目的 探讨单相和双相抑郁障碍患者以及健康对照者脑白质网络节点全局效率属性值的异同并与临床特征进行相关分析.方法 对24例单相抑郁障碍患者(单相抑郁障碍组)、17例双相抑郁障碍患者(双相抑郁障碍组)以及52名健康对照者(对照组)进行弥散张量成像扫描,并采用17项汉密尔顿抑郁量表(17-Item Hamilton Depression Rating Scale,HAMD17)对患者进行临床评估;利用解剖学自动标记模板将整个大脑划分为90个区域,同时对全脑进行确定性纤维追踪,基于复杂理论方法构建脑白质网络;采用单因素方差分析和双样本t检验方法比较3组脑网络节点全局效率属性值的差异,并对差异脑区的全局效率属性值与临床特征进行Pearson相关分析.结果 (1)3组间全局效率属性值差异有统计学意义的脑区包括左侧扣带回前部(F=10.88,P=0.00)以及右侧内侧额上回(F=14.04,P=0.00)、尾状核(F=9.53,P=0.00)、苍白球(F=12.83,P=0.00).(2)单相抑郁障碍组左侧内侧额上回(0.44±0.03与0.47±0.03,t=-3.73,P=0.02)、丘脑(0.44±0.04与0.47±0.04,t=-3.29,P=0.03)以及右侧内侧额上回(0.40±0.02与0.42±0.03,t=-3.30,P=0.03)、右侧苍白球(0.37±0.01与0.39±0.02,t=-5.07,P=0.00)全局效率属性值较对照组下降.(3)双相抑郁障碍组左侧内侧额上回(0.43±0.03与0.47±0.03,t=-4.81,P=0.00)以及扣带回前部(0.47±0.03与0.51±0.03,t=-4.34,P=0.00)全局效率属性值较对照组下降;而右侧尾状核(0.47±0.03与0.45±0.02,t=3.39,P=0.04)全局效率属性值较对照组升高.(4)双相抑郁障碍组左侧扣带回前部全局效率属性值较单相抑郁障碍组下降(t=-3.85,P=0.02);而右侧尾状核(t=3.91,P=0.03)以及苍白球(t=3.75,P=0.04)全局效率属性值较单相抑郁障碍组升高.(5)单相抑郁障碍组左侧扣带回前部全局效率属性值与焦虑躯体化因子分(r=-0.43,P=0.04)呈负相关;双相抑郁障碍组右侧内侧额上回和尾状核全局效率属性值分别与焦虑躯体化因子分(r=-0.49,P=0.04)以及阻滞因子分(r=-0.56,P=0.02)呈负相关,而右侧内侧额上回全局效率属性值与发病年龄(r=0.51,P=0.04)呈正相关.结论 单相抑郁障碍患者前额叶-边缘以及前额叶-基底节神经环路的信息传递效率均下降;双相抑郁障碍患者前额叶-边缘环路的信息传递效率下降,而前额叶-基底节环路信息传递效率代偿性上升.
