中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2008年
4期
212-215
,共4页
陈峰%蒋湘玲%刘涛%郭敏%李建军%吴多育%余宁%李岩
陳峰%蔣湘玲%劉濤%郭敏%李建軍%吳多育%餘寧%李巖
진봉%장상령%류도%곽민%리건군%오다육%여저%리암
抑郁症%老年人%脑%磁共振波谱学
抑鬱癥%老年人%腦%磁共振波譜學
억욱증%노년인%뇌%자공진파보학
Depressive disorder%Aged%Brain%Magnetic resonance spectroscopy
目的 应用磁共振波谱成像(MRS)研究老年抑郁症患者脑内神经环路物质代谢异常,探讨其发病机制.方法 对23例老年抑郁症患者(抑郁症组)及18名老年健康志愿者(正常对照组)行常规磁共振及三维磁共振氢质子波谱(<'1>H-MRS)检查,测量双侧额叶背外侧白质、前部扣带回皮质、杏仁核、海马、丘脑的N-乙酰天门冬氨酸(N从)、胆碱(Cho)与肌酸(Cr)的比值,对两组各部位的比值分别进行独立样本t检验.结果 (1)抑郁症组额叶背外侧白质(2.28±0.32)、前部扣带回皮质(2.19 ±0.39)、杏仁核(1.95 ±0.22)、海马的Cho/Cr比值(2.38 ±0.30)均高于正常对照组(分别为1.88 ±0.40、1.68±0.30、1.66±0.24、2.00±0.34),差异有统计学意义(P＜0.01～0.05);而丘脑Cho/Cr比值与对照组的差异无统计学意义(P＞0.05).(2)抑郁症组前部扣带回皮质(2.08 ±0.26)、杏仁核(2.20 ±0.27)、海马的NAA/Cr比值(2.10 ±0.27)低于正常对照组(分别为2.58 ±0.35、2.52±0.22、2.44±0.24),差异有统计学意义(P＜0.01～0.05);而额叶背外侧白质及丘脑未见明显变化(P＞0.05).结论 老年抑郁症患者额叶背外侧白质、前部扣带回皮质、杏仁核、海马的Cho/Cr比值明显高于对照组,提示边缘系统-皮质-纹状体-苍白球-丘脑环路的功能受到影响,该神经环路在老年抑郁症发病机制中可能起一定作用.
目的 應用磁共振波譜成像(MRS)研究老年抑鬱癥患者腦內神經環路物質代謝異常,探討其髮病機製.方法 對23例老年抑鬱癥患者(抑鬱癥組)及18名老年健康誌願者(正常對照組)行常規磁共振及三維磁共振氫質子波譜(<'1>H-MRS)檢查,測量雙側額葉揹外側白質、前部釦帶迴皮質、杏仁覈、海馬、丘腦的N-乙酰天門鼕氨痠(N從)、膽堿(Cho)與肌痠(Cr)的比值,對兩組各部位的比值分彆進行獨立樣本t檢驗.結果 (1)抑鬱癥組額葉揹外側白質(2.28±0.32)、前部釦帶迴皮質(2.19 ±0.39)、杏仁覈(1.95 ±0.22)、海馬的Cho/Cr比值(2.38 ±0.30)均高于正常對照組(分彆為1.88 ±0.40、1.68±0.30、1.66±0.24、2.00±0.34),差異有統計學意義(P＜0.01～0.05);而丘腦Cho/Cr比值與對照組的差異無統計學意義(P＞0.05).(2)抑鬱癥組前部釦帶迴皮質(2.08 ±0.26)、杏仁覈(2.20 ±0.27)、海馬的NAA/Cr比值(2.10 ±0.27)低于正常對照組(分彆為2.58 ±0.35、2.52±0.22、2.44±0.24),差異有統計學意義(P＜0.01～0.05);而額葉揹外側白質及丘腦未見明顯變化(P＞0.05).結論 老年抑鬱癥患者額葉揹外側白質、前部釦帶迴皮質、杏仁覈、海馬的Cho/Cr比值明顯高于對照組,提示邊緣繫統-皮質-紋狀體-蒼白毬-丘腦環路的功能受到影響,該神經環路在老年抑鬱癥髮病機製中可能起一定作用.
목적 응용자공진파보성상(MRS)연구노년억욱증환자뇌내신경배로물질대사이상,탐토기발병궤제.방법 대23례노년억욱증환자(억욱증조)급18명노년건강지원자(정상대조조)행상규자공진급삼유자공진경질자파보(<'1>H-MRS)검사,측량쌍측액협배외측백질、전부구대회피질、행인핵、해마、구뇌적N-을선천문동안산(N종)、담감(Cho)여기산(Cr)적비치,대량조각부위적비치분별진행독립양본t검험.결과 (1)억욱증조액협배외측백질(2.28±0.32)、전부구대회피질(2.19 ±0.39)、행인핵(1.95 ±0.22)、해마적Cho/Cr비치(2.38 ±0.30)균고우정상대조조(분별위1.88 ±0.40、1.68±0.30、1.66±0.24、2.00±0.34),차이유통계학의의(P＜0.01～0.05);이구뇌Cho/Cr비치여대조조적차이무통계학의의(P＞0.05).(2)억욱증조전부구대회피질(2.08 ±0.26)、행인핵(2.20 ±0.27)、해마적NAA/Cr비치(2.10 ±0.27)저우정상대조조(분별위2.58 ±0.35、2.52±0.22、2.44±0.24),차이유통계학의의(P＜0.01～0.05);이액협배외측백질급구뇌미견명현변화(P＞0.05).결론 노년억욱증환자액협배외측백질、전부구대회피질、행인핵、해마적Cho/Cr비치명현고우대조조,제시변연계통-피질-문상체-창백구-구뇌배로적공능수도영향,해신경배로재노년억욱증발병궤제중가능기일정작용.
Objective To find the characteristics of metabolic changes in neuroanatomical circuit in the aged with major depression through <'1>H-MRS.Methods Twenty-third patients with late-life onset depression and eighteen gender-and age-matched normal controls were involved.The neurochemical abnormalities including the levels of choline ( Cho)/creatine (Cr) and N-acetylaspartic acid ( NAA )/Cr were measured respectively in dorsolateral frontal white matter,eingulate gyrus gray matter,amygdala,hippocampus and thalamus with three-dimension <'1>H-proton MR spectroscopy (3D <'1>H-MRS).Results The values of Cho/Cr ratios in dorsolateral frontal white matter,cingulate gyrus gray matter,amygdala,hippocampus were significant higher in patients than that in controls (P＜0.05),and the values of NAA/Cr in cingulate gyrus gray matter,amygdala,hippocampus were significant lower in patients than that in controls(P＜ 0.05 ).Conclusion It indicates that there is dysfunction in limbic- cortical- striatal- pallidal-thalamic tract in the aged with late-life onset depression.
