Holthoff V A, Beuthien-Baumann B, Pietrzyk U, Pinkert J, Oehme L, Franke W G, Bach O
Klinik für Psychiatrie und Psychotherapie, Technische Universität Dresden.
Nervenarzt. 1999 Jul;70(7):620-6. doi: 10.1007/s001150050487.
The objective of this study was to investigate the relationship between the effect of sleep deprivation, recovery and regional brain perfusion in patients with major depression. Regional cerebral blood flow was assessed by 99mTc-HMPAO-SPECT before and after sleep deprivation in fourteen medicated patients. Three of the patients underwent a follow-up measurement after clinical recovery and with an unchanged antidepressant medication. Before sleep deprivation the responding patients had a significantly higher anterior cingulate perfusion than the nonresponding patients, that normalized after sleep deprivation. Cingulate perfusion uniquely differentiated eventual treatment response from non-responders, as perfusion in no other region under study discriminated the two groups. At baseline all patients revealed hypoperfusion in the left prefrontal cortex when compared to the right side, which was not affected by sleep deprivation, whereas prefrontal hypoperfusion was reversible upon remission. These findings are in agreement with previous PET investigations and provide evidence for cingulate and prefrontal dysfunction associated with depression, that are reversible by successful treatment and may represent state markers.
本研究的目的是调查睡眠剥夺、恢复与重度抑郁症患者脑区灌注之间的关系。对14例正在接受药物治疗的患者在睡眠剥夺前后通过99m锝-六甲基丙烯胺肟单光子发射计算机断层扫描（99mTc-HMPAO-SPECT）评估局部脑血流量。其中3例患者在临床康复且抗抑郁药物未改变的情况下接受了随访测量。在睡眠剥夺前，有反应的患者前扣带回灌注显著高于无反应的患者，睡眠剥夺后这种差异消失。扣带回灌注能唯一区分最终的治疗反应者和无反应者，因为研究中的其他区域灌注均无法区分这两组。在基线时，与右侧相比，所有患者左侧前额叶皮质均显示灌注不足，睡眠剥夺对此无影响，而缓解后前额叶灌注不足是可逆的。这些发现与之前的正电子发射断层扫描（PET）研究结果一致，为与抑郁症相关的扣带回和前额叶功能障碍提供了证据，这些功能障碍可通过成功治疗逆转，可能代表疾病状态标志物。