目的 探討單相和雙相抑鬱障礙患者以及健康對照者腦白質網絡節點全跼效率屬性值的異同併與臨床特徵進行相關分析.方法 對24例單相抑鬱障礙患者(單相抑鬱障礙組)、17例雙相抑鬱障礙患者(雙相抑鬱障礙組)以及52名健康對照者(對照組)進行瀰散張量成像掃描,併採用17項漢密爾頓抑鬱量錶(17-Item Hamilton Depression Rating Scale,HAMD17)對患者進行臨床評估;利用解剖學自動標記模闆將整箇大腦劃分為90箇區域,同時對全腦進行確定性纖維追蹤,基于複雜理論方法構建腦白質網絡;採用單因素方差分析和雙樣本t檢驗方法比較3組腦網絡節點全跼效率屬性值的差異,併對差異腦區的全跼效率屬性值與臨床特徵進行Pearson相關分析.結果 (1)3組間全跼效率屬性值差異有統計學意義的腦區包括左側釦帶迴前部(F=10.88,P=0.00)以及右側內側額上迴(F=14.04,P=0.00)、尾狀覈(F=9.53,P=0.00)、蒼白毬(F=12.83,P=0.00).(2)單相抑鬱障礙組左側內側額上迴(0.44±0.03與0.47±0.03,t=-3.73,P=0.02)、丘腦(0.44±0.04與0.47±0.04,t=-3.29,P=0.03)以及右側內側額上迴(0.40±0.02與0.42±0.03,t=-3.30,P=0.03)、右側蒼白毬(0.37±0.01與0.39±0.02,t=-5.07,P=0.00)全跼效率屬性值較對照組下降.(3)雙相抑鬱障礙組左側內側額上迴(0.43±0.03與0.47±0.03,t=-4.81,P=0.00)以及釦帶迴前部(0.47±0.03與0.51±0.03,t=-4.34,P=0.00)全跼效率屬性值較對照組下降;而右側尾狀覈(0.47±0.03與0.45±0.02,t=3.39,P=0.04)全跼效率屬性值較對照組升高.(4)雙相抑鬱障礙組左側釦帶迴前部全跼效率屬性值較單相抑鬱障礙組下降(t=-3.85,P=0.02);而右側尾狀覈(t=3.91,P=0.03)以及蒼白毬(t=3.75,P=0.04)全跼效率屬性值較單相抑鬱障礙組升高.(5)單相抑鬱障礙組左側釦帶迴前部全跼效率屬性值與焦慮軀體化因子分(r=-0.43,P=0.04)呈負相關;雙相抑鬱障礙組右側內側額上迴和尾狀覈全跼效率屬性值分彆與焦慮軀體化因子分(r=-0.49,P=0.04)以及阻滯因子分(r=-0.56,P=0.02)呈負相關,而右側內側額上迴全跼效率屬性值與髮病年齡(r=0.51,P=0.04)呈正相關.結論 單相抑鬱障礙患者前額葉-邊緣以及前額葉-基底節神經環路的信息傳遞效率均下降;雙相抑鬱障礙患者前額葉-邊緣環路的信息傳遞效率下降,而前額葉-基底節環路信息傳遞效率代償性上升.
목적 탐토단상화쌍상억욱장애환자이급건강대조자뇌백질망락절점전국효솔속성치적이동병여림상특정진행상관분석.방법 대24례단상억욱장애환자(단상억욱장애조)、17례쌍상억욱장애환자(쌍상억욱장애조)이급52명건강대조자(대조조)진행미산장량성상소묘,병채용17항한밀이돈억욱량표(17-Item Hamilton Depression Rating Scale,HAMD17)대환자진행림상평고;이용해부학자동표기모판장정개대뇌화분위90개구역,동시대전뇌진행학정성섬유추종,기우복잡이론방법구건뇌백질망락;채용단인소방차분석화쌍양본t검험방법비교3조뇌망락절점전국효솔속성치적차이,병대차이뇌구적전국효솔속성치여림상특정진행Pearson상관분석.결과 (1)3조간전국효솔속성치차이유통계학의의적뇌구포괄좌측구대회전부(F=10.88,P=0.00)이급우측내측액상회(F=14.04,P=0.00)、미상핵(F=9.53,P=0.00)、창백구(F=12.83,P=0.00).(2)단상억욱장애조좌측내측액상회(0.44±0.03여0.47±0.03,t=-3.73,P=0.02)、구뇌(0.44±0.04여0.47±0.04,t=-3.29,P=0.03)이급우측내측액상회(0.40±0.02여0.42±0.03,t=-3.30,P=0.03)、우측창백구(0.37±0.01여0.39±0.02,t=-5.07,P=0.00)전국효솔속성치교대조조하강.(3)쌍상억욱장애조좌측내측액상회(0.43±0.03여0.47±0.03,t=-4.81,P=0.00)이급구대회전부(0.47±0.03여0.51±0.03,t=-4.34,P=0.00)전국효솔속성치교대조조하강;이우측미상핵(0.47±0.03여0.45±0.02,t=3.39,P=0.04)전국효솔속성치교대조조승고.(4)쌍상억욱장애조좌측구대회전부전국효솔속성치교단상억욱장애조하강(t=-3.85,P=0.02);이우측미상핵(t=3.91,P=0.03)이급창백구(t=3.75,P=0.04)전국효솔속성치교단상억욱장애조승고.(5)단상억욱장애조좌측구대회전부전국효솔속성치여초필구체화인자분(r=-0.43,P=0.04)정부상관;쌍상억욱장애조우측내측액상회화미상핵전국효솔속성치분별여초필구체화인자분(r=-0.49,P=0.04)이급조체인자분(r=-0.56,P=0.02)정부상관,이우측내측액상회전국효솔속성치여발병년령(r=0.51,P=0.04)정정상관.결론 단상억욱장애환자전액협-변연이급전액협-기저절신경배로적신식전체효솔균하강;쌍상억욱장애환자전액협-변연배로적신식전체효솔하강,이전액협-기저절배로신식전체효솔대상성상승.
