标题：大脑灰质体积和前额叶肌酸的变化与抑郁的相关性

      作者：王督 1，黄茂盛 1，周毛毛 1，余泽先 1，杜文永 2    上海市嘉定区中心医院放射科 1、心理科 2，上海 201800

      卷次： 2024年35卷12期

      【摘要】 目的 探讨抑郁症患者大脑灰质体积与前额叶肌酸浓度之间的关系。方法 选取 2019年 5月至2023年3月在上海市嘉定区中心医院心理门诊就诊的86例疑似抑郁症患者，所有患者均完成抑郁-焦虑-压力量表(DASS)评估。依据DASS评分将患者分为抑郁症组(n=20)和非抑郁症组(n=66)，并行颅脑内侧前额叶磁共振波谱和基于体素形态学分析，以确定代谢物浓度及全脑灰质体积，比较两组患者的前额叶代谢物浓度和大脑灰质体积的差异。采用Spearman秩相关性分析DASS评分与前额叶代谢物浓度及大脑灰质体积的相关性，采用Pearson法分析前额叶代谢产物浓度与大脑灰质体积的相关性。结果 抑郁症组患者的右内侧前额叶肌酸浓度、脑灰质、脑白质分别为(6.07±0.94) mmol/L、(0.42±0.05) mL、(0.53±0.06) mL，与非抑郁症组的(6.52±0.90) mmol/L、(0.47±0.03) mL、(0.47±0.04) mL比较差异均无统计学意义(P>0.05)；经Spearman相关性分析结果显示，DASS抑郁评分与前额叶皮层肌酸浓度呈负相关(r=-0.791，P<0.05)，同时与右内侧额上回灰质体积呈负相关(r=-0.752，P<0.05)；焦虑和压力评分与前额叶代谢物浓度、全脑灰质体积均无相关性(P>0.05)；经Pearson 相关性分析结果显示，内侧前额叶肌酸浓度与右内侧额上回灰质体积呈正相关(r=0.689，P<0.05)。结论 前额叶肌酸和灰质体积与抑郁症呈负相关，提高前额叶皮质中肌酸的浓度可能有助于改善情绪和增进幸福感。
      【关键词】 磁共振成像；抑郁症；前额叶；肌酸；大脑灰质体积
      【中图分类号】 R749.4 【文献标识码】 A 【文章编号】 1003—6350（2024）12—1766—05

Correlation of changes in gray matter volume of the brain and creatine concentration in the prefrontal lobe withdepression.
WANG Du 1, HUANG Mao-sheng 1, ZHOU Mao-mao 1, YU Ze-xian 1, DU Wen-yong 2. Department of Radiology 1,Department of Psychology 2, Shanghai Jiading District Central Hospital, Shanghai 201800, CHINA
【Abstract】 Objective To explore the correlation between gray matter volume of the brain in depression pa-tients and the levels of creatine in the prefrontal lobe.Methods Eighty-six suspected depression patients at Shanghai Ji-ading District Central Hospital from May 2019 to March 2023 completed the Depression-Anxiety-Stress Scale (DASS).They were divided into depression (n=20) and non-depression (n=66) groups based on DASS scores. MR spectroscopyand voxel-based morphometry were performed to determine metabolite concentrations and gray matter volume in the me-dial prefrontal cortex. The study investigated differences in these measures between groups. Spearman's rank correlationwas used to analyze associations between DASS scores, prefrontal metabolites, and gray matter volume. Pearson's methodwas applied to assess the correlation between prefrontal metabolites and gray matter volume. Results The depressiongroup displayed no statistically significant differences compared to the non-depression group in terms of creatine concen-tration in right medial prefrontal cortex, brain gray matter, and brain white matter, with values of (6.07±0.94) mmol/L,(0.42±0.05) mL, and (0.53±0.06) mL in the depression group, versus (6.52±0.90) mmol/L, (0.47±0.03) mL, and (0.47±0.04) mL in the non-depression group, respectively (P>0.05). Spearman correlation analysis revealed a negative correla-tion between DASS depression score and prefrontal cortical creatine concentration (r=-0.791, P<0.05), as well as withgray matter volume in right medial superior frontal gyrus (r=-0.752, P<0.05). However, anxiety and stress scoresshowed no correlation with prefrontal metabolite concentrations or whole-brain gray matter volume (P>0.05). Pearsoncorrelation analysis showed a positive correlation between creatine concentration in medial prefrontal cortex and graymatter volume in right medial superior frontal gyrus (r=0.689, P<0.05). Conclusion Creatine in the prefrontal lobe andgray matter volume are negatively correlated with depression. Increasing the concentration of creatine in the frontal lobecortex may help improve mood and enhance feelings of happiness.
      【Key words】 MRI; Depression; Prefrontal lobe; Creatine; Grey matter volume