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中风后抑郁症患者小脑的形态学和代谢改变

Morphological and Metabolic Alteration of Cerebellum in Patients with Post-Stroke Depression.

作者信息

Zhang Ling, Sui Rubo, Zhang Lei, Zhang Zhuang

机构信息

Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.

出版信息

Cell Physiol Biochem. 2016;40(3-4):420-430. doi: 10.1159/000452557. Epub 2016 Nov 25.

Abstract

BACKGROUND

To study morphological and metabolic changes of cerebellum with multimodality magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS), respective, to explore correlation between cerebellum alteration and severity of depression in patients with post-stroke depression.

METHODS

60 subjects, including 40 stroke patients and 20 healthy volunteers were enrolled. Depression of stroke patients was tested by Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD), based on which stroke-patients were grouped into post-stroke depression (PSD group) and without post-stroke depression (CONT group).

RESULTS

Volume of cerebellum decreased in PSD group and CONT group compared with healthy volunteer (NORM) group. White matter of cerebellum in PSD group and CONT group was disrupted; such disruption was significantly in PSD group. In addition, there was correlation between cerebellum volume and FA and HDRS scores (P<00.01). The Cho/Cr and Cho/NAA ratios in cerebellum contralateral to stroke lesion in PSD were higher than those in NORM group (P<0.05). Cho/Cr and Cho/NAA ratios in contralateral cerebellum and ratio difference of Cho/Cr in bilateral cerebellum were positively correlated with HAMD scales (P<0.05).

CONCLUSION

Morphologic and metabolic alterations are evident in patients with post-stroke depression, indicating possible involvement of cerebellum in post-stroke-depression occurrence.

摘要

背景

分别采用多模态磁共振成像(MRI)和质子磁共振波谱(1H-MRS)研究小脑的形态和代谢变化,以探讨脑卒中后抑郁患者小脑改变与抑郁严重程度之间的相关性。

方法

纳入60名受试者,包括40名脑卒中患者和20名健康志愿者。采用自评抑郁量表(SDS)和汉密尔顿抑郁量表(HAMD)对脑卒中患者的抑郁情况进行测评,并据此将脑卒中患者分为脑卒中后抑郁组(PSD组)和非脑卒中后抑郁组(CONT组)。

结果

与健康志愿者(NORM)组相比,PSD组和CONT组的小脑体积均减小。PSD组和CONT组小脑白质均有破坏,且PSD组破坏更为明显。此外,小脑体积与FA及HDRS评分之间存在相关性(P<0.01)。PSD组中与脑卒中病变对侧小脑的Cho/Cr和Cho/NAA比值高于NORM组(P<0.05)。对侧小脑的Cho/Cr和Cho/NAA比值以及双侧小脑Cho/Cr的比值差异与HAMD量表呈正相关(P<0.05)。

结论

脑卒中后抑郁患者存在明显的形态和代谢改变,提示小脑可能参与了脑卒中后抑郁的发生。

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