Wang Yiming, Zhang Hongming, Tang Songlin, Liu Xingde, O'Neil Adrienne, Turner Alyna, Chai Fangxian, Chen Fanying, Berk Michael
Department of Psychiatry, Hospital Affiliated to Guiyang Medical University, Guiyang, Guizhou, China.
Department of Cardiology, The General Hospital of Jinan Military Region, Jinan, China.
PLoS One. 2014 Sep 24;9(9):e107735. doi: 10.1371/journal.pone.0107735. eCollection 2014.
While there is evidence that the development and course of major depressive disorder (MDD) symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT), to assess regional cerebral blood flow (rCBF) in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24) score > 20, and Self-Rating Depression Scale (SDS) score > 53) and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD) ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI). 16 subjects (8 = MDD; 8 = healthy) also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\middle\low shear rate)and hematocrit (HCT) were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.
虽然有证据表明重度抑郁症（MDD）症状的发展和病程与血管疾病有关，且该疾病存在能量利用方面的变化，但目前尚不清楚这种情况下脑血流量改变的程度。本研究采用一种先前用于冠心病和中风患者的新型成像技术——320层计算机断层扫描（CT），来评估MDD患者的局部脑血流量（rCBF），并研究局部脑灌注模式。研究了39名有抑郁症状的参与者（汉密尔顿抑郁量表24项（HAMD24）评分>20，自评抑郁量表（SDS）评分>53）和41名健康志愿者。对所有受试者采集3毫升静脉血以评估血液学参数。利用经颅多普勒（TCD）超声测量脑动脉rCBFV参数并分析搏动指数（PI）。16名受试者（8名MDD患者；8名健康者）还使用320层CT测量了不同脑动脉区域的rCBF。采用方差分析（ANOVA）分析组间差异，并在统计分析中采用Pearson检验。与对照组相比，MDD组全血粘度（包括高、中、低剪切率）和血细胞比容（HCT）显著升高。抑郁参与者不同脑动脉区域的PI值和脑动脉rCBFV参数降低，且灰质和白质中rCBFV与相应血管rCBF之间呈正相关。MDD患者左侧灰质的rCBF低于右侧。重度抑郁症的特征是广泛的CBF损害和灰质血流的显著变化。320层CT似乎是测量rCBF的有效且有前景的工具，因此可用于精神科环境中作为生物标志物和治疗反应评估。
