皮质下梗死后抑郁病人杏仁核功能连接研究

摘要

Objective To detect the changes in functional connectivity(FC)of amygdala in the patients with depression after subcortical infarction. Methods Twenty-one patients with depression after chronic subcortical infarction were recruited,including 13 male and 8 female,age range 41-62 years,average age 53.2 ±4.4 years.Twenty-one healthy subjects were selected as control,including 11 male and 10 female,age range 43-58 years,average age 51.8±6.3 years.By using gradient echo single-shot echo-planar imaging sequence, the resting functional MRI data were obtained, and the statistical parameter mapping software (SPM8) was used to process the data and perform statistical analysis. Bilateral amygdalae were selected as the seeds and the seed-based functional connectivity was calculated. General linear model (GLM)was used to test the intergroup difference in functional connectivity after controlling the age and gender.Correlation analysis was performed by using Pearson correlation analysis between the functional connectivity and the depression scores in patient group. Results There was no significant intergroup difference in functional connectivity of the left amygdala (AlphaSim correction, cluster>65 voxels,P>0.05). The decreased functional connectivity was revealed between the right amygdala and the right prefrontal cortex(voxels=66,T=4.315)and the right posterior parietal cortex(voxels=99,T=4.492)in patient group compared to healthy subjects (AlphaSim correction:single voxel P<0.001,cluster>65 voxels).There was no significant correlation between the depression scores and FC values within the areas with decreased FC of amygdala in patient group (r=0.084, P=0.359). Conclusion Decreased functional connectivity between the right amygdala and the right prefrontal cortex and the right posterior parietal cortex may be one of the neuromechanisms of post-stroke depression.%目的 探讨皮质下梗死后抑郁病人杏仁核功能连接的改变.方法 选取21例慢性期皮质下梗死后抑郁的病人,男13例,女8例,年龄41~62岁,平均(53.2±4.4)岁;以21名健康志愿者为对照组,男11名,女10名,年龄43~58岁,平均(51.8±6.3)岁.采用梯度回波单次激发回波平面成像序列进行静息态功能MR成像.采用统计参数图软件(SPM8)进行数据预处理和统计分析.以双侧杏仁核为种子点进行功能连接分析.在控制性别和年龄情况下,采用一般线性模型(GLM)比较功能连接的组间差异.采用Pearson相关对病人组差异区的功能连接值与抑郁评分之间相关性进行分析.结果2组间左侧杏仁核的功能连接差异无统计学意义(AlphaSim校正,体素数>65,P>0.05).与对照组相比,病人组右侧杏仁核与右侧额叶皮质(体素数66,T=4.315)、右侧后顶叶皮质(体素数99,T=4.492)之间的功能连接显著下降(AlphaSim校正,体素水平P<0.001,体素数>65).病人组杏仁核功能连接下降区的功能连接值与抑郁评分之间无显著相关性(r=0.084,P=0.359).结论 右侧杏仁核与右侧额顶叶皮质之间功能连接下降可能是皮质下梗死后抑郁的神经机制之一.