Li J, Li G X, Guo Y, Lu X Q, Li L, Ding J P
Department of Radiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Hangzhou 310015, China.
Zhonghua Yi Xue Za Zhi. 2018 Jan 16;98(3):196-201. doi: 10.3760/cma.j.issn.0376-2491.2018.03.008.
To explore the changes of the brain regional homogeneity (ReHo) in the patients of irritable bowel syndrome (IBS) complicated with depression by using resting-state functional magnetic resonance imaging (rs-fMRI) and to investigate the relation between abnormal brain function and depression in those patients. A total of 35 patients with IBS were included in this study, collected in Gastroenterology Department of Affiliated Hospital of Hangzhou Normal University from June 2015 to June 2017.According to Hamilton's Depression Scale (HAMD)-17 score, the IBS patients was divided into two groups: IBS with depression group, 21 cases and non-depression group, 14 cases.Thirty-six healthy controls were recruited at the mean time (gender, age and years of education were matched with the patients). Rs-fMRI and 3D T1 data were acquired with 3.0 T scanners.For all subjects, ReHo, a method measuring the synchronism of regional spontaneous activities, was calculated and one-way ANOVA was performed to assess the group effects.For those regions with significant group effects, correlation between ReHo values and GSRS and HAMD scores was analyzed too. Significant group effects were found in multiple regions: the right pons, the left inferior temporal gyrus (ITG)/fusiform, the left superior temporal gyrus (STG)/temporal pole, the right inferior frontal gyrus (IFG), the right middle occipital gyrus (MOG), the right caudate nucleus, the left posterior cingulate cortex/precuneus (pCC/pC), the left postcentral gyrus, the right inferior parietal lobule (IPF). Compared with control group, all the two patient groups had increased ReHo values in the left pCC/pC, the right IPF, the left postcentral gyrus and the left STG/temporal pole; all the two patient groups had decreased ReHo values in the right MOG and the right IFG.Compared with non-depression group, depression group had increased ReHo values in the right caudate nucleus, and decreased ReHo values in the right pons, the left pCC/pC, the right IPF, the left postcentral gyrus.Particularly, there was no significant difference in the ReHo value in the right caudate nucleus between the control group and the non-depressed IBS group.In the depression group, significantly positive correlations were observed between ReHo values and HAMD scores in the left pCC/pC (=0.599, =0.011), and significantly positive correlations were observed between ReHo values and GSRS in the left postcentral gyrus (=0.547, =0.023). IBS patients have abnormal ReHo regions in default network and pain regulation-associated brain area.IBS with depressed patients has its own characteristics in the brain regions which related with pain perception and self-regulation.IBS could has an abnormal self-regulation of visceral pain, which is associated with the occurrence of depression.Depression can aggravate the disorders of pain perception and other functions of IBS patients.
采用静息态功能磁共振成像(rs-fMRI)探讨肠易激综合征(IBS)合并抑郁症患者脑区局部一致性(ReHo)的变化,并研究这些患者脑功能异常与抑郁症之间的关系。本研究共纳入35例IBS患者,于2015年6月至2017年6月在杭州师范大学附属医院消化内科收集。根据汉密尔顿抑郁量表(HAMD)-17评分,将IBS患者分为两组:IBS合并抑郁症组,21例;非抑郁症组,14例。同时招募36名健康对照者(性别、年龄和受教育年限与患者匹配)。使用3.0T扫描仪采集rs-fMRI和3D T1数据。对所有受试者计算测量区域自发活动同步性的方法ReHo,并进行单因素方差分析以评估组间效应。对于有显著组间效应的区域,还分析了ReHo值与胃肠症状评分量表(GSRS)和HAMD评分之间的相关性。在多个区域发现了显著的组间效应:右侧脑桥、左侧颞下回(ITG)/梭状回、左侧颞上回(STG)/颞极、右侧额下回(IFG)、右侧枕中回(MOG)、右侧尾状核、左侧后扣带回皮质/楔前叶(pCC/pC)、左侧中央后回、右侧顶下小叶(IPF)。与对照组相比,两个患者组在左侧pCC/pC、右侧IPF、左侧中央后回和左侧STG/颞极的ReHo值均升高;两个患者组在右侧MOG和右侧IFG的ReHo值均降低。与非抑郁症组相比,抑郁症组在右侧尾状核的ReHo值升高,在右侧脑桥、左侧pCC/pC、右侧IPF、左侧中央后回的ReHo值降低。特别地,对照组与非抑郁IBS组在右侧尾状核的ReHo值无显著差异。在抑郁症组中,左侧pCC/pC的ReHo值与HAMD评分之间观察到显著正相关(r = 0.599,P = 0.011),左侧中央后回的ReHo值与GSRS之间观察到显著正相关(r = 0.547,P = 0.023)。IBS患者在默认网络和疼痛调节相关脑区存在ReHo异常区域。IBS合并抑郁症患者在与疼痛感知和自我调节相关的脑区有其自身特点。IBS可能存在内脏痛自我调节异常,这与抑郁症的发生有关。抑郁症可加重IBS患者的疼痛感知及其他功能障碍。