Dunn Robert T, Willis Mark W, Benson Brenda E, Repella Jennifer D, Kimbrell Tim A, Ketter Terence A, Speer Andrew M, Osuch Elizabeth A, Post Robert M
Biological Psychiatry Branch, National Institute of Mental Health, NIH, 10 Center Drive MSC 1272, Bethesda, MD 20892-1272, USA.
Psychiatry Res. 2005 Nov 30;140(2):181-98. doi: 10.1016/j.pscychresns.2005.07.005.
Cerebral metabolism (CMR for glucose or oxygen) and blood flow (CBF) have been reported to be closely correlated in healthy controls. Altered relationships between CMR and CBF have been reported in some brain disease states, but not others. This study examined relationships between global and regional CMRglu vs. CBF in controls and medication-free primary affective disorder patients. Nine bipolars, eight unipolars, and nine healthy controls had [15O]-water positron emission tomography (PET) scans at rest, and [18F]-fluorodeoxyglucose PET scans during an auditory continuous performance task. Patients had [15O]-water and FDG PET scans in tandem the same day; controls had an average of 45+/-27 days between scans. Maps of regional coupling were constructed for each subject group. In controls and bipolars, global and virtually all regional correlation coefficients for CMRglu and CBF were positive, albeit more robustly so in controls. However, correlative relationships in unipolars were qualitatively different, such that global and most regional measures of flow and metabolism were not positively related. Unipolars had significantly fewer positive regional correlation coefficients than healthy controls and bipolars. These were significantly different from controls in orbital cortex, anterior cingulate, posterior cingulate, and posterior temporal cortex, and different from bipolars in pregenual anterior cingulate. In unipolars, the degree of flow-metabolism uncoupling was inversely correlated with Hamilton depression scores, indicating the severity of uncoupling was directly related to the severity of depression. These preliminary data suggest abnormal relationships between cerebral metabolism and blood flow globally and regionally in patients with unipolar depression that warrant replication and extension to potential pathophysiological implications.
据报道，在健康对照者中，脑代谢（葡萄糖或氧的脑代谢率）与脑血流量（CBF）密切相关。在一些脑部疾病状态下，脑代谢率与脑血流量之间的关系发生了改变，但在其他疾病状态下并非如此。本研究调查了未服用药物的原发性情感障碍患者和对照者中整体及局部葡萄糖代谢率（CMRglu）与脑血流量之间的关系。9名双相情感障碍患者、8名单相情感障碍患者和9名健康对照者在静息状态下进行了[15O] - 水正电子发射断层扫描（PET），并在听觉持续操作任务期间进行了[18F] - 氟脱氧葡萄糖PET扫描。患者在同一天依次进行[15O] - 水和氟代脱氧葡萄糖PET扫描；对照者两次扫描之间的平均间隔时间为45±27天。为每个受试者组构建了局部耦合图。在对照者和双相情感障碍患者中，葡萄糖代谢率和脑血流量的整体及几乎所有局部相关系数均为正值，尽管对照者中的相关性更强。然而，单相情感障碍患者中的相关关系在性质上有所不同，即整体和大多数局部的血流和代谢指标并非正相关。单相情感障碍患者的局部正相关系数显著少于健康对照者和双相情感障碍患者。这些区域在眶额皮质、前扣带回、后扣带回和颞叶后皮质与对照者有显著差异，在膝前扣带回与双相情感障碍患者有差异。在单相情感障碍患者中，血流 - 代谢解偶联程度与汉密尔顿抑郁评分呈负相关，表明解偶联的严重程度与抑郁的严重程度直接相关。这些初步数据表明，单相抑郁症患者在整体和局部水平上脑代谢与脑血流量之间存在异常关系，这值得进一步重复研究并扩展至潜在的病理生理学意义。
