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目的 探讨阿尔茨海默病(Alzheimer’s disease,AD)伴抑郁症状的患者基于弥散张量成像(diffusion tensor imaging,DTI)技术的脑白质特征.方法 对符合入组标准的24例轻度AD患者行头颅DTI检查,数据分析和处理获得的DTI原始数据传输入工作站,应用FSL软件进行预处理,计算各向异性分数(fractional anisotropy,FA)和平均弥散系数(mean diffusivity,MD)图像并保存为三维NIFTI图像格式,选择额叶、颞叶、枕叶和顶叶为感兴趣区域.采用17项汉密尔顿抑郁量表(17-item Hamilton Depression Rating Scale,HAMD17)和神经精神问卷(Neuropsychiatric Inventory,NPI)评定抑郁症状,分为伴有抑郁症状的AD患者(D-AD组)和不伴抑郁症状的AD患者(nD-AD组);2组临床基本资料比较采用独立样本t检验或x2检验,利用双样本t检验对FA、MD值进行以体素为基础的组间比较.结果 D-AD组(n=12)和nD-AD组(n=12)在年龄、性别、受教育年限和MMSE评分方面差异均无统计学意义.D-AD组较nD-AD组HAMD17和NPI评分高,差异有统计学意义(t=14.688、11.133,均P＜0.01).D-AD组较nD-AD组顶叶(0.34±0.03与0.38±0.05)和枕叶(0.39±0.05与0.45±0.06) FA值低,差异有统计学意义(t=-2.083 5,P=0.042 2;t=-2.475 4,P=0.016 2).2组间额叶、颞叶脑区FA和MD值差异均无统计学意义.结论 顶叶和枕叶的脑白质神经纤维完整性受损可能是AD伴发抑郁症状的特征表现.“,”Objective To study the characteristics of cerebral white matter in mild Alzheimer’s disease (AD) with depression,based on diffusion tensor imaging (DTI).Methods Our study included 24mild AD patients.Standardized clinical and neuropsychological evaluation,including 17-Hamilton Depression Rating Scale (HAMD17) and Neuropsychiatric Inventory (NPI),was conducted in each subject.DTI images were acquired,and fractional anisotropy (FA) and mean diffusivity (MD)of white matter in frontal,temporal,parietal,and occipital lobes were determined.These diffusion measurements were compared between the two groups of AD patients with depression (D-AD) and non-depressed AD (nD-AD).Results There were 12 D-AD and 12 nD-AD patients.Compared with nD-AD,D-AD patients demonstrated decreased FA in the parietal(0.34±0.03 vs.0.38±0.05,t=-2.083 5,P=0.042 2) and occipital lobes(0.39±0.05 vs.0.45±0.06,t=-2.475 4,P=0.016 2).There was no significant difference of FA and MD in the frontal and temporal lobes.Conclusion The abnormalities of white matter in parietal and occipital lobes may be an important characteristics of depression in AD.