重性抑郁癥基于低頻振幅的靜息態功能磁共振成像結果觀察

陸莉萍　　邵永良　　沈仲夏

[關鍵詞] 重性抑郁癥;低頻振幅;靜息態功能;磁共振成像

[中圖分類號] R749.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）19-0128-04

Observation on resting-state functional magnetic resonance imaging results of major depressive disorder based on the amplitude of low-frequency fluctuations

LU Liping? ?SHAO Yongliang? ?SHEN Zhongxia

Department of Radiology， Huzhou Third Municipal Hospital in Zhejiang Province， Huzhou? ?313000， China

[Abstract] Objective To explore the results of resting functional magnetic resonance imaging （fMRI） of major depressive disorder （MDD） based on the amplitude of low-frequency fluctuations （ALFF）. Methods A total of 35 patients with MDD who visited our psychological clinic from January 2017 to January 2019 were prospectively selected as the MDD group. 35 healthy volunteers who had physical examination in our hospital in the same period were selected as the control group. mALFF values （obtained by the M processing of ALFF value） of different brain regions in fMRI were compared between the two groups. Results mALFF values of right prefrontal cortex， right superior temporal gyrus， right inferior temporal gyrus， left insula， left medial frontal gyrus and left direct gyrus in MDD group were significantly higher than those in the control group， and the differences were statistically significant（P<0.05）. mALFF values of bilateral supplementary motor areas， right lingual gyrus， left anterior cuneiform lobe and left lingual gyrus in MDD group were significantly lower than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion mALFF values of right prefrontal cortex， right superior temporal gyrus， right inferior temporal gyrus， left insular lobe， left medial frontal gyrus and left direct gyrus increase， while mALFF values of bilateral supplementary motor areas， bilateral lingual gyrus and left anterior cuneiform lobe decrease in MDD patients at rest， which may lead to the basis of MDD.

[Key words] Major depressive disorder; The amplitude of low-frequency fluctuations; Resting state functional; Magnetic resonance imaging

重性抑郁癥（Major depression disorder，MDD）臨床患病率、復發率、自殺率等均較高，不僅會對患者身心健康造成嚴重損害，而且也給家庭、社會帶來較重的經濟負擔[1]。因此，如何有效改善MDD患者的癥狀意義重大。目前，抑郁癥的發病機制尚不清晰，明確致病因素仍存在爭議。隨著大腦影像學技術的發展，基于大腦影像學探索抑郁癥可能發病機制，為MDD的有效治療提供新的方法成為臨床研究的重點。功能磁共振成像（Functional magnetic resonance imaging，fMRI）技術是一種非入侵的新興神經影像學檢查方法，可利用磁共振造影來顯示大腦特定區域神經元活動引發的血液動力的改變[2]。因抑郁癥表現為持續性癥狀，故靜息態fMRI技術應用于抑郁癥研究具有一定前景。近年來，已有報道[3-4]將低頻振幅（Amplitude of low frequency fluctuation，ALFF）用于阿爾茨海默癥、精神分裂癥等功能性精神障礙進行探究，用于抑郁的也有一些報道，但相對較少，且納入樣本包括輕或中度抑郁癥，而本研究僅納入危害較大的重度抑郁癥，通過觀察其基于ALFF的靜息態fMRI成像結果，分析MDD患者腦部自發性神經活動情況，以期為重性抑郁癥的診療提供參考，現報道如下。