Gardner A, Pagani M, Jacobsson H, Lindberg G, Larsson S A, Wägner A, Hällstrom T
NEUROTEC Department, Division of Psychiatry, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Nucl Med Commun. 2002 May;23(5):429-39. doi: 10.1097/00006231-200205000-00002.
An increased occurrence of major depressive disorder has been reported in tinnitus patients, and of tinnitus in depressive patients. Involvement of several Brodmann areas (BAs) has been reported in tinnitus perception. The aim of this study was to assess the regional cerebral blood flow (rCBF) changes in depressed patients with and without tinnitus. The rCBF distribution at rest was compared among 45 patients with a lifetime prevalence of major depressive disorder, of whom 27 had severe tinnitus, and 26 normal healthy subjects. 99mTc-hexamethylenepropylene amine oxime (99mTc-HMPAO) single photon emission computed tomography (SPECT), using a three-headed gamma camera, was performed and the uptake in 34 functional sub-volumes of the brain bilaterally was assessed by a computerized brain atlas. Decreased rCBF in right frontal lobe BA 45 (P<0.05), the left parietal lobe BA 39 (P<0.00) and the left visual association cortex BA 18 (P<0.05) was found in tinnitus patients compared with non-tinnitus patients. The proportion of tinnitus patients with pronounced rCBF alterations in one or more of the temporal lobe BAs 41+21+22 was increased compared to gender matched controls (P<0.00) and patients without tinnitus (P<0.05). Positive correlations were found between trait anxiety scales from the Karolinska Scales of Personality and rCBF in tinnitus patients only in three limbic BAs (P<0.01), and inverse correlations in non-tinnitus patients only in five BAs subserving auditory perception and processing (P<0.05). rCBF differences between healthy controls and depressed patients with and without tinnitus were found in this study. The rCBF alterations were distributed in the cortex and were particularly specific in the auditory cortex. These findings suggest that taking audiological symptoms into account may yield more consistent results between rCBF studies of depression.
据报道，耳鸣患者中重度抑郁症的发病率有所增加，而抑郁症患者中耳鸣的发病率也有所增加。据报道，耳鸣感知涉及多个布罗德曼区域（BA）。本研究的目的是评估伴有和不伴有耳鸣的抑郁症患者的局部脑血流量（rCBF）变化。比较了45例终生患有重度抑郁症的患者（其中27例有严重耳鸣）和26名正常健康受试者静息状态下的rCBF分布。使用三头γ相机进行了99m锝-六甲基丙烯胺肟（99mTc-HMPAO）单光子发射计算机断层扫描（SPECT），并通过计算机脑图谱评估了双侧大脑34个功能亚区的摄取情况。与无耳鸣患者相比，耳鸣患者右侧额叶BA45（P<0.05）、左侧顶叶BA39（P<0.00）和左侧视觉联合皮层BA（P<0.05）的rCBF降低。与性别匹配的对照组（P<0.00）和无耳鸣患者（P<0.05）相比，在一个或多个颞叶BA41+21+22中rCBF有明显改变的耳鸣患者比例增加。仅在耳鸣患者中，卡罗林斯卡人格量表中的特质焦虑量表与三个边缘BA中的rCBF呈正相关（P<0.01），而仅在无耳鸣患者中，与五个负责听觉感知和处理的BA呈负相关（P<0.05）。本研究发现了健康对照组与伴有和不伴有耳鸣的抑郁症患者之间的rCBF差异。rCBF改变分布在皮层，在听觉皮层中尤为明显。这些发现表明，在抑郁症的rCBF研究中，考虑听力症状可能会产生更一致 的结果。
