基于多b值DTI成像:初诊重性抑郁障碍患者脑白质微结构变化及其与认知功能下降的相关性研究
Study on Microstructural Changes of White Matter Fiber Tracts in the Brains of Patients with Major Depressive Disorder
陈静怡 1刘宸佑 2熊博 3陈薇好 2王葛超 2戴慧2
作者信息
- 1. 苏州大学附属第一医院,江苏 苏州 215006;南京医科大学医学影像学院,江苏 南京 210000
- 2. 苏州大学附属第一医院,江苏 苏州 215006
- 3. 苏州大学附属第一医院,江苏 苏州 215006;郑州大学第一附属医院,河南 郑州 450000
- 折叠
摘要
目的 基于多b值(b=0、1 000、2 000 s/mm2)弥散张量成像(diffusion tensor imaging,DTI)观察重性抑郁障碍(major depressive disorder,MDD)患者大脑白质(white matter,WM)纤维束微观结构变化,评估WM纤维束结构变化与MDD患者疾病严重程度、认知功能水平之间的相关性.方法 该研究纳入17 例初诊MDD患者和17 名健康志愿者,并完善人口统计学资料.受试者在入组2 周内接受神经心理学量表评估及DTI和全脑T1加权结构像MRI数据采集.所得原始图像经标准的后处理后获得全脑50 个纤维束的各向异性分数(fractional anisotropy,FA)及平均扩散系数(mean diffusivity,MD).人口统计学和量表数据及WM参数进行组间比较,随后对组间差异具有统计学意义的脑区的FA、MD值与神经心理学量表作相关性分析.结果 MDD组的汉密尔顿抑郁量表-17(Hamilton Depression Scale-17,HAMD-17)评分、听觉词语学习测试-华山版(Auditory Verb Learn Test-Huashan Version,AVLT-H)得分、Stroop色词测验(Stroop Color Word Test,SCWT)得分、动物流畅性测试(Animal Fluency Test,AFT)得分与对照组相比差异具有统计学意义(P＜0.05).MDD组多个大脑WM纤维束出现FA值降低、MD值增高,与对照组差异具有统计学意义(P＜0.05).相关分析显示,MDD组右侧上纵束FA值与AVLT-H中短延迟回忆得分呈中等程度负相关(r=-0.513,P=0.035),左侧内侧丘系和右侧内侧丘系FA值均与汉密尔顿焦虑量表-14(Hamilton Anxiety Scale-14,HAMA-14)评分呈中等程度正相关(r=0.589、0.550,P=0.013、0.022).MDD组左侧额枕下束MD值与AVLT中长延迟回忆得分呈负相关(r=-0.495,P=0.043).结论 该研究中MDD患者情景记忆功能、执行功能和语言功能受损.DTI检查可发现MDD患者的WM纤维束微观结构异常,进而提示WM纤维束微观结构变化与MDD患者认知功能的密切相关性.其中右侧上纵束可能与患者记忆和语言相关的功能有关,内侧丘系可能与患者焦虑症状严重程度存在相关性,而MDD患者左侧额枕下束结构变化可能提示患者语言记忆功能受损.
Abstract
Objective The microstructural changes of white matter(WM)fiber tracts in the brains of patients with major depressive disorder(MDD)were observed based on diffusion tensor imaging(DTI)with multiple b-values(b=0,1 000,2 000 s/mm2),and the correlations between the structural changes of WM fiber tracts and the disease severity and cognitive function level of patients with MDD were evaluated.Methods This study included 17 drug-negative MDD patients and 17 healthy volunteers,with concurrently refined demographic data.Subjects underwent neuropsychological scale assessment and whole brain DTI and T1-weighted structural image MRI data collection within two weeks of enrollment.Fractional Anisotropy(FA)and Mean Diffusivity(MD)of 50 fiber tracts in the whole brain were obtained after normalized post-processing of the raw images.Demographic and scale data and WM parameters were compared intergroup,followed by correlation analyses of FA and MD values of brain regions with intergroup variability with neuropsychological scales.Results In the MDD group,the Hamilton Depression Scale-17(HAMD-17)score,the Auditory Verb Learn Test-Huashan Version(AVLT-H)score,the Stroop Color Word Test(SCWT)score,and the Animal Fluency Test(AFT)score were statistically different the control group(P＜0.05).Multiple brain WM fiber bundles in the MDD group showed decreased FA and increased MD values,which were significantly different from the control group(P＜0.05).Correlation analyses showed that the FA values of the right superior longitudinal fasciculus in the MDD group were moderately negatively correlated with the short delayed recall scores in the AVLT-H(r=-0.513,P=0.035),and both left and right medial thalamic FA values were moderately positively correlated with Hamilton Anxiety Scale-14(HAMA-14)scores(r=0.589,0.550,P=0.013,0.022).The MD value of the left inferior frontal occipital fasciculus in the lesion group was negatively correlated with the long delayed recall score in the AVLT-H(r=-0.495,P=0.043).Conclusion The MDD patients in this study had impaired situational memory function,executive function,and language function.DTI examination revealed abnormalities in the microstructure of the WM fiber tracts in the MDD patients,which further suggests a close correlation between microstructural changes on the WM fiber tracts and the cognitive functions of the MDD patients.The right superior longitudinal fasciculus may be related to memory and language-related functions,the medial thalamic tract may be correlated with the severity of anxiety symptoms,and the structural changes of the left inferior frontal occipital fasciculus in patients with MDD may suggest that the patients have impaired verbal memory functions.
关键词
重性抑郁障碍/弥散张量成像/白质微观结构Key words
major depressive disorder/diffusion tensor imaging/white matter microstructure引用本文复制引用
基金项目
国家自然科学基金资助项目(81971573)
苏州市姑苏卫生人才计划(GSWS2020019)
出版年
2024
NETL
NSTL
万方数据