论文部分内容阅读
目的采用情绪评估量表和任务态功能磁共振成像(Task f MRI)技术,分析库欣病(CD)患者脑功能改变及其与精神症状的关系。方法收集2015年11月-2016年11月在解放军总医院内分泌科住院诊断为库欣病的8例患者,并选取21名年龄、性别和受教育程度相匹配的健康人作为对照组,对其进行Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)、正性负性情绪量表(PANAS)和库欣生活质量量表(Cushing QOL)的评估,并行Task f MRI检查。结果与对照组相比,CD组患者均存在抑郁、焦虑状态,正性情绪评分低,而负性情绪评分较高。Task f MRI结果显示,观看正性图片时CD组左侧小脑和右侧中央后回激活程度较对照组减弱,左侧小脑激活程度与16:00点促肾上腺皮质激素(ACTH)水平呈正相关,右侧中央后回激活程度与尿游离皮质醇(UFC)水平呈正相关;观看负性图片时左侧小脑、双侧海马旁回和左侧额下回激活程度较对照组明显减弱,左侧小脑激活程度与0:00点皮质醇水平和焦虑量表评分呈负相关,与UFC水平呈正相关;观看中性图片时左侧小脑和左侧海马旁回激活程度较对照组减弱。结论 CD患者脑功能受损,会出现抑郁、焦虑等精神障碍,通过Task f MRI技术可发现左侧额下回、右侧中央后回、双侧海马旁回和左侧小脑激活程度减弱与之相关。
Objective To evaluate the changes of brain function and the relationship with mental symptoms in patients with Cushing’s disease (CD) by using the emotion assessment scale and task f MRI. Methods Eight patients with Cushing’s disease who were hospitalized in Department of Endocrinology of Chinese PLA General Hospital from November 2015 to November 2016 were selected and 21 healthy subjects with matched age, gender and education level were selected as control group. The Zung Self-rating Depression Scale (SDS), Zung’s Self-rating Anxiety Scale (SAS), Positive Negative Emotion Scale (PANAS) and Cushing QOL were evaluated and compared with Task f MRI . Results Compared with the control group, all patients in the CD group had depression and anxiety state, with low positive emotion score and high negative emotion score. Task f MRI results showed that the right cerebellum and right central back activation in CD group were weaker than those in control group when viewing positive pictures. The left cerebellar activation was positively correlated with the level of adrenocorticotropic hormone (ACTH) at 16:00, There was a positive correlation between the right central back activation and urinary free cortisol (UFC) level. Left negative cerebellum, bilateral parahippocampal gyrus and left inferior forebrain activation were significantly weaker than the control group The level of activation was negatively correlated with the score of cortisol and anxiety scale at 0:00, which was positively correlated with the level of UFC. The activation of parahippocampal gyrus of the left cerebellum and left hippocampus was weaker than that of the control group when viewing neutral images. Conclusions Brain dysfunction in CD patients may lead to mental disorders such as depression and anxiety. With Task f MRI, we can find that the left lower frontal gyrus, the right middle back, the bilateral parahippocampal gyrus and the left cerebellar activation are weakened Related.