CAJ | 학술논문

目的探讨首发和复发抑郁症患者识别悲伤面部表情时脑区功能的差异.方法首发、复发重性抑郁症患者各11例,以及性别、年龄、受教育年限与患者匹配的健康对照11例入组,利用功能核磁共振成像检测受试者在识别悲伤及中性面部表情视频时的激活脑区.结果与正常对照组相比,首发抑郁症患者识别悲伤面部表情(识别悲伤面部表情-识别中性面部表情)时活动增加的脑区有右楔叶、右梭状回、双侧额中回、左颞中回、左海马旁回(K值≥10,P<0.001),而活动降低的脑区有右颞上回、右海马旁回(K值≥10,P<0.001),复发抑郁症患者活动降低的脑区有右额下回、右颞上回(K值≥10,P<0.001),未发现活动增加的脑区;与首发抑郁症患者相比,复发抑郁症患者活动降低的脑区有右额中回、右颞上回、右中央前回、右丘脑、右屏状核(K值≥10,P<0.001),活动增高的脑区有右海马旁回、右屏状核、右岛叶(K值≥10,P<0.001).结论抑郁症患者特别是首发抑郁症患者悲伤面部表情识别的神经基础与正常人存在差异,表现为更多的脑区参与情绪刺激的识别;复发抑郁症患者与首发抑郁症患者悲伤面部表情识别的神经基础也存在差异,表现为更多情绪识别相关脑区功能下降.
목적 탐토수발화복발억욱증환자식별비상면부표정시뇌구공능적차이.방법 수발、복발중성억욱증환자각11례,이급성별、년령、수교육년한여환자필배적건강대조11례입조,이용공능핵자공진성상검측수시자재식별비상급중성면부표정시빈시적격활뇌구.결과 여정상대조조상비,수발억욱증환자식별비상면부표정(식별비상면부표정-식별중성면부표정)시활동증가적뇌구유우설협、우사상회、쌍측액중회、좌섭중회、좌해마방회(K치≥10,P<0.001),이활동강저적뇌구유우섭상회、우해마방회(K치≥10,P<0.001),복발억욱증환자활동강저적뇌구유우액하회、우섭상회(K치≥10,P<0.001),미발현활동증가적뇌구;여수발억욱증환자상비,복발억욱증환자활동강저적뇌구유우액중회、우섭상회、우중앙전회、우구뇌、우병상핵(K치≥10,P<0.001),활동증고적뇌구유우해마방회、우병상핵、우도협(K치≥10,P<0.001).결론 억욱증환자특별시수발억욱증환자비상면부표정식별적신경기출여정상인존재차이,표현위경다적뇌구삼여정서자격적식별;복발억욱증환자여수발억욱증환자비상면부표정식별적신경기출야존재차이,표현위경다정서식별상관뇌구공능하강.
Objective To explore the difference in the intensity of brain activation during the recognition of sad facial expression and changes in neuropsychology cognition in patients with a first depressive episode and with recurrent depression.Methods 11 patients with a first major depressive episode,11 patients with recurrent major depression and 11 healthy controls matched in all aspects were scanned to compare the intensity of brain activation in the process of sad and neural facial expression recognition Results Compared with the healthy,first-episode depressed patients showed increased activation in right cuneus(BA18),right fusiform gyrus(BA20),left medial frontal gyrus(BA6),left middle temporal gyrus(BA39),left parahippocampal gyrus(BA30)and decreased activation in right temporal gyrus(BA22),right parahippocampal gyrus(BA27);recurrent depressed patients showed increased activation in right medial frontal gyrus(BA6),right superior temporal gyrus(BA38)but no activation increased.In comparation with the first-episode depressed,the recurrent,showed decreased activation in right middle frontal gyrus(BA6),fight thalamus,right superior temporal gyrus(BA22),right precentral gyras(BA44),right claustrum and increased activation in right parahippocampal gyrus(BA28),right claustrum,right insula(BA13). Conclusion The neural correlates of patients with depression,especially the first-episode depressed for recognition of sad facial expression is different from the healthy with more brain regions involved in the process.There are also differences in the neural basis for recognition of sad facial expression between patients with a first depressive episode and patients with recurrent depression.Performances of brain regions related with emotional recognition de-clined more in the recurrent depressed.