扩散张量成像评价抑郁症和抑郁高血压共病患者脑区改变

目的 应用DTI探讨抑郁症患者脑区改变情况及高血压对抑郁症的影响。方法 纳入25例抑郁症(抑郁症组)、25例高血压(高血压组)、21例抑郁高血压共病(共病组)患者和22名健康志愿者(对照组)。对所有受试者进行DTI检查,获得FA及ADC参数图,比较4组间不同脑区FA值和ADC值差异;评价差异脑区平均FA值与17项汉密尔顿抑郁量表(HAMD₁₇)评分的相关性。结果 与对照组比较,抑郁症组FA值下降脑区包括右侧海马旁回、右侧额下回、右侧楔前叶、右侧杏仁核和左侧枕中回;共病组FA值下降脑区包括双侧尾状核、右侧额上回、右侧海马旁回、右侧岛叶、右侧颞极、右侧丘脑、右侧楔前叶和右侧苍白球;高血压组FA值未见明显差异。各组ADC值差异无统计学意义。抑郁症组右侧海马旁回、右侧杏仁核,共病组右侧海马旁回、右侧岛叶、右侧颞极、右侧苍白球、左侧尾状核的平均FA值与HAMD₁₇评分呈负相关(P均<0.05)。结论 DTI中抑郁症和高血压共病患者较抑郁症患者FA值下降脑区增多,高血压可能对抑郁症存在协同作用。

Diffusion tensor imaging in assessing diffusion changes of brain regions in patients with depression and comorbid hypertension and depression

Objective To explore the diffusion changes of brain regions in patients with depression and the influences of hypertension on depression using DTI. Methods Twenty-five depression patients (depression group), 25 hypertension patients (hypertension group), 21 patients with comorbid hypertension and depression (comorbid group) and 22 healthy volunteers (control group) were recruited. DTI was performed on all the subjects to obtain the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps. FA and ADC value among different groups were compared and the correlations between FA value in brain regions with changed FA and depression score evaluated by Hamilton depression scale (HAMD₁₇) were analyzed. Results The FA values of the right parahippocampal gyrus, right inferior frontal gyrus, right precuneus, right amygdale and left middle occipital gyrus in depression group, and of bilateral caudate nucleus, right superior frontal gyrus, right parahippocampal gyrus, right insula, right temporal pole, right thalamus, right precuneus and right pallidum in comorbid group decreased compared with control group. The mean FA values in hypertension patients had no significant changes. The ADC values were not significantly different among the four groups. The FA value of right parahippocampal gyrus, right amygdale in depression group and of right parahippocampal gyrus, right insula, right temporal pole, right pallidum, left caudate nucleus in comorbid group were negatively correlated with HAMD₁₇ score (all P<0.05). Conclusion Patients with comorbid hypertension and depression showed reduction of FA value in more brain regions compared with patients with depression, indicating that hypertension may play a synergistic effect on depression.