Chen Y, Wu M X, Gong J S, Zou L Y, Xu J M, Zhu J, Li G
Department of Radiology , the Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China.
Zhonghua Yi Xue Za Zhi. 2018 Aug 21;98(31):2471-2475. doi: 10.3760/cma.j.issn.0376-2491.2018.31.004.
To investigate the alterations of the volumes and 3D shapes of fifteen subcortical nucleus in patients with post-stroke depression (PSD) and to explore the pathogenesis regularity and mechanism of early PSD. From 2015 to 2017, a total of 28 patients with PSD and 18 stroke patients without depression (PSND), 13 patients with depression (De) and 11 cases of healthy volunteers (NC) were enrolled to perform 3.0 T high resolution MRI.Computer automatic segmentation and vertex analysis were used to segment and measure the volume of bilateral nucleus accumbens, caudate nucleus, putamen, globus pallidus, thalamus, hippocampus, mygdale and brainstem. The volume of bilateral nucleus accumbens and bilateral thalamus, left pallidum were different among groups with statistical difference (<0.05). The nucleus volume of the PSD group was (415±128) mm(3) (L-Nac)/(303±90) mm(3) (R-Nac), (7 590±867) mm(3) (L-Th)/(7 459±905) mm(3) (R-Th), (1 675±328) mm(3) (L-Pa), which was smaller than that of PSND group (433±100) mm(3) /(307±88) mm(3), (7 999±961) mm(3) /(7 753± 955) mm(3), (1 790±286) mm(3) and other groups.The nuclei with significantly statistical differences between inter-group were found in following: between PSD group and NC group, right accumbens and bilateral thalamus (<0.01); between PSD group and De group, right accumbens and right thalamus (<0.001), left accumbens, left pallidum and left thalamus (<0.01); between PSND group and NC group, right accumbens (<0.05); between PSND group and De group, right accumbens (<0.001), left accumbens and right thalamus (<0.05). Significant differences in morphology changes of nuclei (<0.05) by test mainly located on the top and tail of right accumbens, the anterior and middle body of right caudate nucleus, the most part of bilateral thalamus, the ventromedial body of bilateral hippocampus, the anterior and body of left caudate nucleus, especially in left thalamus. PSD has abnormal volume and morphological structure of subcortical nuclei, which supports the role of subcortical structures changes in the pathophysiology and pathogenesis of early PSD.
探讨脑卒中后抑郁（PSD）患者15个皮质下核团体积及三维形态的改变，以探索早期PSD的发病规律及机制。2015年至2017年，共纳入28例PSD患者、18例无抑郁的脑卒中患者（PSND）、13例抑郁症患者（De）和11例健康志愿者（NC），进行3.0T高分辨率磁共振成像检查。采用计算机自动分割和顶点分析方法，对双侧伏隔核、尾状核、壳核、苍白球、丘脑、海马、杏仁核及脑干进行分割并测量体积。双侧伏隔核、双侧丘脑及左侧苍白球体积在各组间存在差异，有统计学意义（<0.05）。PSD组伏隔核体积为（415±128）mm³（左侧伏隔核）/（303±90）mm³（右侧伏隔核），丘脑体积为（7590±867）mm³（左侧丘脑）/（7459±905）mm³（右侧丘脑），苍白球体积为（1675±328）mm³（左侧苍白球），均小于PSND组[（433±100）mm³/（307±88）mm³，（7999±961）mm³/（7753±955）mm³，（1790±286）mm³]及其他组。组间具有显著统计学差异的核团如下：PSD组与NC组之间，右侧伏隔核及双侧丘脑（<0.01）；PSD组与De组之间，右侧伏隔核及右侧丘脑（<0.001），左侧伏隔核、左侧苍白球及左侧丘脑（<0.01）；PSND组与NC组之间，右侧伏隔核（<0.05）；PSND组与De组之间，右侧伏隔核（<0.001），左侧伏隔核及右侧丘脑（<0.05）。经检验，核团形态变化有显著差异（<0.05），主要位于右侧伏隔核的顶部和尾部、右侧尾状核的前体和中体、双侧丘脑的大部分、双侧海马的腹内侧体、左侧尾状核的前体和主体，尤其是左侧丘脑。PSD患者存在皮质下核团体积及形态结构异常，这支持了皮质下结构改变在早期PSD病理生理及发病机制中的作用。
