CAJ | 학술논문

目的探索静息状态围绝经期女性下丘脑的功能连接及其与性激素和抑郁症状的相关性.方法本研究纳入2012年10月至2013年6月在广州中山大学附属第三医院精神科广告招募的围绝经期女性志愿者66名,以Zung抑郁自评量表(ZSDS)评估其抑郁症状,以化学发光免疫法检测其雌二醇、睾酮、孕酮水平;采集3.0T静息状态功能磁共振成像数据,以下丘脑为种子区,计算基于体素的下丘脑功能连接z值图;经统计参数图(SPM)单样本t检验生成下丘脑功能连接图;用SPM多重回归分析性激素相关的下丘脑功能连接脑区,然后用Pearson相关分析性激素相关脑区平均z值与ZSDS评分的相关性.结果围绝经期女性下丘脑功能连接脑区主要为外侧额叶下回,内侧前额叶,背外侧前额叶,眶额叶皮质,膝下皮质,前扣带回,后扣带回,楔形回和楔前叶,海马区,角回(FDR校正q＜0.05).其中,睾酮与右侧角回-下丘脑连接强度正相关,与右侧膝下皮质-下丘脑和双侧内侧额上回-下丘脑连接强度负相关(PAlphasim＜0.05),同时右侧膝下皮质平均z值与ZSDS总分(r=0.279,P=0.023)、核心症状分(r=0.278,P=0.024)及躯体症状分(r=0.357,P=0.003)正相关.结论围绝经期女性静息状态下丘脑和抑郁相关网络及默认网络存在广泛功能连接,而血浆雄激素水平对部分脑区与下丘脑的功能连接强度具有调整作用,并可能降低围绝经期女性对抑郁的易感性.
목적 탐색정식상태위절경기녀성하구뇌적공능련접급기여성격소화억욱증상적상관성.방법 본연구납입2012년10월지2013년6월재엄주중산대학부속제삼의원정신과엄고초모적위절경기녀성지원자66명,이Zung억욱자평량표(ZSDS)평고기억욱증상,이화학발광면역법검측기자이순、고동、잉동수평;채집3.0T정식상태공능자공진성상수거,이하구뇌위충자구,계산기우체소적하구뇌공능련접z치도;경통계삼수도(SPM)단양본t검험생성하구뇌공능련접도;용SPM다중회귀분석성격소상관적하구뇌공능련접뇌구,연후용Pearson상관분석성격소상관뇌구평균z치여ZSDS평분적상관성.결과 위절경기녀성하구뇌공능련접뇌구주요위외측액협하회,내측전액협,배외측전액협,광액협피질,슬하피질,전구대회,후구대회,설형회화설전협,해마구,각회(FDR교정q＜0.05).기중,고동여우측각회-하구뇌련접강도정상관,여우측슬하피질-하구뇌화쌍측내측액상회-하구뇌련접강도부상관(PAlphasim＜0.05),동시우측슬하피질평균z치여ZSDS총분(r=0.279,P=0.023)、핵심증상분(r=0.278,P=0.024)급구체증상분(r=0.357,P=0.003)정상관.결론 위절경기녀성정식상태하구뇌화억욱상관망락급묵인망락존재엄범공능련접,이혈장웅격소수평대부분뇌구여하구뇌적공능련접강도구유조정작용,병가능강저위절경기녀성대억욱적역감성.
Objective This study aimed to investigate the resting-state functional connectivity of the hypothalamus and its relationships with gonadal steroid hormones and depression symptoms in perimenopausal women.Methods Total 66 perimenopausal women voluntarily participated in this study from October 2012 to June 2013.Zung Self-rating Depression Scale (ZSDS) was used to assess depression symptoms.Plasma gonadal steroid hormones including estradiol, testosterone, and progesterone were determined by the chemiluminescence immunoassay.A 3.0 Tesla magnetic resonance imaging (MRI) scanner was utilized to acquire resting-state functional MRI data.The z-value functional connectivity map of each participant was calculated voxel-wisely based on the seed region of the hypothalamus.One sample t test of Statistical Parametric Mapping (SPM) were used to determine the brain areas with statistically significant functional connectivity to the hypothalamus, then multiple regression of SPM was used to calculate the correlated areas with 3 gonadal steroid hormones, respectively.Finally,Pearson correlation was performed to analyze bivariate correlations between mean z-values and ZSDS scores.Results Significant functional connectivity to the hypothalamus were found in brain areas as follows : the lateral inferior frontal gyrus, medial prefrontal cortex, dorsal lateral prefrontal cortex, orbitofrontal cortex, subgenual cortex, anterior cingulate cortex, posterior cingulate cortex, cuneus and precuneus, hippocampus and parahippocampal gyms, and angular gyrus (False Discovery Rate q ＜ 0.05).Among these areas, the plasma testosterone level was positively related to the functional connectivity strength of the right angular gyrus, and negatively related to the strengths of the right subgenual cortex and bilateral medial superior frontal gyrus to the hypothalamus (PAlphaSim ＜0.05).Especially, mean z-value in the subgenual cortex was positively related to the ZSDS index score (r =0.279, P =0.023), and factor scores of the core depression symptoms (r =0.278, P =0.024) and somatic symptoms (r =0.357, P =0.003).Conclusion In perimenopausal women, the hypothalamus has restingstate functional connectivity with widespread areas involved in the brain depression-related network and default mode network, and the plasma androgen level may modulate the functional connectivity strengths of the hypothalamus and decrease the susceptibility of perimenopausal women to depression.