPSS 25.0 software was used to evaluate the correlation of CBF values with HAMD scores and CTQ scores. Results Compared with the HC group, the CBF of the EOD group was reduced significantly［P<0.05, cluster size>50, false discovery rate(FDR) correction］ in the right opercular inferior frontal gyrus (t=5.89), right temporo-parieto-occipital (TPO) region (t=6.49), and blood perfusion increased significantly (P<0.05, cluster size>50, FDR correction) in the left superior frontal gyrus (t=5.31) and left insular lobe (t=4.70). Conclusion The proportion of EOD patients with childhood trauma experience is relatively large. EOD patients have both reduced areas and increased areas in cerebral perfusion. The CBF value of the right TPO area is negatively correlated with HAMD scores; The CBF value of the left superior frontal gyrus is positively correlated with the total score of CTQ and the index of physical neglect score in CTQ, which is different from the result of studies that do not distinguish between early-onset and late-onset depression.

Key words:

Early-onset depression, Cerebral blood flow, Childhood trauma, Magnetic resonance imaging, 3D pseudo-continuous arterial spin labeling, Human

中图分类号:

孙晨曦刘天赐尹常青刘树伟. 磁共振三维伪连续动脉自旋标记技术分析初诊早发型抑郁症患者脑血流灌注[J]. 解剖学报, 2024, 55(4): 493-500.

SUN Chen-xi LIU Tian-ci YIN Chang-qing LIU Shu-wei. Analysis of cerebral blood flow perfusion in newly diagnosed early-onset depression using 3D pseudo-continuous arterial spin labeling MRI[J]. Acta Anatomica Sinica, 2024, 55(4): 493-500.

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