Pujol J, Bello J, Deus J, Martí-Vilalta J L, Capdevila A
Magnetic Resonance Center of Pedralbes, Creu Roja Hospital, Hospitalet de Llobregat, Barcelona, Spain.
Neurology. 1997 Oct;49(4):1105-10. doi: 10.1212/wnl.49.4.1105.
Depression is a common mood disturbance in multiple sclerosis (MS) patients. Epidemiologic data suggest a causative relationship between depressive symptoms and cerebral demyelination, although a specific lesion site responsible for depressed mood has not been identified. Given that depression in neurologic disease is closely related to frontal and temporal lobe damage, we focused our study on investigating the extent to which lesions in the white matter connecting both cerebral lobes may account for depressive symptoms in MS. Forty-five patients were assessed using the Beck Depression Inventory and an MRI protocol conceived to quantify lesions separately in the basal, medial, and lateral frontotemporal white matter. The presence of lesions in the left suprainsular white matter, the region that mainly includes the arcuate fasciculus, was specifically associated with depressive symptoms, accounting for a significant 17% of the depression score variance. Although a multifactorial origin is suspected for depression in MS, this finding gives support to the existence of a direct negative effect of demyelination on mood.
抑郁症是多发性硬化症（MS）患者常见的情绪障碍。流行病学数据表明抑郁症状与脑脱髓鞘之间存在因果关系，尽管尚未确定导致情绪低落的具体病变部位。鉴于神经疾病中的抑郁症与额叶和颞叶损伤密切相关，我们将研究重点放在调查连接两个脑叶的白质病变在多大程度上可能导致MS患者出现抑郁症状。我们使用贝克抑郁量表对45名患者进行了评估，并采用了一种MRI方案来分别量化基底、内侧和外侧额颞叶白质中的病变。左侧岛叶上白质（主要包括弓状束的区域）出现病变与抑郁症状显著相关，该病变可解释抑郁评分差异的17%。尽管怀疑MS患者的抑郁症有多种因素起源，但这一发现支持了脱髓鞘对情绪存在直接负面影响的观点。
