血管性抑郁症功能磁共振成像研究进展
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摘要
旨在总结血管性抑郁症(Vascular Depression,VD)脑部功能磁共振成像的研究进展情况,包括弥散张量成像和血氧水平依赖功能磁共振成像。通过对VD患者脑组织及脑功能进行实时成像,发现与抑郁相关脑区的神经通路及脑功能活动发生变化。其中脑白质异常高信号是VD主要病理改变,边缘系统-皮层-纹状体-丘脑环路破坏是VD发病的重要环节。前额叶皮质、边缘皮质(如扣带回、海马回)、杏仁核、小脑等脑区的异常功能连接为VD功能影像学的主要表现。血管性抑郁发病机制复杂,功能磁共振成像作为一种非损伤性活体检测技术将对血管性抑郁的全面认识发挥重要作用,为VD的临床诊疗提供新的思路。
The paper was aimed to summarize the development of vascular depression(VD) in functional magnetic resonance imaging(f MRI) of brain research, including diffusion tensor imaging and blood oxygenation level dependentf MRI. Through the real-time imaging of brain tissues and brain function in VD patients, it was found that the neurological and brain function in the brain regions related to depression were changed. The main pathologic changes were abnormal white matter hyperintensities of the brains. The key link of VD pathogenesis was that limbic systemcortex-striatum-thalamus circuits were destroyed. And the main performance of VD in f MRI was abnormal brain function connection in prefrontal cortex, limbic cortex(i.e., cingulate gyrus, hippocampal gyrus), amygdala, cerebellum, and etc. in f MRI. The pathogenesis of VD was complex. As a noninvasive living brain function detection technique, f MRI will play an important role in the comprehensive understanding of VD and provide new ideas in clinical diagnosis and treatment.
The paper was aimed to summarize the development of vascular depression(VD) in functional magnetic resonance imaging(f MRI) of brain research, including diffusion tensor imaging and blood oxygenation level dependentf MRI. Through the real-time imaging of brain tissues and brain function in VD patients, it was found that the neurological and brain function in the brain regions related to depression were changed. The main pathologic changes were abnormal white matter hyperintensities of the brains. The key link of VD pathogenesis was that limbic systemcortex-striatum-thalamus circuits were destroyed. And the main performance of VD in f MRI was abnormal brain function connection in prefrontal cortex, limbic cortex(i.e., cingulate gyrus, hippocampal gyrus), amygdala, cerebellum, and etc. in f MRI. The pathogenesis of VD was complex. As a noninvasive living brain function detection technique, f MRI will play an important role in the comprehensive understanding of VD and provide new ideas in clinical diagnosis and treatment.
引文
1 Vasic N,Wolf N D,Gr?n G,et al.Baseline brain perfusion and brain structure in patients with major depression:a multimodal magnetic resonance imaging study.J Psychiatry,2015,40(6):412.
2 Hickie I,Scott E,Mitchell P,et al.Subcortical hyperintensities on magnetic resonance imaging:Clinical correlates and prognostic significance in patients with severe depression.Biol Psychiatry,1995,37(3):151-160.
3 Salloway S,Malloy P,Kohn R,et al.MRI and neuropsychological differences in early-and late-life-onset geriatric depression.Neurology,1996,46(6):1567-1574.
4 Alexopoulos G S,Meyers B S,Young R C,et al.'Vascular depression′hypothesis.Arch Gen Psychiatry,1997,54(10):915-922.
5 黄世敬,王彦云,陈宇霞.血管性抑郁与脑白质损害.国际精神病学杂志,2009,36(1):20-23.
6 Van Sloten T T,Sigurdsson S,van Buchem M A,et al.Cerebral Small Vessel Disease and Association With Higher Incidence of Depressive Symptoms in a General Elderly Population:The AGES-Reykjavik Study.Am J Psychiatry,2015,172(6):570-578.
