抑郁症患者静息态功能磁共振与睡眠结构研究(1)
【摘要】 目的：研究抑郁症患者睡眠结构特征和静息态脑部活动特征。方法：选取首发单相抑郁症患者19例为病例组、体检健康者10例为对照组。两组均行静息态功能磁共振成像扫描(rfMRI)和睡眠脑电图检查，磁共振采用局部一致性法(ReHo)和低频振幅法(ALFF)分析，比较两组检查结果。结果：病例组睡眠潜伏期长于对照组，睡眠效率、N3期和REM期比例均低于对照组，N1、N2期比例高于对照组，比较差异均有统计学意义(P<0.05);与对照组相比，病例组左梭状回、左小脑后叶ReHo值降低，右顶上小叶、左楔前叶、右枕叶舌回ReHo值升高，右额叶直回、右枕叶舌回、左小脑后叶、右小脑前叶ALFF值降低，右楔叶ALFF值升高，比较差异均有统计学意义(P<0.05)。结论：伴睡眠障碍的首发单相抑郁症患者存在多区域脑功能异常。
【关键词】 抑郁; 睡眠; 静息态功能磁共振; 睡眠脑电图
【Abstract】 Objective：To study the characteristics of sleep structure and resting brain activity in patients with depression.Method：A total of 19 patients with first-episode unipolar depression were selected as case group and 10 healthy persons as control group.Resting-state functional magnetic resonance imaging(rfMRI) and sleep electroencephalogram were performed in both groups，and ReHo and ALFF were used for magnetic resonance analysis.The results of two groups were compared.Result：The sleep latency of case group was longer than that of control group，sleep efficiency，the proportion of N3 and REM stages were lower than those of control group，and the proportion of stage N1 and N2 was higher than that of control group，the differences were statistically significant(P<0.05).Compared with the control group，the ReHo values of left fusiform gyrus and left posterior cerebellar lobe decreased，the ReHo values of right superior parietal lobe，left precuneus and right occipital lobe lingual gyrus increased，the ALFF values of right frontal lobe straight gyrus，right occipital lobe lingual gyrus，left posterior cerebellar lobe and right anterior cerebellar lobe decreased，and the ALFF values of right cuneus increased，the differences were statistically significant(P<0.05).Conclusion：Patients with first-episode unipolar depression with sleep disorders have multiple regional brain dysfunction.
【Key words】 Depression; Sleep; Resting-state functional magnetic resonance imaging; Polysomnography
First-author’s address：Guangzhou First People’s Hospital，Guangzhou 510180，China
doi：10.3969/j.issn.1674-4985.2019.03.006
失眠和抑郁癥两者关系密切，一方面，失眠是抑郁症常见的主诉和治疗后的残留症状;另一方面，失眠是抑郁症的危险因素，这两者可能有某些共同的脑功能网络异常。静息态功能磁共振成像(resting-state functional magnetic resonance imaging，rfMRI)可以无创性研究静息状态下脑区的功能活性，广泛用于神经精神疾病的研究中。rfMRI有许多数据后处理方法，其中局部一致性法(regional homogeneity，ReHo)可反映脑区的局部一致性[1]，低频振幅法(amplitude of low frequency fluctuation，ALFF)可反映脑区神经元自发活动的能量水平[2]，两者结合可从不同角度进行研究。多导睡眠脑电图监测(polysomnography，PSG)可以对睡眠结构进行详细的分析和诊断，是研究睡眠结构改变的客观指标。本研究采用rfMRI和PSG相结合的方法，研究伴有失眠主诉的首发单相抑郁症患者的睡眠结构和脑功能改变，可能是探索情绪和睡眠障碍的脑功能网络异常的一个有效方法。现报道如下。, http://www.100md.com(赖明君 潘小平 魏新华 郑浩 任继亮 徐向东 周进)
【关键词】 抑郁; 睡眠; 静息态功能磁共振; 睡眠脑电图
【Abstract】 Objective：To study the characteristics of sleep structure and resting brain activity in patients with depression.Method：A total of 19 patients with first-episode unipolar depression were selected as case group and 10 healthy persons as control group.Resting-state functional magnetic resonance imaging(rfMRI) and sleep electroencephalogram were performed in both groups，and ReHo and ALFF were used for magnetic resonance analysis.The results of two groups were compared.Result：The sleep latency of case group was longer than that of control group，sleep efficiency，the proportion of N3 and REM stages were lower than those of control group，and the proportion of stage N1 and N2 was higher than that of control group，the differences were statistically significant(P<0.05).Compared with the control group，the ReHo values of left fusiform gyrus and left posterior cerebellar lobe decreased，the ReHo values of right superior parietal lobe，left precuneus and right occipital lobe lingual gyrus increased，the ALFF values of right frontal lobe straight gyrus，right occipital lobe lingual gyrus，left posterior cerebellar lobe and right anterior cerebellar lobe decreased，and the ALFF values of right cuneus increased，the differences were statistically significant(P<0.05).Conclusion：Patients with first-episode unipolar depression with sleep disorders have multiple regional brain dysfunction.
【Key words】 Depression; Sleep; Resting-state functional magnetic resonance imaging; Polysomnography
First-author’s address：Guangzhou First People’s Hospital，Guangzhou 510180，China
doi：10.3969/j.issn.1674-4985.2019.03.006
失眠和抑郁癥两者关系密切，一方面，失眠是抑郁症常见的主诉和治疗后的残留症状;另一方面，失眠是抑郁症的危险因素，这两者可能有某些共同的脑功能网络异常。静息态功能磁共振成像(resting-state functional magnetic resonance imaging，rfMRI)可以无创性研究静息状态下脑区的功能活性，广泛用于神经精神疾病的研究中。rfMRI有许多数据后处理方法，其中局部一致性法(regional homogeneity，ReHo)可反映脑区的局部一致性[1]，低频振幅法(amplitude of low frequency fluctuation，ALFF)可反映脑区神经元自发活动的能量水平[2]，两者结合可从不同角度进行研究。多导睡眠脑电图监测(polysomnography，PSG)可以对睡眠结构进行详细的分析和诊断，是研究睡眠结构改变的客观指标。本研究采用rfMRI和PSG相结合的方法，研究伴有失眠主诉的首发单相抑郁症患者的睡眠结构和脑功能改变，可能是探索情绪和睡眠障碍的脑功能网络异常的一个有效方法。现报道如下。, http://www.100md.com(赖明君 潘小平 魏新华 郑浩 任继亮 徐向东 周进)