目的 探讨合并抑郁状态的2型糖尿病患者自发性脑活动的静息态功能磁共振特点。方法 应用患者健康自评量表(patient health questionnaire-9, PHQ-9)筛查糖尿病伴抑郁状态(DM-D)患者29例,选取与之年龄、性别、受教育年限匹配的单纯糖尿病(DM)患者25例。受试者均接受MRI扫描,应用分数低频振幅(fractional amplitude of low-frequency fluctuation fALFF)分析方法比较两组自发性脑区活动性异常的改变。结果 相对于DM组,DM-D组在右小脑后叶2区,右颞叶上、下角回,右额叶上、下回,右边缘叶前扣带回,右顶叶缘上回,左顶叶中央后回,左楔前叶,左角回等脑区fALFF值减低【P＜0.05,多重比较校正(GRF校正)】;在左壳核、左枕叶距状回、右枕中回、右顶叶中央后回fALFF值增高(P＜0.05,GRF校正)。相关性分析显示DM-D组降低的角回及前扣带回与PHQ-9自评量表评分成负相关。结论 应用静息态功能磁共振技术显示糖尿病合并抑郁状态的患者存在多个脑区活动性异常的改变,且这些改变的脑区有助于进一步了解糖尿病共病抑郁患者的病理生理机制。
Abstract
Objective To investigate the spontaneous brain activity in patients of diabetes complicated with depressive state using resting-state fMRI.Methods Twenty-nine cases were screened by PHQ-9 as diabetic patients complicated with depressive state (DM-D),while another 25 patients with diabetes mellitus(DM)alone who matched the DMD patients in gender, age, and education were selected as the control group. All the subjects were examined by resting-state fMRI. Fractional amplitude of low-frequency fluctuation (fALFF)was used to compare the changes of spontaneous abnormal brain activity in both groups.Results Compared with the DM group, DM-D group displayed decreased fALFF values in right cerebellum posterior crus2, the right temporal superior, right inferior gyrus, right angular gyrus, right frontal superior,middle, inferior gyrus, right limbic Lobe, right anterior cingulate, right parietal supramarginal gyrus, left parietal precuneus, and in left angular gyrus. However, in the left putamen, left occipital calcarine, left middle occipital gyrus, and left parietal postcentral gyrus, fALFF values were increased. Bivariate correlation analyses indicated that the decreased fALFF values and PHQ-9 self-rating scale scores were negatively correlated in DM-D group.Conclusions This resting-state fMRI study suggests that diabetic patients with depression have more than one abnormal brain activity, which helps to understand the pathophysiological mechanism of diabetic patients with depression.
关键词
2型糖尿病 /
抑郁状态 /
功能磁共振 /
分数低频振幅
Key words
type 2 diabetes /
depressive state /
resting-state fMRI /
fractional amplitude of low-frequency fluctuation
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