7 Krishnan K R R,Taylor W D,Mc Quoid D R,et al.Clinical characteristics of magnetic resonance imaging-defined subcortical ischemic depression.Biol Psychiatry,2004,55(4):390-397.
8 Agudelo C,Aizenstein H J,Karp J F,et al.Applications of magnetic resonance imaging for treatment-resistant late-life depression.Dialogues Clin Neurosci,2015,17(2):151-169.
9 Vakilian A,Iranmanesh F.Assessment of cerebrovascular reactivity during major depression and after remission of disease.Ann Indian Acad Neurol,2010,13(1):52-56.
10 Videbech P.PET measurements of brain glucose metabolism and blood flow in major depressive disorder:a critical review.Acta Psychiatr Scand,2000,101(1):11-20.
11 崔秀芬.抗抑郁治疗对老年脑梗死患者脑血流的影响分析.医学信息,2015,28(14):22.
12 Gong Q,Yong H.Depression,Neuroimaging and Connectomics:A Selective Overview.Biol Psychiatry,2015,77(3):223-235.
13 Liu Z,Xu C,Xu Y,et al.Decreased regional homogeneity in insula and cerebellum:a resting-state f MRI study in patients with major depression and subjects at high risk for major depression.Psychiatry Res,2010,182(3):211-215.
14 Wu Q Z,Li D M,Kuang W H,et al.Abnormal regional spontaneous neural activity in treatment-refractory depression revealed by restingstate f MRI.Hum Brain Mapp,2011,32(8):1290-1299.
15 Takeda M,Tanaka T,Kudo T.Elderly depression and diffusion tensor imaging.Psychogeriatrics,2011,11(1):1-5.
16 Alexopoulos GS.Frontostriatal and Limbic Dysfunction in Late-Life Depression.Am J Geriatr Psychiatry,2002,10(6):687-695.
17 张彤,薛静,梁德君,等.脑梗死慢性期抑郁状态的磁共振弥散张量成像初步研究.中国卒中杂志,2012,7(09):690-697.
18 Tang W K,Lu J Y,Chen Y K,et al.Association of Frontal Subcortical Circuits Infarcts in Poststroke Depression:A Magnetic Resonance Imaging Study of 591 Chinese Patients With Ischemic Stroke.J Geriatr Psychiatry Neurol,2011,24(1):44-49.
19 Brookes R L,Vanessa H,Lawrence A J,et al.Depression in small-vessel disease relates to white matter ultrastructural damage,not disability.Neurology,2014,83(16):1417-1423.
20 许孝南,吴军,陈旭辉,等.卒中后抑郁的扩散张量成像研究进展.中国脑血管病杂志,2015,12(06):321-324.
21 Alexopoulos G S,Murphy C F,Gunning F M.Serotonin transporter polymorphisms,microstructural white matter abnormalities and remission of geriatric depression.J Affect Disord,2009,119(2):132-141.
22 Alexopoulos G S,Glatt CEHoptman M J,Kanellopoulos D,et al.BDNF Val66met polymorphism,white matter abnormalities and remission of geriatric depression.J Affect Disord,2010,125(s 1-3):262-268.
23 Taylor W D,Kuchibhatla M,Payne M E,et al.Frontal white matter anisotropy and antidepressant remission in late-life depression.PLo S One,2008,3(9):e3267.
24 Taylor W D,Payne M E,Krishnan K R R,et al.Evidence of white matter tract disruption in MRI hyperintensities.Biol Psychiatry,2001,50(3):179-183.
25 Ms D B W,Moscufo N,Guttmann C R,et al.White matter hyperintensities predict functional decline in voiding,mobility,and cognition in older adults.J Am Geriatr Soc,2010,58(2):275-281.
26 Dalby R B,Frandsen J,Chakravarty M M,et al.Depression severity is correlated to the integrity of white matter fiber tracts in late-onset major depression.Psychiatry Res,2010,184(1):38-48.
27 Nobuhara K,Okugawa G,Minami T,et al.Effects of electroconvulsive therapy on frontal white matter in late-life depression:a diffusion tensor imaging study.Neuropsychobiology,2004,50(1):48-53.
