摘要
目的采用静息态功能磁共振(rs-fMRI)对首发重度抑郁症(MDD)患者改良型电休克(MECT)治疗前后的脑功能活动变化进行分析,探讨MECT治疗抑郁症的脑神经机制。方法选取2021年1月—2022年2月于徐州医科大学附属徐州东方医院就诊、需要行MECT的MDD患者28例。MECT治疗前后行rs-fMRI扫描,并采用汉密尔顿抑郁量表(HAMD-24)进行评估。采用基于Matlab R2019b平台的DPABI V6.0软件对影像学数据进行处理,提取差异脑区的标准化低频振幅(mALFF)值和功能连接(FC)值,并与临床治疗减分率进行相关性分析。结果与治疗前相比,MDD患者经MECT治疗后HAMD-24评分显著降低,差异有统计学意义(P<0.001)。与治疗前相比,MDD患者MECT治疗后两侧中央后回的mALFF降低(P<0.05),与患者临床减分率呈负相关(r=-0.558,P=0.002);以左侧中央后回为感兴趣区(ROI),MDD患者MECT治疗后左侧中央后回与右侧距状回、舌回的FC减低(P<0.05),与患者临床减分率呈负相关(r=-0.425,P=0.024)。结论MECT可能通过调节MDD患者两侧中央后回的mAFLL和左侧中央后回与右侧距状回、舌回的FC缓解患者的抑郁症状。fMRI在抑郁症患者MECT治疗前后脑功能变化的研究中具有重要的使用价值。
Objective To investigate the changes of brain functional activity in resting-state functional magnetic resonance imaging(rs-fMRI)before and after modified electroconvulsive therapy(MECT),so as to clarify the neuroimaging mechanism of MECT in first-episode patients with major depressive disorder(MDD).Methods A total of 28 MDD patients who were admitted to the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University and scheduled for MECT from January 2021 to February 2022 were selected.Then,rs-fMRI scan was performed,and the 24 Hamilton Depression Scale(HAMD-24)scores were evaluated before and after MECT.Imaging data were processed by the DPABI V6.0 software based on Matlab R2019b platform.The standardized amplitude of low-frequency fluctuation(mALFF)value and functional connectivity(FC)value were obtained from the brain regions with remarkable differences.Then,their associations with the rate of score reduction during clinical treatment were analyzed.Results Compared with those before treatment,the total score of HAMD-24 in MDD patients after MECT significantly decreased(P<0.001).Compared with those before treatment,the mALFF of the postcentral gyrus on both sides of the MDD patients decreased after MECT(P<0.05),and was negatively associated with the rate of score reduction during clinical treatment(r=-0.558,P=0.002).When the left postcentral gyrus was highlighted as a region of interest(ROI),the FC of the left postcentral gyrus to the right calcarine gyrus and the right lingual gyrus decreased after MECT in MDD patients(P<0.05),and was negatively associated with the rate of score reduction during clinical treatment(r=-0.425,P=0.024).Conclusions MECT may relieve the depression symptoms of MDD patients through regulating the mALFF of the postcentral gyrus on both sides,and the FC of the left postcentral gyrus to the right calcarine gyrus and the right lingual gyrus.Therefore,fMRI plays an important role in investigating the changes of brain function before and after MECT in depression patients.
作者
邱志强
李皖陇
王其智
乔娟
李绍东
QIU Zhiqiang;LI Wanlong;WANG Qizhi;QIAO Juan;LI Shaodong(School of Medical Imaging,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Department of Medical Imaging,the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221004;Department of Medical Psychology,the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University;Department of Medical Imaging,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002)
出处
《徐州医科大学学报》
CAS
2022年第6期407-412,共6页
Journal of Xuzhou Medical University
基金
江苏省卫生健康委科研面上项目(M2021112)。
关键词
改良型电休克
静息态功能磁共振成像
低频振幅
功能连接
modified electroconvulsive therapy
resting-state fMRI
amplitude of low-frequency fluctuation
functional connectivity
