摘要
目的 :研究难治性抑郁症患者与正常对照之间特定区域脑代谢产物及r TMS治疗前后难治性抑郁症局部脑代谢物的差异及变化。方法 :应用3T磁共振三维CSI序列扫描34例难治性抑郁症患者双侧前额叶背外侧区并分别计算NAA、Glx、Cho、m I与Cr的比值并与28名健康对照者比较。对34例难治性抑郁症患者进行4周共20次高频r TMS治疗,治疗前后分别评定汉密尔顿抑郁量表(HAMD)。治疗后再次应用相同设备序列及参数扫描34例难治性抑郁症患者双侧前额叶背外侧区。结果 :r TMS治疗前难治性抑郁症组患者左侧前额叶皮质m I/Cr比值明显低于健康对照组r TMS,治疗组治疗有效患者m I/Cr比值增高。结论 :难治性抑郁症患者可能存在前额叶胶质细胞代谢及血流异常,有效的r TMS治疗可改善神经胶质细胞功能。
Objective In this study Cerebral metabolic product within Bilateral Prefrontal Cortex of severely depressed patients before and after repetitive transcranial magnetic stimulation(r TMS) were evaluated by proton magnetic resonance spectroscopy(1H-MRS). Methods Thirty-four young depressed patients with treatment resistant unipolar depression were enrolled in a double-blind, randomized study, and the PFC was investigated before and after high-frequency(15Hz) r TMS using 3-tesla three-dimensional CSI sequence. The N-acetylaspartate(NAA), glutamine+glutamate(Glx), choline(Cho), myo-Inositol(m I) and creatine(Cr) were measured and their ratios of metabolite to Cr levels were determined in bilateral frontal lobe. The result of metabolites were compared with 28 age-and gender-matched controls. Results In depressive patients a significant reduction in m I/Cr was observed pre-r TMS. After successful treatment, m I/Cr increased significantly in left PFC. Conclusion There might exist abnormal metabolism of glual cells in prefrontal cortex of young patients with treatment-resistant depression, which can be partly reversed by successful r TMS.
出处
《湖南师范大学学报（医学版）》
2015年第1期55-57,共3页
Journal of Hunan Normal University(Medical Sciences)
关键词
难治性抑郁症
磁共振波谱
重复经颅磁刺激
前额叶
treatment-resistant depression
proton magnetic resonance spectroscopy
repetitive transcranial magnetic stimulation
prefrontal cortex
