CAJ | 학술논문

目的探讨伴轻躁狂症状的抑郁症患者在静息状态下脑功能磁共振低频振幅的特异性.方法对54例处于抑郁发作的抑郁症患者及36名健康对照者进行静息态脑功能磁共振扫描.抑郁症患者经HCL-32自评,＜12分为抑郁症不伴轻躁狂症状,≥12分为抑郁症伴轻躁狂症状.HCL-32评分＜12分31例,≥12分23例,考虑性别、年龄等因素匹配,最后纳入分析的抑郁症不伴轻躁狂症状组及抑郁症伴轻躁狂症状组每组各19例,相匹配的健康对照者19名(对照组).利用静息态脑功能活动低频振幅指标,对被试者的静息态脑功能活动进行分析和比较.抑郁症患者的HCL-32评分与全脑的低频振幅值进行相关分析.结果抑郁症患者与健康对照者相比,低频振幅值在较多脑区差异有统计学意义.与不伴轻躁狂症状的抑郁症患者比较,伴轻躁狂症状的抑郁症患者在双侧眶额皮质[左眶额回:MNI坐标(x、y、z):-34、56、-10,t=5.26;右眶额回:MNI坐标(x、y、z):20、66、-2,t=4.93]、额上回[左额上回:MNI坐标(x、y、z):-4、66、8,t=4.12;右额上回:MNI坐标(x、y、z):14、56、18,t=3.97]低频振幅值显著增高(P＜0.05);而在双侧丘脑、左侧梭回则显著降低(P＜0.05).抑郁症患者的HCL-32评分与全脑的低频振幅值的相关分析显示,HCL-32评分与双侧眶额皮质(左额中回、右额中回、右上额回)的低频振幅值呈正相关(r=0.363、0.426、0.405,均P＜0.05),与左侧丘脑、左侧梭回低频振幅值呈负相关(r=-0.352,P＜0.05;r=-0.468,P＜0.01).结论与不伴轻躁狂症状的抑郁症患者相比,伴轻躁狂症状的抑郁症患者静息态脑低频振幅具有特异性,尤其表现为双侧眶额回低频振幅值增高,左侧丘脑及左侧梭回低频振幅值降低.该结果或许可以作为HCL-32筛查阳性抑郁症患者的生物学标记.
목적 탐토반경조광증상적억욱증환자재정식상태하뇌공능자공진저빈진폭적특이성.방법 대54례처우억욱발작적억욱증환자급36명건강대조자진행정식태뇌공능자공진소묘.억욱증환자경HCL-32자평,＜12분위억욱증불반경조광증상,≥12분위억욱증반경조광증상.HCL-32평분＜12분31례,≥12분23례,고필성별、년령등인소필배,최후납입분석적억욱증불반경조광증상조급억욱증반경조광증상조매조각19례,상필배적건강대조자19명(대조조).이용정식태뇌공능활동저빈진폭지표,대피시자적정식태뇌공능활동진행분석화비교.억욱증환자적HCL-32평분여전뇌적저빈진폭치진행상관분석.결과 억욱증환자여건강대조자상비,저빈진폭치재교다뇌구차이유통계학의의.여불반경조광증상적억욱증환자비교,반경조광증상적억욱증환자재쌍측광액피질[좌광액회:MNI좌표(x、y、z):-34、56、-10,t=5.26;우광액회:MNI좌표(x、y、z):20、66、-2,t=4.93]、액상회[좌액상회:MNI좌표(x、y、z):-4、66、8,t=4.12;우액상회:MNI좌표(x、y、z):14、56、18,t=3.97]저빈진폭치현저증고(P＜0.05);이재쌍측구뇌、좌측사회칙현저강저(P＜0.05).억욱증환자적HCL-32평분여전뇌적저빈진폭치적상관분석현시,HCL-32평분여쌍측광액피질(좌액중회、우액중회、우상액회)적저빈진폭치정정상관(r=0.363、0.426、0.405,균P＜0.05),여좌측구뇌、좌측사회저빈진폭치정부상관(r=-0.352,P＜0.05;r=-0.468,P＜0.01).결론 여불반경조광증상적억욱증환자상비,반경조광증상적억욱증환자정식태뇌저빈진폭구유특이성,우기표현위쌍측광액회저빈진폭치증고,좌측구뇌급좌측사회저빈진폭치강저.해결과혹허가이작위HCL-32사사양성억욱증환자적생물학표기.
Objective To investigate the characteristics of hypomanic symptoms (HS) to the brain neural activity in the resting-state of the patients with major depressive disorder (MDD).Methods Twenty-three patients from 54 patients with MDD were defined as MDD with HS because their HCL-32 scores were higher than or equal to 12.The rest 31 patients were defined as MDD patients without HS because of the lower scores.After checking the match of the factors such as gender and age et al,there were 19 MDD patients with HS,19 patients without HS and 19 healthy controls in the final analysis.We analyzed the impact of HS to the regional brain function of the patients with MDD by amplitude of low-frequency fluctuation (ALFF).Results The patients with MDD had abnormal resting-state brain activity in a diffuse brain areas compared to healthy controls by the ALFF analysis.Compared to the patients without HS,the ALFF of the depressed MDD patients with HS were significantly higher in the bilateral orbitofrontal cortex (OFC;left OFC:MNI(x,y,z):-34,56,-10;t=5.26;right OFC:MNI(x,y,z):20,66,-2;t=493) and superior frontal cortex (SFC;left SFC:MNI(x,y,z):-4,66,8;t=4.12;right SFC:MNI(x,y,z):14,56,18,t=3.97,all P＜ 0.05);while lower in bilateral thalamus and left fusiform gyrus (P＜0.05).Correlation analysis of ALFF at each voxel in the whole brain against the HCL-32 in the patients with MDD revealed significantly positive correlation in OFC (r=0.363,0.426,0.405,all P＜0.05),negative correlation in left thalamus and left fusiform gyrus (r=-0.352,P＜0.05;r=-0.468,P＜0.01).Conclusions The study suggested that there were differences between the two subgroups patients with MDD defined by the HCL-32.Compared to the MDD without HS patients,MDD with HS patients showed increase ALFF in bilateral frontal cortex (especially the OFC),and decrease ALFF in left thalamus and left fusiform gyrus.These features may be regarded as the biomarker of the MDD patients who were positive to HCL-32 screening.