目的 基于血管周围间隙弥散张量成像分析(diffusion tensor image-analysis along the perivascular space,DTI-ALPS)探讨双相情感障碍Ⅰ型(bipolar disorder Ⅰ,BD-Ⅰ)患者大脑类淋巴系统功能改变.方法 招募从2012年1月至2017年12月广州医科大学附属脑科医院收治的BD-Ⅰ型患者44例(BD-Ⅰ组),另外招募与其匹配的正常对照者30人(HC组).采集受试者的弥散张量成像(diffusion tensor image,DTI)数据并计算沿血管周围间隙(along the perivascular space,ALPS)指数.采用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、17项-汉密尔顿抑郁量表(17-item Hamilton de-pression rating scale,HAMD-17)、杨氏躁狂评定量表(Young mania rating scale,YMRS)、功能大体评定量表(global assessment function,GAF)评估被试焦虑、抑郁、躁狂和社会功能.采用SPSS 25.0软件进行t检验、Z检验、卡方检验,比较受试者临床资料和DTI-ALPS指数的组间差异,采用偏相关检验分析DTI-ALPS指数与HAMA、HAMD-17、YMRS、GAF评分的相关性.结果 BD-Ⅰ组受试者左脑、右脑及双侧平均 DTI-ALPS 指数[(1.69±0.17),(1.44±0.15),(1.56±0.15)]均比 HC 组的 DTI-ALPS 指数[(1.71±0.15),(1.46±0.13),(1.58±0.12)]低,但差异无统计学意义(t=-0.441,-0.545,-0.556,均P＞0.05).控制性别、年龄、受教育年限、病程后,右脑、双侧平均DTI-ALPS指数与HAMA躯体性焦虑因子评分均呈负相关(分别为r=-0.349,P=0.030;r=-0.334,P=0.038).结论 BD-Ⅰ型患者大脑类淋巴系统功能障碍不明显,但患者焦虑情绪可能与大脑类淋巴功能障碍有关.
Evaluation of brain glymphatic system function in patients with bipolar disorder based on diffusion tensor imaging along the perivascular space
Objective To investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space(DTI-ALPS)in bipolar disorder Ⅰ(BD-Ⅰ).Methods A total of 44 BD-Ⅰ patients(BD-Ⅰ group)admitted to the Affiliated Brain Hospital of Guangzhou Medical University from January 2012 to December 2017 were selected.In addition,totally 30 healthy controls(HC group)were recruited.The diffusion tensor image data were analyzed retrospectively,and along the perivascular space(ALPS)index was calculated.Hamilton anxiety scale(HAMA),17-item Hamilton depression rating scale(HAMD-17),Young mania rating scale(YMRS)and global assessment function(GAF)were used to eval-uate the severity of anxiety,depression,mania and social function respectively.SPSS 25.0 software was used for t-test,Z-test and chi-square test,and the differences in clinical data and DTI-ALPS index between the two groups were compared.The partial correlation test was used to analyze the correlations between DTI-ALPS index and the clinical indicators such as HAMA,HAMD-17,YMRS and GAF.Results The DTI-ALPS in-dexes in left(1.69±0.17),right(1.44±0.15)and bilateral cerebral hemispheres(1.56±0.15)of BD-Ⅰgroup were lower than those in HC group((1.71±0.15),(1.46±0.13)and(1.58±0.12)),but the differences were not statistically significant(t=-0.441,-0.545,-0.556,all P＞0.05).After controlling for gender,age,years of education and course of disease,there were significant negative correlations between bi-lateral average DTI-ALPS index and somatic anxiety(r=-0.334,P=0.038),as well as between right DTI-ALPS index and somatic anxiety(r=-0.349,P=0.030)in BD-Ⅰ group.Conclusion The dysfunction of cerebral glymphatic system is not obvious in BD-Ⅰ patients,but their anxiety may be related to dysfunction cerebral glymphatic system.
NETL
NSTL
万方数据
