刘文洪+罗光华+赵衡++刘进才

[摘要]目的 研究采用静息态多功能磁共振成像（rs-fMRI）技术分析卒中后抑郁患者的脑默认网络功能连接性的变化情况。方法 选取2016年2月～2017年2月我院收治的卒中后抑郁患者30例為观察组，另选取同期收治的卒中后无抑郁30例为对照组，比较两组患者基本资料，治疗前、治疗后4及12周的日常生活活动评分。对所有患者均行rs-fMRI技术检查，选取双侧楔前叶作为感兴趣区，计算并比较两组默认网络功能连接的变化情况。结果 观察组入院时NIHSS评分为（11.1±5.3）分，显著高于对照组的（6.7±2.9）分；观察组治疗后4周及12周的ADLS评分分别为（40.2±15.6）、（29.2±12.7）分，均显著高于对照组[（32.1±13.9）、（21.5±10.4）分]。观察组较对照组的右侧顶下小叶、双侧额颞叶及左侧楔前叶功能连接降低；双侧顶下小叶、双侧额颞叶和右侧楔前叶功能连接降低；未见功能连接较对照组显著升高的脑区。结论 卒中后抑郁的发生与默认网络功能连接的变化情况在密切相关，值得重点关注。

[关键词]脑卒中；抑郁；默认网络；功能连接

[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0113-04

Analysis of depression after stroke in patients with brain function default network connectivity rs-fMRI

LIU Wen-hong LUO Guang-hua ZHAO Heng LIU Jing-cai

Department of Radiology，the Affiliated First Hospital，University of South China，Hunan Province，Hengyang 421001，China

[Abstract]Objective To study the change of brain network connectivity in patients with poststroke depression using resting multifunctional magnetic resonance imaging （rs-fMRI）.Methods From February 2016 to February 2017，30 patients with post-stroke depression were selected as observation group，30 patients with no depression after the same period were selected as the control group.Basic information on patients，the daily life activity score before treatment，4 weeks after treatment and 12 weeks after treatment were compared between the two groups.In addition，all patients were examined by rs-fMRI technique.The bilateral anterior wedge was selected as the region of interest，and the changes of the default network function were calculated and compared.Results The scores of NIHSS in the observation group were （11.1±5.3）points，which was significantly higher than that of the control group[（6.7±2.9）points].The ADLS score of the observation group was （40.2±15.6）points at 4 weeks after treatment and 12 weeks after treatment[（29.2±12.7） points] were significantly higher than those in the control group [（32.1±13.9），（21.5±10.4） points].Compared with the control group，the connection of the right lower lobe，bilateral frontal temporal lobe and left anterior lobe of the anterior fissure was decreased.The bilateral lobular，bilateral frontal temporal lobe and right anterior lobe anterior lobe were decreased functional linkage was significantly higher in the brain area than that in the control group.Conclusion There is a close relation with the occurrence of post-stroke depression and the change of the default network function connection，it is worth focusing on attention.endprint

[Key words]Stroke；Depression；Default network；Function connection

脑卒中是较为常见的心脑血管疾病之一，我国脑卒中的发病率在全球范围内位列第一[1]。卒中已成为国民死亡的首位因素，有30%～35%的脑卒中幸存者在随访过程中存在明显的抑郁症状。卒中后抑郁患者的主要临床特征包括持续情感低落及兴趣减退等，严重影响了患者的生存质量，有碍神经功能的恢复[2]，并提高了卒中复发及死亡的风险，已成为临床上最为关注的公共卫生问题之一[3]。……