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首发抑郁症患者静息态功能磁共振低频振幅成像及其差异脑区与攻击行为的关系
雍那1,吴飞2,胡华3*,吕发金2,杜莲3,黄庆玲3,邓伟4,蒙华庆3
0
(1. 川北医学院临床医学系精神病与医学心理学教研室, 南充 637000;
2. 重庆医科大学附属第一医院放射科, 重庆 400016;
3. 重庆医科大学附属第一医院精神科, 重庆 400016;
4. 四川大学华西医院精神医学研究室, 成都 610041
*通信作者)
摘要:
目的 通过静息态功能磁共振(fMRI)探讨首发抑郁症患者脑区低频振幅(ALFF)的改变及差异脑区与其攻击行为的关系。方法 选择30例未经治疗或已停药2周的首发抑郁症患者(抑郁症组)和30例性别、年龄、文化程度相匹配的健康志愿者(正常对照)作为研究对象,对所有入选人群进行3.0 T静息态功能磁共振扫描,采集血氧水平依赖信号(BOLD)图像,低频振幅(ALFF)技术处理两组BOLD图像,对结果进行两样本t检验,获取差异改变脑区,并提取差异改变脑区的ALFF值与抑郁症攻击行为之间进行相关分析获得相关显著脑区。结果 与正常对照组相比,抑郁症组左侧岛叶、顶叶亚脑回、中央前回,右侧颞上回、中央前回、额下回的ALFF值增高,差异具有统计学意义(P<0.001,Alphasim校正);而左侧丘脑、楔前叶,右侧枕叶梭状回、舌回脑区的ALFF值减低(P<0.001,Alphasim校正)。相关分析仅发现:抑郁症组ALFF增加的脑区中左侧中央前回与身体攻击、面向自我的攻击和攻击总分正相关(r=0.41、0.49、0.39,P<0.05或P<0.01);右侧额下回ALFF值增加与愤怒负相关(r=-0.44,P<0.05)。结论 在静息状态下抑郁症患者大脑部分区域存在自发性神经活动异常,其中额叶有关区域的功能磁共振ALFF增加与攻击行为的发生密切相关。
关键词:  抑郁症  攻击  静息态功能磁共振  低频振幅
DOI:10.3724/SP.J.1008.2015.00261
投稿时间:2014-08-06修订日期:2014-12-29
基金项目:重庆市卫生局医学科研计划项目 (2011-2-066).
Resting-state fMRI study on alteration of amplitude of low frequency fluctuation and its relationship with aggressive behaviors in first-episode major depressive disorder patients
YONG Na1,WU Fei2,HU Hua3*,LÜ Fa-jin2,DU Lian3,HUANG Qing-ling3,DENG Wei4,MENG Hua-qing3
(1. Department of Psychiatry and Mental Health, Clinical Medicine Faculty, North Sichuan Medical College, Nanchong 637000, Sichuan, China;
2. Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;
3. Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;
4. The Mental Health Center & Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
Co-first authors.
*Corresponding author)
Abstract:
Objective To investigate the alterations of the amplitude of low frequency fluctuation (ALFF) by the resting-state fMRI in first-episode major depressive disorder (MDD) patients, and to analyze the relationship between brain area of different ALFF alterations with their aggressive behaviors. Methods Thirty first-episode MDD patients receiving no treatment or stopping treatment for 2 weeks and 30 sex-, age-, and education-matched healthy controls were included in this study. All the participants were scanned with 3.0 T resting-state fMRI scanner and the blood oxygenation level dependent (BOLD) signals were acquired to calculate the amplitude of low frequency fluctuation (ALFF). Then we examined the differences in ALFF findings between the two groups and the correlations between the scores of aggressive behavior and ALFF in the brain areas showing significant group differences. Results Our results showed that MDD patients had significantly increased ALFF in the left insula, parietal lobe sub-gyral, precentral gyrus, and the right superior temporal gyrus, precentral gyrus, and inferior frontal gyrus compared with the health controls (P<0.001, corrected by Alphasim); while they had decreased ALFF in the left thalamus, precuneus and right lingual gyrus, and fusiform gyrus (P<0.001, corrected by Alphasim). The correlation analysis indicated that the increased ALFF in the left precentral gyrus was positively correlated with the scores of physical aggression, self-aggression, and total score of aggressive behaviors (r=0.41, 0.49, 0.39, P<0.05 or 0.01). The increased ALFF in the right inferior frontal gyrus was negatively correlated with anger (r=-0.44, P<0.05). Conclusion Spontaneous abnormal neural activities exist in some brain regions of MDD patients in the resting-state fMRI, and the increase of ALFF in regions of frontal is closely related to the aggressive behaviors of patients.
Key words:  depressive disorder  aggression  resting state functional magnetic resonance  amplitude of low frequency fluctuation