28 Murphy C F,Gunning-Dixon F M,Hoptman M J,et al.White-Matter Integrity Predicts Stroop Performance in Patients with Geriatric Depression.Biol Psychiatry,2007,61(8):1007-1010.
29 Colloby S J,Firbank M J,Thomas A J,et al.White matter changes in late-life depression:A diffusion tensor imaging study.J Affect Disord,2011,135(1-3):216-220.
30 Alexopoulos G S,Kiosses D N,Choi S J,et al.Frontal White Matter Microstructure and Treatment Response of Late-Life Depression:A Preliminary Study.Am J Psychiatry,2002,159(11):1929-1932.
31 孙军,刘含秋,孙华平,等.首发抑郁症患者基于体素的脑形态学MRI研究.中国医学计算机成像杂志,2009,15(6):495-499.
32 Taylor W D,Macfall J R,Payne M E,et al.Late-life depression and microstructural abnormalities in dorsolateral prefrontal cortex white matter.Am J Psychiatry,2004,161(7):1293-1296.
33 Cao X,Liu Z,Cheng X,et al.Disrupted resting-state functional connectivity of the hippocampus in medication-na?ve patients with major depressive disorder.J Affect Disord,2012,141(2):194-203.
34 王秀丽,黄晓琦,龚启勇.抑郁症静息态脑功能磁共振成像研究进展.华西医学,2015,4:047.
35 Sheline Y I.Neuroimaging studies of mood disorder effects on the brain.Biol Psychiatry,2003,54(3):338-352.
36 Guo W B,Liu F,Xun G L,et al.Reversal alterations of amplitude of low-frequency fluctuations in early and late onset,first-episode,drugnaive depression.Prog Neuropsychopharmacol Biol Psychiatry,2013,40(2):153-159.
37 Bohr I J,Kenny E,Blamire A,et al.Resting-state functional connectivity in late-life depression:higher global connectivity and more long distance connections.Front Psychiatry,2012,3(116):1-14.
38 Sheline Y I,Price J L,Yan Z,et al.Resting-state functional MRI in depression unmasks increased connectivity between networks via the dorsal nexus.Proc Natl Acad Sci,2010,107(24):11020-11025.
39 Alalade E,Denny K,Potter G,et al.Altered Cerebellar-Cerebral Functional Connectivity in Geriatric Depression.PLo S One,2011,6(5):e20035.
40 Yuan Y,Zhang Z,Feng B,et al.Abnormal neural activity in the patients with remitted geriatric depression:a resting-state functional magnetic resonance imaging study.J Affect Disord,2008,111(2):145-152.
41 Bin J,Chun-Hong L,Xin M,et al.Difference in amplitude of lowfrequency fluctuation between currently depressed and remitted females with major depressive disorder.Brain Res,2013,1540(17):74-83.
42 Tadayonnejad R,Yang S,Kumar A,et al.Multimodal brain connectivity analysis in unmedicated late-life depression.PLo S One,2014,9(4):e96033.
43 Van d HMP,Ml RCW,Kahn R S,et al.Functionally linked resting-state networks reflect the underlying structural connectivity architecture of the human brain.Hum Brain Mapp,2009,30(10):3127-3141.
44 Krishnan K R R,Mc Donald W.Arteriosclerotic depression.Med Hypotheses,1995,44(2):111-115.
2 Hickie I,Scott E,Mitchell P,et al.Subcortical hyperintensities on magnetic resonance imaging:Clinical correlates and prognostic significance in patients with severe depression.Biol Psychiatry,1995,37(3):151-160.
3 Salloway S,Malloy P,Kohn R,et al.MRI and neuropsychological differences in early-and late-life-onset geriatric depression.Neurology,1996,46(6):1567-1574.
