Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
Department of Nuclear Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, China.
BMC Psychiatry. 2018 Mar 21;18(1):70. doi: 10.1186/s12888-018-1654-6.
Major depressive disorder (MDD) is a common mental disorder worldwide, but now there is a lack of clinically effective assessment and management of MDD. In this study, we used technetium-99 m ethylcysteinate dimer ([Tc]ECD) SPECT/CT to characterize the regional cerebral blood flow (rCBF) status of MDD patients, and to explore an objective image assessment model of MDD which is non- or minimally-invasive, convenient and accurate in a clinical setting.
The severity of MDD was assessed by three trained psychiatrists, based on scores obtained from HAMD and HAMA. [Tc]ECD rCBF SPECT/CT was performed in 20 healthy controls and 74 unipolar MDD patients before receiving the treatment. The CT attenuation-corrected SPECT images data were automatically registered, analyzed simultaneously by 3D-SSP and eZIS.
The mean score of HAMD and HAMA in the MDD patients was 25.49 ± 6.00, and 23.12 ± 5.83, respectively. There was a positive correlation between two scores. The MDD women had higher HAMD scores than MDD men. The decreased rCBF of MDD patients in frontal lobes (bilateral B11, B47 and right B4, B6, B10, B46), temporal lobe (right B21, B41, B42) and cingulated cortex (bilateral B24, B33), while their increased rCBF in occipital lobe (bilateral B17, B19 and left B18). Additionally, the depression severity was negatively correlated with decreased rCBF in left ventral anterior cingulate cortex B24, and was positively correlated with decreased rCBF in left inferior prefrontal gyrus B47 and increased rCBF in right associative visual cortex B19. The anxiety severity was negatively correlated with decreased rCBF in left subgenual cortex B25.
Although the mechanism underlying the correlation is not yet fully understood, our findings indicated that the rCBF SPECT/CT may provide an objective assessment for MDD severity. It might be used monitoring therapeutic efficacy in the management of MDD.
重度抑郁症（MDD）是一种常见的精神障碍，全球范围内均有发生，但目前临床上缺乏对 MDD 进行有效评估和管理的方法。在本研究中，我们使用锝-99 甲基乙基半胱氨酸二聚体 ([Tc]ECD) SPECT/CT 来描述 MDD 患者的区域性脑血流（rCBF）状态，并探索一种客观的、非侵入性或微创性、方便且准确的 MDD 影像评估模型。
由 3 位经过培训的精神科医生根据汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）的评分来评估 MDD 的严重程度。对 20 名健康对照者和 74 名未接受治疗的单相 MDD 患者进行 [Tc]ECD rCBF SPECT/CT 检查。CT 衰减校正后的 SPECT 图像数据由 3D-SSP 和 eZIS 自动配准和同步分析。
MDD 患者的 HAMD 和 HAMA 平均评分分别为 25.49±6.00 和 23.12±5.83，两者呈正相关。女性 MDD 患者的 HAMD 评分高于男性 MDD 患者。MDD 患者额叶（双侧 B11、B47 和右侧 B4、B6、B10、B46）、颞叶（右侧 B21、B41、B42）和扣带回皮质（双侧 B24、B33）的 rCBF 降低，而枕叶（双侧 B17、B19 和左侧 B18）的 rCBF 升高。此外，抑郁严重程度与左侧腹侧前扣带回皮质 B24 的 rCBF 降低呈负相关，与左侧额下回 B47 的 rCBF 降低和右侧联合视觉皮质 B19 的 rCBF 升高呈正相关。焦虑严重程度与左侧穹窿下皮质 B25 的 rCBF 降低呈负相关。
尽管其相关机制尚未完全阐明，但我们的研究结果表明，rCBF SPECT/CT 可能为 MDD 严重程度提供客观评估。它可能被用于监测 MDD 治疗的疗效。