Objective To explore the differences of the nodal global efficiency (GE) of brain white matter networks in the unipolar depression (UD) patients,bipolar depression (BD) patients and healthy controls (HC) subjects.Method The diffusion tensor imaging data were obtained from 24 UD patients,17 BD patients and 52 HC subjects.And the 17-Item Hamilton Depression Rating Scale (HAMD17) was used to evaluate the patients' condition.The whole cerebral cortex was divided into 90 regions by the automated anatomical labeling map.Fiber tracking was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts using the fiber assignment by continuous tracking algorithm.And then the brain white matter networks were constructed using the complex network theory.The nodal GE of the brain networks of UD,BD and HC were compared by the one-way ANOVA and two sample t-tests,and then the correlations between the GE of the significant nodes and the clinical features of patients were explored by the Pearson correlation analysis.Result The significant nodes of the GE in there groups included the left anterior cingulate gyri (F=10.88,P=0.00) and right medial superior frontal gyrus (F=14.04,P=0.00),caudate nucleus (F=9.53,P=0.00),pallidum (F=12.83,P=0.00).The GE of UD was descendant significantly in the left medial superior frontal gyrus (0.44±0.03 vs.0.47±0.03,t=-3.73,P=0.02),thalamus (0.44±0.04 vs.0.47± 0.04,t=-3.29,P=0.03) and right medial superior frontal gyrus (0.40±0.02 vs.0.42±0.03,t=-3.30,P=0.03),caudate nucleus (0.37 ±0.01 vs.0.39± 0.02,t=-5.07,P=0.00) when compared with HC.The GE of BD descent significantly in the left medial superior frontal gyrus (0.43±0.03 vs.0.47±0.03,t=-4.81,P=0.00) and anterior cingulate gyri (0.47±0.03 vs.0.51±0.03,t=-4.34,P=0.00),however,increased significantly in the right caudate nucleus (0.47±0.03 vs.0.45±0.02,t=3.39,P=0.04) when compared with HC.The GE of BD was descendant significantly in the left anterior cingulate gyri (t=-3.85,P=0.02),however,increased significantly in the right caudate nucleus (t=3.91,P=0.03) and pallidum (t=3.75,P=0.04) when compared with UD.Significant negative correlation was found between the GE of the left anterior cingulate gyri and the scores of anxiety/somatization factor (r=-0.43,P=0.04) in UD.And that were also found between the GE of the right medial superior frontal gyrus and the scores of anxiety/somatization (r=-0.49,P=0.04),and between the caudate nucleus and the retardation factor (r=-0.56,P=0.02) in BD.However,significant positive correlation was found between the GE of the right medial superior frontal gyrus and the age of the onset (r=0.51,P=0.04) in BD.Conclusion The efficiency of information integrating within the prefrontal-limbic and prefrontal-basal ganglia pathways may be decreased in UD.The efficiency of information integrating within the prefrontal-limbic pathway could be decreased,however,increased compensatorily within the prefrontal-basal ganglia pathway in BD.