4 Alexopoulos G S,Meyers B S,Young R C,et al.'Vascular depression′hypothesis.Arch Gen Psychiatry,1997,54(10):915-922.
5 黄世敬,王彦云,陈宇霞.血管性抑郁与脑白质损害.国际精神病学杂志,2009,36(1):20-23.
6 Van Sloten T T,Sigurdsson S,van Buchem M A,et al.Cerebral Small Vessel Disease and Association With Higher Incidence of Depressive Symptoms in a General Elderly Population:The AGES-Reykjavik Study.Am J Psychiatry,2015,172(6):570-578.
7 Krishnan K R R,Taylor W D,Mc Quoid D R,et al.Clinical characteristics of magnetic resonance imaging-defined subcortical ischemic depression.Biol Psychiatry,2004,55(4):390-397.
8 Agudelo C,Aizenstein H J,Karp J F,et al.Applications of magnetic resonance imaging for treatment-resistant late-life depression.Dialogues Clin Neurosci,2015,17(2):151-169.
9 Vakilian A,Iranmanesh F.Assessment of cerebrovascular reactivity during major depression and after remission of disease.Ann Indian Acad Neurol,2010,13(1):52-56.
10 Videbech P.PET measurements of brain glucose metabolism and blood flow in major depressive disorder:a critical review.Acta Psychiatr Scand,2000,101(1):11-20.
11 崔秀芬.抗抑郁治疗对老年脑梗死患者脑血流的影响分析.医学信息,2015,28(14):22.
12 Gong Q,Yong H.Depression,Neuroimaging and Connectomics:A Selective Overview.Biol Psychiatry,2015,77(3):223-235.
13 Liu Z,Xu C,Xu Y,et al.Decreased regional homogeneity in insula and cerebellum:a resting-state f MRI study in patients with major depression and subjects at high risk for major depression.Psychiatry Res,2010,182(3):211-215.
14 Wu Q Z,Li D M,Kuang W H,et al.Abnormal regional spontaneous neural activity in treatment-refractory depression revealed by restingstate f MRI.Hum Brain Mapp,2011,32(8):1290-1299.
15 Takeda M,Tanaka T,Kudo T.Elderly depression and diffusion tensor imaging.Psychogeriatrics,2011,11(1):1-5.
16 Alexopoulos GS.Frontostriatal and Limbic Dysfunction in Late-Life Depression.Am J Geriatr Psychiatry,2002,10(6):687-695.
17 张彤,薛静,梁德君,等.脑梗死慢性期抑郁状态的磁共振弥散张量成像初步研究.中国卒中杂志,2012,7(09):690-697.
18 Tang W K,Lu J Y,Chen Y K,et al.Association of Frontal Subcortical Circuits Infarcts in Poststroke Depression:A Magnetic Resonance Imaging Study of 591 Chinese Patients With Ischemic Stroke.J Geriatr Psychiatry Neurol,2011,24(1):44-49.
19 Brookes R L,Vanessa H,Lawrence A J,et al.Depression in small-vessel disease relates to white matter ultrastructural damage,not disability.Neurology,2014,83(16):1417-1423.
20 许孝南,吴军,陈旭辉,等.卒中后抑郁的扩散张量成像研究进展.中国脑血管病杂志,2015,12(06):321-324.
21 Alexopoulos G S,Murphy C F,Gunning F M.Serotonin transporter polymorphisms,microstructural white matter abnormalities and remission of geriatric depression.J Affect Disord,2009,119(2):132-141.
22 Alexopoulos G S,Glatt CEHoptman M J,Kanellopoulos D,et al.BDNF Val66met polymorphism,white matter abnormalities and remission of geriatric depression.J Affect Disord,2010,125(s 1-3):262-268.
23 Taylor W D,Kuchibhatla M,Payne M E,et al.Frontal white matter anisotropy and antidepressant remission in late-life depression.PLo S One,2008,3(9):e3267.
24 Taylor W D,Payne M E,Krishnan K R R,et al.Evidence of white matter tract disruption in MRI hyperintensities.Biol Psychiatry,2001,50(3):179-183.
