Zhang Lei, Li Muzi, Sui Rubo
School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China.
Department of Neurology, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China.
Oncotarget. 2017 Sep 19;8(53):91711-91722. doi: 10.18632/oncotarget.21063. eCollection 2017 Oct 31.
The neurochemical changes that occur in the brain of patients with post-stroke depression (PSD) are not fully understood. This study aims to explore the correlation between cerebellar metabolism changes and PSD using proton magnetic resonance spectroscopy (H-MRS). Participants were assigned to 3 groups: 60 patients with PSD (PSD group), 60 stroke patients without depression (NOPSD group), and 60 healthy volunteers (HEAL group). T1 WI, T2 WI, DWI and H-MRS examination were performed for patients at 14 days, 3 months after the stroke, respectively, and for healthy volunteers once when included in the study. Cho/Cr and Cho/NAA ratios in the cerebellar hemisphere contralateral to the lesion were higher in the PSD group than those in the HEAL and NOPSD groups on 14th day after the stroke ( < 0.05). In PSD group, Cho/Cr and Cho/NAA ratios in the cerebellar hemisphere contralateral to the lesion were positively correlated to the HAMD scale scores at both 14 days and 3 months after stroke ( < 0.05); Higher Cho/Cr and Cho/NAA ratios, and lower NAA/Cr ratio in the cerebellar hemisphere contralateral to the lesion were observed at 3 months after stroke compared to that at 14 days after stroke. Cerebellar damage may lead to PSD, and the degree of cerebellar damage may be associated with severity of PSD.
中风后抑郁症(PSD)患者大脑中发生的神经化学变化尚未完全明确。本研究旨在使用质子磁共振波谱(H-MRS)探讨小脑代谢变化与PSD之间的相关性。参与者被分为3组:60例PSD患者(PSD组)、60例无抑郁症的中风患者(非PSD组)和60名健康志愿者(健康组)。分别在中风后14天、3个月对患者进行T1 WI、T2 WI、DWI和H-MRS检查,对健康志愿者在纳入研究时进行一次检查。中风后第14天,PSD组病变对侧小脑半球的Cho/Cr和Cho/NAA比值高于健康组和非PSD组(<0.05)。在PSD组中,病变对侧小脑半球的Cho/Cr和Cho/NAA比值在中风后14天和3个月均与HAMD量表评分呈正相关(<0.05);与中风后14天相比,中风后3个月病变对侧小脑半球的Cho/Cr和Cho/NAA比值更高,NAA/Cr比值更低。小脑损伤可能导致PSD,且小脑损伤程度可能与PSD的严重程度相关。