·3324·中华临床医师杂志(电子版)2016年11月第10卷第22期Chin J Clinicians(Electronic Edition),November 15,2016,V ol.10,No.22·临床论著· 伴睡眠障碍首发抑郁症患者静息态功能磁共振研究王利娟1,2刘志芬1曹晓华1李建英1张爱霞1张克让1【摘要】 目的本研究利用静息态功能磁共振技术，采用局部一致性数据分析方法，探讨伴睡眠障碍首发抑郁症患者分别较健康正常人和不伴睡眠障碍首发抑郁症患者基础状态下的特征性脑功能改变。方法纳入42例首发抑郁症患者和20例正常对照者，根据睡眠情况将抑郁障碍患者分为伴睡眠障碍组（21例）和不伴睡眠障碍组（21例），对所有受试者进行静息态功能磁共振扫描，采用17项汉密尔顿抑郁量表评估患者的抑郁症状，匹兹堡睡眠质量指数评定量表评估睡眠质量。在Matlab平台上应用SPM5依次进行时间校正、头动校正、空间标准化、去线性漂移、滤波平滑的预处理，应用REST 1.8分别对伴睡眠障碍组与正常对照组和伴睡眠障碍组与不伴睡眠障碍组被试者脑区局部一致性进行双样本t检验比较。结果（1）与正常对照组相比，伴睡眠障碍组左枕中回（t=3.828 3，P＜0.01）、右颞中回（t=3.486 7，P＜0.01）、右额叶运动区（t=3.844 2，P＜0.01）局部一致性升高，左顶下回（t=－3.611 2，P＜0.01）、右缘上回（t=－3.817 8，P＜0.01）、左眶部额下回（t=－3.636 1，P＜0.01）、右梭状回（t=－3.999 6，P＜0.01）、左颞下回（t=－3.475 1，P＜0.01）、左小脑后叶（t=－4.390 4，P＜0.01）局部一致性降低。（2）与不伴睡眠障碍组相比，伴睡眠障碍组右小脑后叶（t=3.597 5，P＜0.01）、右岛盖部额下回（t=3.966 8，P＜0.01）、右额叶运动区（t=3.641 7，P＜0.05）局部一致性升高，左顶下回（t=－3.390 9，P＜0.01）、左颞中回（t=－4.819 9，P＜0.01）、右颞下回（t=－4.045 5，P＜0.01）、右小脑前叶（t=－4.268 8，P＜0.01）局部一致性降低。结论伴睡眠障碍首发抑郁症患者静息状态下存在广泛脑功能异常，如额叶、颞叶、顶叶、枕叶、小脑，这些脑区的异常活动可能是伴睡眠障碍首发抑郁症的神经病理学基础。【关键词】抑郁症；睡眠障碍；静息态；局部一致性Resting-state functional magnetic resonance imaging of first-episode depression patients with sleepdisorder Wang Lijuan1,2, Liu Zhifen1, Cao Xiaohua1, Li Jianying1, Zhang Aixia1, Zhang Kerang1.1Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan 030001, China; 2TheFirst Clinical Medical College, Shanxi Medical University, Taiyuan 030001, ChinaCorresponding author: Zhang Kerang, Email: atomsxmu@vip.163.com【Abstract】 Objective To explore the specific brain function activities in first-episodedepression patients with sleep disorder respectively with healthy controls and first-episode depressionpatients without sleep disorder in regional homogeneity using the resting-state functional magneticresonance imaging (fMRI) technology. Methods 42 first-episode depression patients and 20 healthycontrols received fMRI scans. Divided the patients into two groups according to their sleeping condition:21 patients with sleep disorder and 21 patients without it. 17 Hamilton Depression Scale (HAMD17) wasused to evaluate patients' symptoms, and the Pittsburgh sleep quality index (PSQI) was used to evaluatepatients' sleep quality. Conducted slice timing, realignment, normalization, smoothing in turn in SPM5, andcompared the regional homogeneity in first-episode depression patients with sleep disorder respectivelywith healthy controls and patients without sleep disorder in two sample t test in REST 1.8. Results(1)DOI:10.3877/cma.j.issn.1674-0785.2016.22.003基金项目：国家自然科学基金面上项目（81471379）；山西省自然科学基金面上项目（2014011041-1）；山西省回国留学人员科研资助项目（2015100）；2015年山西省基础研究项目青年科技研究基金（2015921294）作者单位：030001 太原，山西医科大学第一医院精神卫生科1；030001 太原，山西医科大学第一临床医学院2通讯作者：张克让，Email: atomsxmu@vip.163.com

伴睡眠障碍首发抑郁症患者静息态功能磁共振研究