摘要
目的探讨抑郁症患者静息状态下后扣带回的功能连接特点及抗抑郁药治疗对后扣带回功能连接的影响。方法共纳入21例符合DSM-Ⅳ诊断标准的首次发病未服药抑郁症患者（抑郁症组）以及21名与之相匹配的健康对照者（对照组）。所有被试者入组后行脑静息状态fMRI检查，抑郁症组接受8周艾司西酞普兰单药治疗，并于8周末再次行静息状态fMRI检查。选取左侧后扣带回为感兴趣区域，分别对提取的后扣带回的时间序列与全脑的时间序列进行功能连接分析，比较抑郁症组与对照组、抑郁症组治疗前后的功能连接变化。结果与对照组比较，抑郁症组治疗前后扣带回与多个脑区功能连接异常，包括后扣带回与海马及海马旁回（Z=4.70）、左侧额中回（Z=4.65）功能连接增强（均P〈0.05），与右侧额中回（Z=3.98）、右颞极（Z=3.66）、左颞中回（Z=3.80）、双侧枕中回（Z=3.57、3.54）功能连接减弱（P〈0.05）。治疗8周后抑郁症组以上功能连接异常脑区得到部分调整，后扣带回与右侧额下回（Z=4.35）、右侧中央前回（Z=5.87）、左侧颞中回（Z=3.96）、左侧枕中回（Z=3.65）、左岛叶（Z=3.25）的功能连接明显增强（均P〈0.05）；但与双侧额上回（Z=5.10）、双侧楔前叶（Z=5.63）、右侧海马及海马旁回（Z=4.96）、右枕叶角回（Z=3.65）的功能连接强度降低（均P〈0.05）。结论首次发病未服药抑郁症患者静息状态后扣带回与情感调节环路多个脑区功能连接异常，短期抗抑郁药治疗可部分调整这些异常，提示脑功能连接异常可能与疗效相关。
Objective This study aimed to find the resting state functional connectivity of posterior cingulate with other brain regions in major depressive disorder （MDD）, as well as the effect and correlations with antidepressant agents. Methods Twenty-one first-episode MDD patients according to the diagnosis criteria of DSM-Ⅳ and 21 sex-, age-, and education-matched health controls were recruited. All subjects underwent brain resting state fMRI scans at baseline. Depressive patients subsequently underwent 8 weeks of escitalopram mouotherapy, and took resting state fMRI at the end of the treatment. The left posterior eingulate gyms was selected as the region of interest, and the time series of the extraction of the posterior cingulate and the whole brain were analyzed. Results Compared to controls, MDD patients showed abnormal brain functional connectivity at baseline, especially increased functional connectivity in the hippocampus and parahippocampal gyms （Z=4.70）, left middle frontal （Z=4.65, both P〈0.05）, but decreased functional connectivity in the right middle frontal gyms （Z=3.98）, right temporal pole （Z=3.66）, bilateral inferior temporal gyms （Z=3.80）, bilateral occipital gyms （Z=3.57, 3.54; all P〈0.05）. The drug significantly increased the functional connectivity of posterior cingulate with right inferior frontal gyms （Z= 4.35）, right precentral gyms （Z=5.87）, left middle temporal gyms （Z=3.96）, left middle occipital gyms （Z= 3.65） and insula cortex, while reduced the functional connectivity of posterior cingulate with the bilateral superior frontal gyms （Z=5.10）, bilateral precuneus （Z=5.63）, right hippocampus and parahippocampal gyms （Z=4.96）, right angular gyms （Z=3.65, all P〈0.05）. Conclusion There may be abnormal resting state functional connectivities of the posterior cingulate with other brain regions in MDD patients, these abnormalities could partially change after escitalopram treatment, suggesting these abnormal connectivities might be co
作者
程宇琪
余红军
卢瑾
刘芳
罗春蓉
王继才
许秀峰
Cheng Yuqi Yu Hongjun Lu Jin Liu Fang Luo Chunrong Wang Jicai Xu Xiufeng(Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, Chin)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2017年第3期201-207,共7页
Chinese Journal of Psychiatry
基金
国家自然科学基金（81660237）
关键词
抑郁症
抗抑郁药
磁共振成像
后扣带回
静息态
功能连接
Depressive disorder
Antidepressive agents
Magnetic resonance imaging
Posterior cingulate
Resting state
Functional connectivity
