摘要
目的探讨伴自杀意念青少年首发抑郁症(major depressive disorder,MDD)患者静息状态大脑活动的改变及其意义。方法对42名伴自杀意念青少年首发MDD患者(SU组)、17名不伴自杀意念MDD患者(NSU组)和29名健康对照组(HC组)进行心理评估和静息态功能磁共振(fMRI)扫描,运用低频振荡振幅(ALFF)方法比较三组间大脑功能活动的差异,并进一步分析差异脑区的zALFF值与抑郁严重程度、自杀意念强度之间的关系。结果三组被试zALFF值在左侧海马(MNI:x=-21,y=-33,z=0)、左侧内侧额上回(MNI:x=3,y=33,z=63)显著异常,差异有统计学意义(P<0.001,k>20,未校正)。事后检验结果示,与NSU组和HC组相比,SU组左侧海马zALFF值显著升高(F=28.931)、左侧内侧额上回zALFF值显著降低(F=16.648),差异有统计学意义(P<0.001,Bonferroni校正),HC组和NSU组之间zALFF值差异无统计学意义(P>0.05)。SU组左侧海马、左侧内侧额上回zALFF值与HAMD-24总分(r=-0.214,-0.103)、自杀意念强度因子分(r=0.115,-0.055)无相关性(P>0.05)。结论伴自杀意念青少年MDD患者左侧海马、左侧内侧额上回存在异常的自主神经活动,可能是其产生自杀意念的神经基础和生物学指标。
Objective To investigate the changes of brain activity in adolescents with first-episode major depressive disorder(MDD)and its significance.Methods Totally 42 first-episode MDD patients with suicidal ideation(SU group),17 MDD patients without suicidal ideation(NSU group)and 29 healthy controls(HC group)were examined by psychological assessment and resting-state functional magnetic resonance imaging(fMRI).The differences of brain functional activities between the three groups were compared by amplitude of low frequency fluctuation(ALFF).The relationship between the difference of zALFF value in brain regions and the severity of depression,intensity of suicidal ideation were further analyzed.Results The zALFF values in the left hippocampus(MNI:x=-21,y=-33,z=0)and left Frontal_Sup_Medial(MNI:x=3,y=33,z=63)of the three groups were significantly abnormal(P<0.001,k>20,uncorrected).The results of Post-hoc test showed that the zALFF value of left hippocampus increased significantly(F=28.931)and decreased significantly in left Frontal_Sup_Medial(F=16.648)in SU group,compared with NSU group and HC group(P<0.001,Bonferroni correction).There was no significant difference in zALFF value between HC group and NSU group(P>0.05).In SU group,the zALFF values of left hippocampus and left Frontal_Sup_Medial were not correlated with total scores of HAMD-24(r=-0.214,-0.103)and suicide ideation intensity factor scores(r=0.115,-0.055)(P>0.05).Conclusion Abnormal autonomic nervous activity exists in left hippocampus and left Frontal_Sup_Medial in adolescent MDD patients with suicidal ideation,which may be the neurological basis and biological index of suicidal ideation.
作者
潘红庆
李淑英
王源莉
吕培培
李飞燕
张瑶
张午阳
Pan Hongqing;Li Shuying;Wang Yuanli;Lyu Peipei;Li Feiyan;Zhang Yao;Zhang Wuyang(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2019年第12期1091-1095,共5页
Chinese Journal of Behavioral Medicine and Brain Science
基金
河南省卫健委省部共建项目(SBGJ2018033)
河南省科技厅重点攻关计划项目(152102310046)。
关键词
抑郁症
自杀意念
青少年
低频振幅
Major depressive disorder
Suicidal ideation
Adolescents
Amplitude of low frequency fluctuation