25 Ms D B W,Moscufo N,Guttmann C R,et al.White matter hyperintensities predict functional decline in voiding,mobility,and cognition in older adults.J Am Geriatr Soc,2010,58(2):275-281.
26 Dalby R B,Frandsen J,Chakravarty M M,et al.Depression severity is correlated to the integrity of white matter fiber tracts in late-onset major depression.Psychiatry Res,2010,184(1):38-48.
27 Nobuhara K,Okugawa G,Minami T,et al.Effects of electroconvulsive therapy on frontal white matter in late-life depression:a diffusion tensor imaging study.Neuropsychobiology,2004,50(1):48-53.
28 Murphy C F,Gunning-Dixon F M,Hoptman M J,et al.White-Matter Integrity Predicts Stroop Performance in Patients with Geriatric Depression.Biol Psychiatry,2007,61(8):1007-1010.
29 Colloby S J,Firbank M J,Thomas A J,et al.White matter changes in late-life depression:A diffusion tensor imaging study.J Affect Disord,2011,135(1-3):216-220.
30 Alexopoulos G S,Kiosses D N,Choi S J,et al.Frontal White Matter Microstructure and Treatment Response of Late-Life Depression:A Preliminary Study.Am J Psychiatry,2002,159(11):1929-1932.
31 孙军,刘含秋,孙华平,等.首发抑郁症患者基于体素的脑形态学MRI研究.中国医学计算机成像杂志,2009,15(6):495-499.
32 Taylor W D,Macfall J R,Payne M E,et al.Late-life depression and microstructural abnormalities in dorsolateral prefrontal cortex white matter.Am J Psychiatry,2004,161(7):1293-1296.
33 Cao X,Liu Z,Cheng X,et al.Disrupted resting-state functional connectivity of the hippocampus in medication-na?ve patients with major depressive disorder.J Affect Disord,2012,141(2):194-203.
34 王秀丽,黄晓琦,龚启勇.抑郁症静息态脑功能磁共振成像研究进展.华西医学,2015,4:047.
35 Sheline Y I.Neuroimaging studies of mood disorder effects on the brain.Biol Psychiatry,2003,54(3):338-352.
36 Guo W B,Liu F,Xun G L,et al.Reversal alterations of amplitude of low-frequency fluctuations in early and late onset,first-episode,drugnaive depression.Prog Neuropsychopharmacol Biol Psychiatry,2013,40(2):153-159.
37 Bohr I J,Kenny E,Blamire A,et al.Resting-state functional connectivity in late-life depression:higher global connectivity and more long distance connections.Front Psychiatry,2012,3(116):1-14.
38 Sheline Y I,Price J L,Yan Z,et al.Resting-state functional MRI in depression unmasks increased connectivity between networks via the dorsal nexus.Proc Natl Acad Sci,2010,107(24):11020-11025.
39 Alalade E,Denny K,Potter G,et al.Altered Cerebellar-Cerebral Functional Connectivity in Geriatric Depression.PLo S One,2011,6(5):e20035.
40 Yuan Y,Zhang Z,Feng B,et al.Abnormal neural activity in the patients with remitted geriatric depression:a resting-state functional magnetic resonance imaging study.J Affect Disord,2008,111(2):145-152.
41 Bin J,Chun-Hong L,Xin M,et al.Difference in amplitude of lowfrequency fluctuation between currently depressed and remitted females with major depressive disorder.Brain Res,2013,1540(17):74-83.
42 Tadayonnejad R,Yang S,Kumar A,et al.Multimodal brain connectivity analysis in unmedicated late-life depression.PLo S One,2014,9(4):e96033.
43 Van d HMP,Ml RCW,Kahn R S,et al.Functionally linked resting-state networks reflect the underlying structural connectivity architecture of the human brain.Hum Brain Mapp,2009,30(10):3127-3141.
44 Krishnan K R R,Mc Donald W.Arteriosclerotic depression.Med Hypotheses,1995,44(2):111-115.