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度洛西汀治疗 6 周后,首发未用药的伴有惊恐障碍的抑郁症患者缓解后额区局部一致性增加,颞区局部一致性降低。

Frontal regional homogeneity increased and temporal regional homogeneity decreased after remission of first-episode drug-naïve major depressive disorder with panic disorder patients under duloxetine therapy for 6 weeks.

机构信息

Department of Psychiatry, Buddhist Tzu-Chi General Hospital, Taipei Branch, Taipei, Taiwan.

出版信息

J Affect Disord. 2012 Feb;136(3):453-8. doi: 10.1016/j.jad.2011.11.004. Epub 2011 Dec 1.

Abstract

OBJECTIVE

We designed this study to investigate the changes of regional homogeneity (ReHo) after a 6-week duloxetine therapy in first-episode drug-naïve major depressive disorder with panic disorder (FEMDDPD) patients.

METHOD

3T magnetic resonance imaging (MRI) scanning and ReHo functional MRI analysis were performed on 15 patients (male: 5; female: 10; age: 35.87±9.59 years old) at baseline and remitted status (sixth week) compared with 15 healthy control subjects (male: 4; female: 11; age: 34.30±9.87 years old) which were scanned twice within 6 weeks. The ReHo was analyzed by the REST toolbox (resting-state functional MRI data analysis toolbox). The ReHos of different time-points were compared by using paired t test function of REST.

RESULTS

ReHo increased in right superior frontal cortex, right medial frontal cortex and decreased in right superior temporal cortex (uncorrected p<0.00005, cluster threshold>20, surface connected theory) after remission of symptoms in these FEMDDPD patients within 6 weeks (improvements of clinician rating and self rating scale scores; post-hoc corrected p<0.001). No significant changes of ReHo were observed in the controls within 6 weeks (uncorrected p<0.1, no cluster threshold setting, surface connected theory). The changes of ReHo value were mildly correlated with improvements of clinical rating scales with age, gender, depression and anxiety severity as covariates.

CONCLUSION

Our study suggested that differential modulations inside the default mode network probably were associated with remission of FEMDDPD symptoms after duloxetine therapy.

摘要

目的

本研究旨在探讨首发未用药伴惊恐障碍的抑郁症(FEMDDPD)患者经 6 周度洛西汀治疗后局部一致性(ReHo)的变化。

方法

对 15 例患者(男 5 例,女 10 例,年龄 35.87±9.59 岁)进行了 3T 磁共振成像(MRI)扫描和 ReHo 功能 MRI 分析,分别在基线和缓解期(第 6 周)与 15 名健康对照者(男 4 例,女 11 例,年龄 34.30±9.87 岁)进行了比较,15 名健康对照者在 6 周内进行了两次扫描。采用 REST 工具包(静息态功能 MRI 数据分析工具包)对 ReHo 进行分析。采用 REST 的配对 t 检验函数比较不同时间点的 ReHo。

结果

在这些 FEMDDPD 患者的症状缓解后 6 周内(临床医生评分和自我评分量表评分的改善;事后校正 p<0.001),右侧额上回、右侧额内侧回的 ReHo 增加,右侧颞上回的 ReHo 减少(未校正 p<0.00005,簇阈值>20,表面连通理论)。在 6 周内,对照组的 ReHo 没有明显变化(未校正 p<0.1,无聚类阈值设置,表面连通理论)。ReHo 值的变化与年龄、性别、抑郁和焦虑严重程度作为协变量的临床评分量表的改善呈轻度相关。

结论

本研究表明,默认模式网络内的差异调节可能与度洛西汀治疗后 FEMDDPD 症状的缓解有关。

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