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重度抑郁症患者脑血流变化的特征性分布:一项伪连续动脉自旋标记(pCASL)研究。

Characteristic distributions of regional cerebral blood flow changes in major depressive disorder patients: a pseudo-continuous arterial spin labeling (pCASL) study.

作者信息

Ota Miho, Noda Takamasa, Sato Noriko, Hattori Kotaro, Teraishi Toshiya, Hori Hiroaki, Nagashima Anna, Shimoji Keigo, Higuchi Teruhiko, Kunugi Hiroshi

机构信息

Department of Mental Disorder Research, National Institute of Neuroscience, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, Japan.

Department of Psychiatry, National Institute of Neuroscience, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, Japan.

出版信息

J Affect Disord. 2014 Aug;165:59-63. doi: 10.1016/j.jad.2014.04.032. Epub 2014 Apr 21.

DOI:10.1016/j.jad.2014.04.032
PMID:24882178
Abstract

BACKGROUND

Most previous studies that examined regional cerebral blood flow (rCBF) abnormalities in major depressive disorder (MDD) required the injection of radioisotopes into subjects. Here by using magnetic resonance imaging (MRI) with the pseudo-continuous arterial spin labeling (pCASL) method which does not require radioisotopes, we examined rCBF in patients with MDD in comparison with that in patients with schizophrenia and healthy subjects, taking the regional cerebral gray matter volume into account.

METHODS

Subjects were 27 patients with MDD, 42 with schizophrenia and 43 healthy volunteers who underwent 3-T MRI with pCASL. Obtained pCASL imaging data were subject to the voxel-by-voxel statistical analysis.

RESULTS

There were significant reductions of rCBF in the right inferior prefrontal cortex and anterior cingulate cortices (ACCs) in the MDD patients compared with the healthy controls. When compared with the schizophrenic patients, the MDD patients showed lower rCBF in the subgenual ACC and higher rCBF in left occipital region.

LIMITATION

The abnormalities of rCBF in MDD were known to reverse during symptom remission. Further study with follow-up period would bring the perception about the treatment response.

CONCLUSION

The rCBF reduction in the subgenual region may be a specific functional abnormality to MDD patients, which may provide a biological marker for MDD. The MRI with pCASL method is a promising tool to detect rCBF abnormalities controlling for gray matter volume in psychiatric disorders.

摘要

背景

以往大多数研究主要抑郁症(MDD)患者的局部脑血流(rCBF)异常时,都需要向受试者注射放射性同位素。在此,我们使用无需放射性同位素的伪连续动脉自旋标记(pCASL)方法进行磁共振成像(MRI),在考虑局部脑灰质体积的情况下,对MDD患者与精神分裂症患者及健康受试者的rCBF进行了检测。

方法

研究对象为27例MDD患者、42例精神分裂症患者和43名健康志愿者,他们均接受了3-T的pCASL-MRI检查。对获得的pCASL成像数据进行逐体素统计分析。

结果

与健康对照组相比,MDD患者右侧额下回和前扣带回皮质(ACC)的rCBF显著降低。与精神分裂症患者相比,MDD患者膝下前扣带回皮质的rCBF较低,而左侧枕叶区域的rCBF较高。

局限性

已知MDD患者的rCBF异常在症状缓解期会逆转。进一步的随访研究将有助于了解治疗反应。

结论

膝下区域的rCBF降低可能是MDD患者特有的功能异常,这可能为MDD提供一个生物学标志物。采用pCASL方法的MRI是检测精神疾病中控制灰质体积的rCBF异常的一种有前景的工具。

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