CAJ | 학술논문

目的探讨抑郁症患者认知功能损害的脑功能解剖学特点及病理基础. 方法选择安徽医科大学深圳二院临床学院自2008年5月至2009年12月收治的24例青年首发抑郁症患者及健康青年24名进行汉密尔顿抑郁量表(HAMD)和威斯康星测验(WCST)评定,采用弥散张量成像(DTI)测量各部位脑白质各向异性(FA)值,并进行工作记忆任务时的功能性磁共振(fMRI)扫描,对相关指标及影像学结果进行统计学分析. 结果抑郁组与对照组各脑区FA值比较差异有统计学意义的脑区包括:双侧额叶、扣带回前部、胼胝体膝.抑郁组患者病程和左额叶FA值,WCST量表持续性错误数(Rpe)、平均正确反应时间(mRT)与双侧额叶、扣带回前部FA值均呈负相关关系(P＜0.05);病程与Rpe、mRT呈正相关关系(P＜0.05).工作记忆任务中抑郁组比对照组激活减弱的脑区包括双侧额上回、左侧额中回、额下回、顶上小叶. 结论抑郁症患者有明显的认知功能损害,额叶白质纤维束的破环和灰质异常可能是其病理基础.
목적 탐토억욱증환자인지공능손해적뇌공능해부학특점급병리기출. 방법 선택안휘의과대학심수이원림상학원자2008년5월지2009년12월수치적24례청년수발억욱증환자급건강청년24명진행한밀이돈억욱량표(HAMD)화위사강성측험(WCST)평정,채용미산장량성상(DTI)측량각부위뇌백질각향이성(FA)치,병진행공작기억임무시적공능성자공진(fMRI)소묘,대상관지표급영상학결과진행통계학분석. 결과 억욱조여대조조각뇌구FA치비교차이유통계학의의적뇌구포괄:쌍측액협、구대회전부、변지체슬.억욱조환자병정화좌액협FA치,WCST량표지속성착오수(Rpe)、평균정학반응시간(mRT)여쌍측액협、구대회전부FA치균정부상관관계(P＜0.05);병정여Rpe、mRT정정상관관계(P＜0.05).공작기억임무중억욱조비대조조격활감약적뇌구포괄쌍측액상회、좌측액중회、액하회、정상소협. 결론 억욱증환자유명현적인지공능손해,액협백질섬유속적파배화회질이상가능시기병리기출.
Objective To investigate the characteristics of functional anatomy of the brain in depression patients with cognitive dysfunction and its pathological basis.Methods Twenty-four patients with first episode of depression,admitted to our hospital from May 2008 to December 2009,and 24 healthy controls,collected at the same time period,were chosen in our study; they were all assessed by Hamilton depression (HAMD) scale and Wisconsin test; fractional anisotropy (FA) values of the various parts of white matter were measured by diffusion tensor imaging (DTI),and functional MRI was performed when the testers were conducting N-back task; the related indicators and imaging results were statistically analyzed.Results The brain areas in the depression group having significant difference as compared with those in the healthy controls (P＜0.05) included the bilateral frontal lobes (the leg bilateral frontal lobe,t=-5.884; the right bilateral frontal lobe,t=-4.517),anterior cingulate cortex (t=-14.402) and corpus callosum (t=-3.701).In patients of depression group,the left frontal FA values were negatively correlated with the disease duration (r=-0.555),and FA values of left bilateral frontal lobe and anterior cingulate cortex were negatively correlated to perseverative responses errors (Rpe) and mean response times (mRT,P＜0.05); the disease duration was positively correlated to Rpe and mRT (P＜0.05).The activating reduced brain areas of the depression group when they were conducting N-back task included bilateral frontal gyrus,left middle frontal gyrus,inferior fiontal gyrus and superior parietal lobule.Conclusion The depression patients have significant cognitive impairment; the damage of frontal white matter fiber and abnormalities of gray matter may be the pathological basis.