摘要
目的应用扩散张量成像研究卒中后抑郁(PSD)患者小脑、额叶及边缘系统(扣带回、海马、杏仁核)结构发生的改变,进一步证实小脑参与PSD的发生,并研究小脑与传统抑郁相关部位如额叶、边缘系统(扣带回、海马、杏仁核)的相关性。资料与方法回顾性选取2020年10月—2021年10月锦州医科大学附属第一医院首次基底节区梗死患者39例,行汉密尔顿抑郁量表(HAMD)评定后分为PSD组19例与非PSD组20例,随机选取入组基础信息差异无统计学意义的20人作为正常对照组,应用扩散张量成像扫描测定感兴趣区的各向异性分数(FA)值及表观扩散系数。比较3组病灶及病灶对侧感兴趣区的FA值,并分析其与HAMD评分的相关性。结果PSD组前额叶、海马、扣带回及胼胝体膝部的病灶侧,小脑中脚、小脑下脚的病灶对侧,与非PSD组及正常对照组相应感兴趣区的FA值比较,差异有统计学意义(t=0.12~0.06,P<0.05)。小脑、额叶、边缘系统的FA值改变与HAMD评分均呈显著负相关(R^(2)_(调整)=0.954,P<0.05)。PSD患者小脑中脚对侧FA值与病灶侧的前额叶、海马、扣带回及胼胝体膝部FA值呈显著正相关(r=0.977、0.752、0.637、0.539,P均<0.05)。结论PSD患者小脑白质纤维束可能发生改变,且与传统抑郁相关部位具有相关性。
Purpose To explore the changes of structure of cerebellum,frontal lobe and limbic system(cingulate gyrus,hippocampus and amygdala)in poststroke depression(PSD)via diffusion tensor imaging,and to confirm that cerebellum was involved in the occurrence of PSD,and to study the correlation between cerebellum and traditional depression-related areas such as frontal lobe,limbic system(cingulate gyrus,hippocampus and amygdala).Materials and Methods A total of 39 patients with basal ganglia infarction for the first time from October 2020 to October 2021 in the First Affiliated Hospital of Jinzhou Medical University were evaluated by Hamilton depression scale(HAMD),and all subjects were divided into PSD group(19 cases)and non-PSD group(20 cases),and 20 people with no statistical difference in basic information were randomly selected as the normal control group.The fractional anisotropy(FA)values and apparent diffusion coefficient in region of interest via diffusion tensor imaging were measured.The FA values of lesion and contralateral region of interest were compared among the three groups,and the correlation between FA value and HAMD score was analyzed.Results The FA values of ROI in the prefrontal lobe,hippocampus,cingulate gyrus,corpus callosum,middle cerebellar peduncle,and inferior cerebellar crus in the PSD group were significantly different from those in the non-PSD group and normal control group(t=-0.12--0.06,all P<0.05).The FA values of cerebellum,frontal lobe and limbic system were significantly negatively correlated with HAMD scores(R^(2)_(adjust)=0.954,P<0.05).There was a positive correlation between the FA value of contralateral foot in the cerebellum of PSD patients and that of prefrontal lobe,hippocampus,cingulate gyrus and knee of corpus callosum(r=0.977,0.752,0.637 and 0.539,all P<0.05),respectively.Conclusion PSD patients may have changes in the white matter fiber tracts of the cerebellum,which are associated with traditional depressions.
作者
陈玥寰
隋汝波
CHEN Yuehuan;SUI Rubo(Department of Neurology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 125100,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2024年第1期42-47,共6页
Chinese Journal of Medical Imaging
基金
国家自然科学基金项目(81371461)
辽宁省教育厅科技项目(JYTJCZR201903)。
关键词
卒中后抑郁
小脑
额叶
边缘系统
磁共振成像
扩散张量成像
Poststroke depression
Cerebellum
Frontal lobe
Limbic system
Magnetic resonance imaging
Diffusion tensor imaging
