帕金森病伴抑郁患者静息态下脑活动的局部一致性改变
Alterations in regional homogeneity of resting state brain activity in Parkinson's disease patients with depression
孙佳男 1闫磊 1刘卫国 1谢春明 2胡晓3
作者信息
- 1. 210029 南京医科大学附属脑科医院神经内科
- 2. 东南大学中大医院神经内科
- 3. 210029 南京医科大学附属脑科医院影像科
- 折叠
摘要
目的 运用静息态功能磁共振探讨帕金森病伴抑郁患者脑局部一致性(ReHo)的变化及其与抑郁之间的关系.方法 收集2017年6月至10月于南京医科大学附属脑科医院门诊就诊的62例帕金森病患者(不伴抑郁组42例、伴抑郁组20例)、20例抑郁症患者及47名健康对照的静息态功能磁共振成像数据,进行2×2的协方差分析,比较4组间的ReHo差异,并将存在组间差异的脑区的ReHo值与汉密尔顿抑郁量表( HAMD)、统一帕金森病评定量表第三部分( UPDRS－Ⅲ)评分以及Hoehn－Yahr分期进行相关分析.结果 帕金森病主效应作用下,帕金森病组ReHo增高的脑区主要位于左侧腹外侧前额叶和右侧楔前叶,降低的脑区主要位于两侧辅助运动区、左侧角回.抑郁主效应作用下,抑郁组ReHo在两侧小脑增高,而在两侧中央前回、中央后回、左侧额下回、左侧后扣带回、左侧辅助运动区、右侧背外侧前额叶、右侧顶下叶、右侧距状裂降低.帕金森病与抑郁交互作用的脑区包括双侧额中回、左侧额下回及右侧缘上回.抑郁主效应下差异脑区右侧背外侧前额叶(r＝－0.526,P＜0.01)、顶下叶(r＝－0.456,P＜0.01) ReHo值与HAMD评分均存在明显的负相关.结论 伴抑郁的帕金森病患者静息状态下存在脑功能异常,且帕金森病患者出现抑郁并不是帕金森病及抑郁症两者的叠加.
Abstract
Objective To investigate the changes of regional homogeneity ( ReHo) in Parkinson's disease (PD) patients with depression and their relationship with major depressive disorder.Methods A total of 42 PD patients without depression , 20 PD patients with depression, 20 major depressive disorder patients and 47 well-matched healthy controls were scanned with resting-state functional magnetic resonance imaging for ReHo analysis.The Hamilton Depression Scale (HAMD), Unified Parkinson's Disease Rating Scale (UPDRS-Ⅲ) and Hoehn-Yahr stage were used to assess the clinical symptoms , then the correlations between abnormal brain regions and clinical data were explored.Results ( 1 ) The main effect of Parkinson's disease: PD group showed higher ReHo in left ventrolateral prefrontal cortex and right precuneus, but lower ReHo in bilateral supplementary motor area and left angular gyrus.(2) The main effect of depression: The depression group had increased ReHo in bilateral cerebellum , and decreased ReHo in bilateral precentral gyrus , postcentral gyrus , left inferior frontal gyrus, left posterior cingulate gyrus , left supplementary motor area , right dorsolateral prefrontal cortex , right inferior parietal gyrus and right calcarine.(3) Interactive effect of PD and depression : Interactive brain areas included bilateral middle frontal gyrus, left inferior frontal cortex and supramarginal gyrus.(4) The ReHo of the brain regions under main effect of depression including right dorsolateral prefrontal cortex (r＝-0.526, P＜0.01) and right inferior parietal gyrus ( r＝-0.456, P＜0.01) had significant negative correlation with HAMD scores. Conclusion PD patients with depression have abnormal brain function , and PD with depression is not simply an overlay of PD and major depressive disorder.
关键词
帕金森病/抑郁/静息态/磁共振成像/局部一致性Key words
Parkinson disease/Depression/Resting state/Magnetic resonance imaging/Regional homogeneity引用本文复制引用
基金项目
国家自然科学基金面上项目(81571348)
国家自然科学基金青年科学基金(81701671)
江苏省自然科学基金面上项目(SBK2015022028)
出版年
2018
NETL
NSTL
维普
万方数据