Pillay S S, Renshaw P F, Bonello C M, Lafer B C, Fava M, Yurgelun-Todd D
Brain Imaging Center, McLean Hospital, Belmont, MA 02178, USA.
Psychiatry Res. 1998 Dec 14;84(2-3):61-74. doi: 10.1016/s0925-4927(98)00048-1.
The authors investigated whether there were differences in caudate and lenticular nucleus volumes in depressed patients relative to comparison subjects, and whether differences in basal ganglia volume were associated with treatment response to fluoxetine. Brain magnetic resonance images were obtained from 38 unipolar depressed patients and 20 matched comparison subjects. Patients were divided into groups of 'responders' and 'non-responders' based on change in the 17-item Hamilton Depression Rating Scale (HDRS) score after a 10-week open trial of fluoxetine, 20 mg/day. There were no group mean differences in caudate and lenticular nucleus volumes between patients and comparison subjects. Female treatment responders tended to have larger caudate nucleus volumes than male 'responders', and also larger right caudate nucleus volumes than their female 'non-responder' counterparts. Baseline HDRS scores correlated negatively with left caudate nucleus volume in depressed patients. Thus, in mild to moderately depressed patients, we were unable to find differences in caudate and lenticular nucleus-gray matter volumes relative to comparison subjects. One possible reason is that caudate nucleus-gray matter volume and severity of depression are inversely correlated, suggesting that severity of depression may be an important covariate when comparing caudate volumes in depressed patients and control subjects.
作者调查了抑郁症患者相对于对照受试者在尾状核和豆状核体积上是否存在差异，以及基底节体积差异是否与氟西汀治疗反应相关。从38名单相抑郁症患者和20名匹配的对照受试者获取脑磁共振图像。在进行为期10周、每天20毫克氟西汀的开放试验后，根据17项汉密尔顿抑郁量表（HDRS）评分的变化，将患者分为“反应者”和“无反应者”组。患者与对照受试者之间在尾状核和豆状核体积上无组间平均差异。女性治疗反应者的尾状核体积往往比男性“反应者”大，且右侧尾状核体积也比其女性“无反应者”对应者大。抑郁症患者的基线HDRS评分与左侧尾状核体积呈负相关。因此，在轻度至中度抑郁症患者中，相对于对照受试者，我们未能发现尾状核和豆状核灰质体积存在差异。一个可能的原因是尾状核灰质体积与抑郁症严重程度呈负相关，这表明在比较抑郁症患者和对照受试者的尾状核体积时，抑郁症严重程度可能是一个重要的协变量。
