抑郁症首次发病中年女性患者的弥散张量成像研究

摘要

Objective To explore the microstructural abnormalities of white matter in middle-aged female patients with first-episode major depressive disorder by tract-based spatial statistics (TBSS).Methods Diffusion tensor imaging(DTI) was performed in 20 patients with major depressive disorder and 15 healthy controls matched for age,gender,and education.Fractional anisotropy (FA) values were compared between the patients and controls by TBSS.Results Compared with normal controls,FA values were significantly decreased in the white matter of the left prefrontal cortex,left internal capsule and the right precuneus (P ＜ 0.005,cluster ＞ 40).Conclusion The microstructural abnormalities of white matter integrity may occur early in the course of depression,the abnormal brain areas include the prefrontal-subcortical neural circuit and default mode network which are related to cognitive and emotional adjustment.%目的 运用基于纤维束示踪的空间统计学方法(tract-based spatial statistics,TBSS)探索首次发病抑郁症中年女性患者脑白质微观结构的损害.方法 对20例首次发病抑郁症中年女性患者(患者组)和15名与患者组性别、年龄、受教育程度相匹配的健康志愿者(对照组)进行全脑弥散张量成像扫描.应用TBSS方法对患者组和对照组的部分各向异性(fractional anisotropy,FA)值进行组间比较.结果 与对照组相比,患者组左侧前额叶、左侧内囊、右侧楔前叶白质的FA值显著降低(P ＜0.005,簇＞40).结论 脑白质病变在抑郁症发病的早期即已存在,异常脑区涉及与认知和情感调节关系较密切的前额叶-子皮质神经环路和默认网络的纤维束.