Pagani Marco, Gardner Ann, Salmaso Dario, Sánchez Crespo Alejandro, Jonsson Cathrine, Jacobsson Hans, Lindberg Greger, Wägner Anna, Hällström Tore, Larsson Stig A
Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy.
Eur J Nucl Med Mol Imaging. 2004 Jul;31(7):995-1004. doi: 10.1007/s00259-004-1457-5. Epub 2004 Feb 19.
Previous regional cerebral blood flow (rCBF) studies on patients with unipolar major depressive disorder (MDD) have analysed clusters of voxels or single regions and yielded conflicting results, showing either higher or lower rCBF in MDD as compared to normal controls (CTR). The aim of this study was to assess rCBF distribution changes in 68 MDD patients, investigating the data set with both volume of interest (VOI) analysis and principal component analysis (PCA). The rCBF distribution in 68 MDD and 66 CTR, at rest, was compared. Technetium-99m d, l-hexamethylpropylene amine oxime single-photon emission tomography was performed and the uptake in 27 VOIs, bilaterally, was assessed using a standardising brain atlas. Data were then grouped into factors by means of PCA performed on rCBF of all 134 subjects and based on all 54 VOIs. VOI analysis showed a significant group x VOI x hemisphere interaction ( P<0.001). rCBF in eight VOIs (in the prefrontal, temporal, occipital and central structures) differed significantly between groups at the P<0.05 level. PCA identified 11 anatomo-functional regions that interacted with groups ( P<0.001). As compared to CTR, MDD rCBF was relatively higher in right associative temporo-parietal-occipital cortex ( P<0.01) and bilaterally in prefrontal ( P<0.005) and frontal cortex ( P<0.025), anterior temporal cortex and central structures ( P<0.05 and P<0.001 respectively). Higher rCBF in a selected group of MDD as compared to CTR at rest was found using PCA in five clusters of regions sharing close anatomical and functional relationships. At the single VOI level, all eight regions showing group differences were included in such clusters. PCA is a data-driven method for recasting VOIs to be used for group evaluation and comparison. The appearance of significant differences absent at the VOI level emphasises the value of analysing the relationships among brain regions for the investigation of psychiatric disease.
以往针对单相重度抑郁症（MDD）患者的局部脑血流量（rCBF）研究，分析了体素簇或单个区域，结果相互矛盾，显示与正常对照组（CTR）相比，MDD患者的rCBF要么更高，要么更低。本研究的目的是评估68例MDD患者的rCBF分布变化，采用感兴趣区（VOI）分析和主成分分析（PCA）对数据集进行研究。比较了68例MDD患者和66例CTR患者静息状态下的rCBF分布。进行了锝-99m d，l-六甲基丙烯胺肟单光子发射断层扫描，并使用标准化脑图谱评估双侧27个VOI的摄取情况。然后，通过对所有134名受试者的rCBF进行PCA，并基于所有54个VOI，将数据分组为因子。VOI分析显示出显著的组×VOI×半球交互作用（P<0.001）。在P<0.05水平上，8个VOI（前额叶、颞叶、枕叶和中央结构）中的rCBF在组间存在显著差异。PCA确定了11个与组相互作用的解剖功能区域（P<0.001）。与CTR相比，MDD患者右侧联合颞顶枕叶皮质的rCBF相对较高（P<0.01），双侧前额叶（P<0.005）、额叶皮质（P<0.025）、颞叶前皮质和中央结构的rCBF相对较高（分别为P<0.05和P<0.001）。使用PCA在五组具有密切解剖和功能关系的区域中发现，与静息状态下的CTR相比，一组选定的MDD患者的rCBF更高。在单个VOI水平上，所有显示组间差异的8个区域都包含在这些组中。PCA是一种数据驱动的方法，用于重新构建用于组评估和比较的VOI。VOI水平上不存在的显著差异的出现，强调了分析脑区之间关系对精神疾病研究的价值。
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