抑郁症患者丘脑磁共振波谱研究(1)
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【摘要】 目的 研究抑郁症患者丘脑是否存在代谢异常。方法 应用质子磁共振波谱分析技术检测14例未用药首发抑郁症患者和16例健康志愿者丘脑的多个代谢指标，包括N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌醇(MI)等。结果 病例组右丘脑等部位的Cho、NAA含量明显低于对照组(P<0.05)；病例组右侧丘脑MI含量与HAMD评分成正相关(P<0.05)。结论 抑郁症患者右丘脑的Cho含量明显低于对照组，提示脑部Cho含量的改变与抑郁症患者情感症状相关； NAA含量明显低于对照组(P<0.05)，提示抑郁症患者这些部位的神经元受损较明显。郁症患者右丘脑MI含量与HAMD评分呈正相关，提示MI在抑郁症发病中有重要作用，尤其是右丘脑MI水平与抑郁症发病关系密切，且对抑郁症诊断及严重程度的判断具有一定指导意义。
【关键词】 抑郁症;磁共振波谱;神经生化;丘脑
Studies of the MRS of the thalamus in patients with depression
WEN Fei,WU Wen-tao.Department of Psychology,The Second Affiliated of Guangzhou Medical College,Guangzhou 510260,China
【Abstract】 ObjectiveTo find the metabolic changes in different brain regions of patients with depression. Methods 1H-MRS was performed on the thalamus in 14 patients with depression and 16 control. Cho, NAA and MI were calculated respectively. Results Metabolic ratios compared between the patients and controls showed the Cho and NAA levels of right thalamus of the patients were significantly lower than the controls (P<0.05).Correlative analysis showed that MI scales in the right thalamus were positively related to the HAMD scales in the right thalamus (P<0.05). Conclusion The depressive patients have lower level of Cho in the right thalamus suggested the decrease of Cho of these regions should be related to the affective symptoms of depression.The depressive patients had lower higher of NAA in the right thalamus suggested that the neurons of these regions should be significantly damaged. The positive correlation between MI and HAMD scales in the right thalamus suggested that MI should play an important role in the pathogenesis of depression. The MI level of the right thalamus has close relationship with the depression, and has great value in diagnosing depression.
【Key words】 Depression; Magnetic resonance spectroscopy (MRS)；Neurochemical;Thalamus
抑郁症是常见的精神障碍，该病因为病程长，易复发及自杀率高等特点，影响患者社会功能，严重危害着人类身心健康。但至今其确切的病因及发病机制仍不清楚。目前，已有大量的研究提示生物学因素与抑郁症的发病有着密切的关系。磁共振波谱(Magnetic resonance spectroscopy，MRS)是目前唯一可以在活体无损伤检测细胞水平代谢变化的非侵入性技术[1-3]。通过MRS对抑郁症患者脑部与情感有关部位的神经化学物质水平代谢变化的研究已经引起了国内外学者的广泛关注。但是，国内关于抑郁症患者中枢神经系统MRS研究较少。相关研究结果支持抑郁症患者脑内，特别是额叶、颞叶、基底节区、海马确实存在代谢的变化，但因其研究方法的不同，部分结果存在互相矛盾的情况。而且既往研究采样的脑区范围局限，难以确定上述发现同抑郁症的确切关系，更不能作为该病的诊断、疗效评定的指标。因此对抑郁症患者丘脑神经化学物质水平的研究，进一步完善了通过MRS对抑郁症患者脑区代谢产物研究的方法 ......
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