1.400038 重庆,陆军军医大学(第三军医大学)第一附属医院:医学心理科
2.400038 重庆,陆军军医大学(第三军医大学)第一附属医院:放射科
Received:16 April 2019,
Revised:2019-05-15,
Published:30 September 2019
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Daiyan LIU, Yao WANG, Xianling HU, et al. Diffusion tensor imaging of the white matter in young adults aged 18-25 years with first-episode major depression disorder[J]. Journal of Third Military Medical University, 2019, 41(18): 1807-1814.
Daiyan LIU, Yao WANG, Xianling HU, et al. Diffusion tensor imaging of the white matter in young adults aged 18-25 years with first-episode major depression disorder[J]. Journal of Third Military Medical University, 2019, 41(18): 1807-1814. DOI: 10.16016/j.1000-5404.201904124.
目的
2
利用弥散张量成像技术(diffusion tensor imaging
DTI)探索青年中期人群(18~25岁)首发重度抑郁障碍(major depression disorder,MDD)脑白质神经环路结构的改变,以及脑白质神经环路结构改变与抑郁程度和病程的关系。
方法
2
选取2018年6-12月本院医学心理科青年中期MDD人群23例为抑郁症组,选取健康志愿者25例为对照组。两组均进行流调中心用抑郁量表(center for epidemiological studies depression scale
CES-D)和9条患者健康问卷(the 9-item patient health questionnaire
PHQ-9)测试,并进行磁共振扫描,获取DTI图像,利用基于纤维束示踪的空间统计分析方法(tract-based spatial statistics,TBSS)进行分析,通过无阈值簇群增强(threshold-free cluster enhancement
TFCE)方法进行多重比较校正,比较两组被试各向异性分数(fractional anisotropy
FA)、径向扩散系数(radial diffusivity
RD)、平均扩散系数(mean diffusion
MD)以及轴向扩散系数(axial diffusivity
AD)的差异,对两组纤维束有差异区域的FA值、RD值与PHQ-9评分和病程进行相关性分析。
结果
2
与对照组比较,抑郁症组左侧上纵束、右侧丘脑前辐射以及双侧皮质脊髓束FA值下降(TFCE
P
<
0.05),左侧上纵束RD值升高(TFCE
P
<
0.05),两组MD值和AD值差异无统计学意义;左侧上纵束RD值与病程呈正相关(
r
=0.534
P
<
0.05),左侧皮质脊髓束FA值与病程呈负相关(
r
=-0.659
P
<
0.05),左侧上纵束、右侧丘脑前辐射以及双侧皮质脊髓束的FA值和RD值与PHQ-9评分无显著相关(
P
>
0.05)。
结论
2
青年中期首发MDD人群存在脑白质神经环路的改变,其改变可能与青年中期人群MDD病程有关。
Objective
2
To investigate the microstructural alternations of the white matter nerve circuit detected by diffusion tensor imaging (DTI) in young adults aged 18-25 years with first-episode major depression disorder (MDD) and explore the association of such changes with the symptoms and disease course of depression.
Methods
2
From June to December
2018
23 young adults aged 18-25 years with the diagnosis of MDD were recruited from the Department of Medical Psychology of our hospital as the depression group
with 25 age-matched healthy volunteers as the control group. All the participants were tested using the Center for Epidemiological Studies Depression Scale (CDS-D) and the 9-item Patient Health Questionnaire (PHQ-9)
and DTI images were obtained by magnetic resonance scanning and analyzed using tract-based spatial statistics (TBSS) method. Correction for multiple comparisons was carried out using a threshold-free cluster enhancement (TFCE) method. The differences in the fractional anisotropy (FA)
radial diffusivity (RD)
mean diffusion (MD) and axial diffusivity (AD) between the 2 groups were analyzed. The correlations of FA
RD
MD and AD values in the brain regions showing microstructural alternations with the PHQ-9 scores and the disease course were also analyzed.
Results
2
Compared with the healthy volunteers
the patients with first-episode MDD showed significantly decreased FA values in the left superior longitudinal tract
the right anterior thalamic radiation and the bilateral corticospinal tract (
P
<
0.05) and increased RD values in the left superior
longitudinal tract (
P
<
0.05); the MD and AD values did not differ significantly between the two groups. In the patients with MDD
the RD values of the left superior longitudinal tract was positively correlated with the disease course (
r
=0.534
P
<
0.05)
and the FA values of the left corticospinal tract was negatively correlated with the disease course (
r
=-0.659
P
<
0.05); The FA and RD values of the left superior longitudinal tract
the right anterior thalamic radiation and the bilateral corticospinal tract were not significantly correlated with the PHQ-9 scores (
P
>
0.05).
Conclusion
2
The patients with MDD in their early adulthood have obvious alternations of the white matter fiber nerve circuit
which can be related with the disease course of MDD.
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