摘要目的 探讨首发重性抑郁症患者扣带回区域神经纤维、执行功能损害状况及其相关影响因素.方法 25例首发重性抑郁症患者及24例对照,均经弥散张量成像(Diffusion Tensor Imaging,DTI)扫描及威斯康星测试(WCST),对2组各向异性值(FA)及WCST因子分做相关统计学分析.结果 男性抑郁组在左额中回(-29 24 32,16像素)、左颞上回(-36 -34 16,11像素)、左颞叶下回(-45 1 -15/-47-6 -9;16/10像素)及右扣带回(18 -2 29,22像素)的FA值较对照组降低;女性抑郁组主要在额下回(-42 23 4/45 24 6;15/21像素)、左中央前回(39 -44 -15,17像素)、右额中层(6 16 -18;10像素)、左颞上回(-55 -31 15;89像素)、左颞叶下回(-38 -12 -19;12像素)及右扣带前回(71 26 -9;15像素)(P<0.001,像素集合>10);扣带回感兴趣区分析结果仅在女性抑郁组发现右扣带前回的FA相对值降低(0.26±0.05/0.33±0.08;P=0.03).患者组右扣带前回与持续错误数(r=-0.49,P=0.03),右扣带中回与持续错误数(r=-0.56,P=0.01)线性相关存在,正常组间扣带回FA值与WCST执行改变未发现线性相关.结论 抑郁症患者扣带回区域存在神经纤维的完整性降低,可能是影响患者执行功能的病理生理基础这一.

abstractsObjective To investigate the white matter microstructural changes of cingulation and congni-tive function impairment in patient with major depression. Methods 25 middle-aged first episode patients and 24 nondepressed comparison participants were enrolled,and all the subjects scanned by diffusion tensor imaging and tested by Wisconsin Card Sorting Test. Correlation analysis was done respectively for both two groups with FA and WCST items. Results Male patients with depression decreased FA in the middle frontal lobe ( - 29 24 32,16 voxels),the left superior temporal lobe (-36 -34 16,11 voxels),the sub-gyral of temporal lobe ( -45 1 - 15/ - 47 - 6 - 9; 16/10 voxels) and the right lobe of cingulate (18 - 2 29,22 voxels). And the female patients with depression shows reduced FA in the inferior frontal lobe ( -42 23 4/45 24 6; 15/21 voxels) ,the left precentral gy-rus (39 -44 -15,17 voxels) ,the right medial frontal gyrus (6 16 -18; 10 voxels) ,the left superior temporal lobe ( -55 -31 15; 89 voxels) ,the sub-gyral of temporal lobe ( -38 - 12 - 19;12 voxels) and the right anterior cingulate gyrus (71 26 -9; 15 voxels) (P<0.001 ,cluster > 10 voxels). The Regions of interests analyze with cingulate only found reduced FA in the right lobe of female group(0.26 ±0.05,0.33 ±0.08; P=0.03). Correlation were found between the right anterior cingulate and Rpe (r= -0.49, P = 0. 03) ,the right middle cingulate and Rpe (r= -0.56, P = 0. 01) in depressed patients. No significant association were found in healthy control group(P> 0.05). Conclusion Cingulate white matter fiber is abnormal in first episode depression and these abnormalities may be one of the pathophysiology of major depression.