Kim Seong-Jang, Song Sang Heon, Kim Ji Hoon, Kwak Ihm Soo
Department of Nuclear Medicine, Pusan National University Hospital, 1-10 Ami-dong, Seo-gu, Busan, South Korea.
Ann Nucl Med. 2008 Apr;22(3):201-6. doi: 10.1007/s12149-007-0108-x. Epub 2008 May 23.
The aim of this study is to investigate the relationship between regional cerebral blood flow (rCBF) and symptom clusters of depressive mood in pre-dialytic chronic kidney disease (CKD).
Twenty-seven patients with stage 4-5 CKD were subjected to statistical parametric mapping analysis of brain single-photon emission computed tomography. Correlation analyses between separate symptom clusters of depressive mood and rCBF were done.
The first factor (depressive mood) was negatively correlated with rCBF in the right insula, posterior cingulate gyrus, and left superior temporal gyrus, and positively correlated with rCBF in the left fusiform gyrus. The second factor (insomnia) was negatively correlated with rCBF in the right middle frontal gyrus, bilateral cingulate gyri, right insula, right putamen, and right inferior parietal lobule, and positively correlated with rCBF in left fusiform gyrus and bilateral cerebellar tonsils. The third factor (anxiety and psychomotor aspects) was negatively correlated with rCBF in the left inferior frontal gyrus, right superior frontal gyrus, right middle temporal gyrus, right superior temporal gyrus, and left superior frontal gyrus, and positively correlated with rCBF in the right ligual gyrus and right parahippocampal gyrus.
In this study, the separate symptom clusters were correlated with specific rCBF patterns similar to those in major depressive disorder patients without CKD. However, some areas with discordant rCBF patterns were also noted when compared with major depressive disorder patients. Further larger scale investigations are needed.
本研究旨在探讨透析前慢性肾脏病(CKD)患者局部脑血流量(rCBF)与抑郁情绪症状群之间的关系。
对27例4-5期CKD患者进行脑单光子发射计算机断层扫描的统计参数映射分析。对抑郁情绪的各个症状群与rCBF进行相关性分析。
第一个因素(抑郁情绪)与右侧岛叶、后扣带回和左侧颞上回的rCBF呈负相关,与左侧梭状回的rCBF呈正相关。第二个因素(失眠)与右侧额中回、双侧扣带回、右侧岛叶、右侧壳核和右侧顶下小叶的rCBF呈负相关,与左侧梭状回和双侧小脑扁桃体的rCBF呈正相关。第三个因素(焦虑和精神运动方面)与左侧额下回、右侧额上回、右侧颞中回、右侧颞上回和左侧额上回的rCBF呈负相关,与右侧舌回和右侧海马旁回的rCBF呈正相关。
在本研究中,各个症状群与特定的rCBF模式相关,这些模式与无CKD的重度抑郁症患者相似。然而,与重度抑郁症患者相比,也发现了一些rCBF模式不一致的区域。需要进一步进行更大规模的研究。