Department of Psychiatry, Cheng Hsin General Hospital, No. 45, Cheng Hsin St., Pai-Tou Destrict, Taipei City, Taiwan, ROC.
J Affect Disord. 2013 Sep 5;150(2):330-6. doi: 10.1016/j.jad.2013.04.014. Epub 2013 May 13.
We designed this study to investigate neural correlates of white matter micro-structural integrity of remitted patients with first-episode, medication-naïve and very late-onset panic disorder.
Twenty-one remitted patients with panic disorder completed treatment course with treatment of escitalopram (dose range around 10-15 mg/d). Twenty-one healthy controls were also enrolled into this study. Patients and controls all received 3-Tesla magnetic resonance imaging diffusion tensor imaging scanning at baseline and 6th week. We utilized FDT (FMRIB's Diffusion Toolbox v2.0) function of FSL (FMRIB Software Library) to calculate fractional anisotropy (FA). We compared FA values of patients and controls at baseline and 6th week to estimate the changes of FA of remitted patient group and inter-scan bias of controls. FA outputs of remitted patients and controls were compared by independent t test.
We found increased FA in some regions of right uncinate fasciculus and left fronoto-occipital fasciculus after remission in patient group (corrected p<0.05). Reduced FA of other regions of right uncinate fasciculus was still observed in remitted patients when they were compared to the control group.
Subtle changes of white matter micro-structural integrity after remission might represent neural correlates of treatment effects for first-episode, medication-naïve and very late-onset panic disorder.
本研究旨在探讨首发、未经药物治疗和极晚发性惊恐障碍缓解患者的白质微观结构完整性的神经相关性。
21 例缓解期惊恐障碍患者接受了艾司西酞普兰(剂量范围约为 10-15mg/d)的治疗疗程。同时招募了 21 名健康对照者。患者和对照组均在基线和第 6 周接受 3T 磁共振成像弥散张量成像扫描。我们使用 FSL(FMRIB 软件库)中的 FDT(FMRIB 的弥散工具箱 v2.0)功能计算各向异性分数(FA)。我们比较了患者和对照组在基线和第 6 周的 FA 值,以评估缓解组 FA 的变化和对照组的扫描间偏差。采用独立 t 检验比较缓解患者和对照组的 FA 输出。
我们发现患者组在缓解后右侧钩束和左侧额枕束的一些区域 FA 值增加(校正后 p<0.05)。与对照组相比,缓解后的患者右侧钩束的其他区域的 FA 值仍然较低。
缓解后白质微观结构完整性的细微变化可能代表首发、未经药物治疗和极晚发性惊恐障碍治疗效果的神经相关性。