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    邱志强, 李皖陇, 王其智, 乔娟, 李绍东. fMRI在抑郁症患者MECT前后脑功能变化的应用研究[J]. 徐州医科大学学报, 2022, 42(6): 407-412. DOI: 10.3969/j.issn.2096-3882.2022.06.004
    引用本文: 邱志强, 李皖陇, 王其智, 乔娟, 李绍东. fMRI在抑郁症患者MECT前后脑功能变化的应用研究[J]. 徐州医科大学学报, 2022, 42(6): 407-412. DOI: 10.3969/j.issn.2096-3882.2022.06.004
    shu
    Investigate the changes in brain function before and after MECT in Major depressive disorder patients by using fMRI[J]. Journal of Xuzhou Medical University, 2022, 42(6): 407-412. DOI: 10.3969/j.issn.2096-3882.2022.06.004
    Citation: Investigate the changes in brain function before and after MECT in Major depressive disorder patients by using fMRI[J]. Journal of Xuzhou Medical University, 2022, 42(6): 407-412. DOI: 10.3969/j.issn.2096-3882.2022.06.004
    shu

    fMRI在抑郁症患者MECT前后脑功能变化的应用研究

    Investigate the changes in brain function before and after MECT in Major depressive disorder patients by using fMRI

      摘要
    • 摘要: 目的采用静息态功能磁共振（rs-fMRI）对首发重度抑郁症（MDD）患者改良型电休克（MECT）治疗前后的脑功能活动变化进行分析，探讨MECT治疗抑郁症的脑神经机制。方法选取2021年1月—2022年2月于徐州医科大学附属徐州东方医院就诊、需要行MECT的MDD患者28例。MECT治疗前后行rs-fMRI扫描，并采用汉密尔顿抑郁量表（HAMD-24）进行评估。采用基于Matlab R2019b平台的DPABI V6.0软件对影像学数据进行处理，提取差异脑区的标准化低频振幅（mALFF）值和功能连接（FC）值，并与临床治疗减分率进行相关性分析。结果与治疗前相比，MDD患者经MECT治疗后HAMD-24评分显著降低，差异有统计学意义（P＜0.001）。与治疗前相比，MDD患者MECT治疗后两侧中央后回的mALFF降低（P＜0.05），与患者临床减分率呈负相关（r=-0.558，P=0.002）；以左侧中央后回为感兴趣区（ROI），MDD患者MECT治疗后左侧中央后回与右侧距状回、舌回的FC减低（P＜0.05），与患者临床减分率呈负相关（r=-0.425，P=0.024）。结论MECT可能通过调节MDD患者两侧中央后回的mAFLL和左侧中央后回与右侧距状回、舌回的FC缓解患者的抑郁症状。fMRI在抑郁症患者MECT治疗前后脑功能变化的研究中具有重要的使用价值。

       

      Abstract: ob＜x＞jective To investigate the changes of brain functional activity in resting-state functional magnetic resonance (fMRI) before and after modified electroconvulsive therapy (MECT), further clarify the neuroimaging mechanism of MECT in first-episode patients with Major depressive disorder(MDD). Methods fMRI scan was performed before MECT in 28 MDD patients with first-episode,and another fMRI scan followed after 2 weeks of MECT (6 times on average).Meanwhile,the 24 Hamilton Depression Scale (HAMD-24) of MDD patients were evaluated before and after MECT.Imaging data were processed by the DPARSF software ba＜x＞sed on Matlab platform,where a total of 5,000 permutation tests were used.The results were obtained with threshold-free cluster enhancement (TFCE) correction.The mALFF voxel difference between pre-treatment and pro-treatment was highlighted as a seed point to calculate the different brain regions of the whole-brain functional connectivity (FC).The results were corrected by alphasim correction.The mALFF value and FC value of different brain regions were further related with the clinical treatment score reduction rate. Results Compared with pre-treatment state,the total score of HAMD-24 in MDD patients after MECT was significantly decreased,and the difference was statistically significant (P<0.001). Compared with pre-treatment state, the mALFF values of the postcentral gyrus of both sides of the MDD patients with MECT decreased(P＜0.05). When the left postcentral gyrus was highlighted as the seed point, the FC of the left postcentral gyrus to the right calcarine gyrus,the right lingual gyrus were decreased after MECT in MDD patients(P＜0.05). Conclusions MECT may relieve symptoms of depression by regulating the low frequency amplitude of the postcentral gyrus of MDD patients and regulating function connection of the left postcentral gyrus to the right calcarine gyrus,the right lingual gyrus.Therefore,the fMRI takes a great important application value in investigating the changes in brain function before and after MECT in depressed patients.

       

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