The Study Of Resting-State Functional Magnetic Resonance Imaging On The Neural Mechanisms Of Mect Anti-Depression

CHAPTER1THE STUDY OF RESTING STATEFUNCTIONAL MAGNETIC RESONANCE IMAGING ONMAJOR DEPRESSIONObjective：To investigate the pathological mechanism of depression,we observe changes of brain function in patients with major depression atresting state using blood oxygen level dependent functional magneticresonance imaging.Methods: Twelve major depressive patients，which met with CCMD-3and DSM-4diagnosis criteria were recruited.. Fifteen healthy controlswhich are matched with major depressive patients in gender, age and level ofeducation were recruited．The24-item Hamilton Depression Rating Scale(HAMD) scores were requested no less than35in major depressive patientsand the score need no more than8in healthy control. These two groupsexperienced functional magnetic resonance imaging scan at resting statewithin24hours after HAMD assessment, the MR images were comparedusing regional homogeneity(ReHo) analysis, to observe the differences inbrain function between patients with major depression and normal controls. Results: Compared with normal controls, major depressive patientsshowed significantly increased regional homogeneity in bilateral medialfrontal gyrus, left superior frontal gyrus, right middle frontal gyrus, rightinferior frontal gyrus, left precentral gyrus, left angular gyrus, left precuneus,left middle temporal gyrus, right superior temporal gyrus, left anteriorcingulate gyrus, right insula, right caudate nucleus; and decreased ReHo inright temporal gyrus, left middle temporal gyrus, bilateral parahippocampalgyrus, right cerebellar anterior lobe and bilateral anterior lobe culmen.Correlation analysis results showed that the ReHo in medial frontal gyrus,superior frontal gyrus, middle frontal gyrus, inferior temporal gyrus,fusiform gyrus, inferior parietal lobule and precuneus were positively relatedto the total HAMD scores, and the ReHo in transverse temporal gyrus, insula,posterior cingulated, thalamus, anterior lobe culmen, declive of vermis andclaustrum were negatively correlated to the total HAMD scores.Conclusions：Major depressive patients have abnormal regionalhomogeneity in several regions especially in the frontal lobe, temporal lobe,insula, basal ganglia and limbic system in resting state, which furtherconfirmed the presence of depression neuropathology loop and the abnormalactivity of these brain regions in the pathogenesis of major depression CHAPTER2THE STUDY OF RESTING-STATEFUNCTIONAL MAGNETIC RESONANCE IMAGING ONTHE NEURAL MECHANISMS OF MECTANTI-DEPRESSION Objective：We observe changes of brain function in patients with majordepression before and after modified electroconvulsive therapy (MECT) atresting state using blood oxygen level dependent functional magneticresonance imaging, to explore the antidepressant mechanism of MECT.Methods: Twelve major depressive patients，which met with CCMD-3and DSM-4diagnosis criteria were recruited, and the number is twelve.24-item Hamilton Depression Rating Scale (HAMD) score were requestedno less than35in major depressive patients. HAMD assessment and MRimages scan were performed before MECT, after the first MECT and afterthe eighth MECT within24h. the MR images were compared using ReHoanalysis, to observe the differences in brain function in major depressivepatients.Results: Compared with pre-MECT, major depressive patients showedsignificantly increased ReHo in the right precuneus, left superior frontalgyrus, left middle frontal gyrus,and decreased ReHo in right inferior frontalgyrus, precentral gyrus after the first MECT. Compared to pre-MECT, majordepressive patients showed significantly increased ReHo in the left fusiformgyrus, left middle temporal gyrus, right angular gyrus, rightparahippocampal gyrus, and decreased ReHo in the right frontal gyrus, rightmiddle temporal gyrus, left dorsal anterior cingulate, bilateral insula, leftcaudate after the eighth MECT. Compared with normal controls, majordepressive patients showed significantly increased ReHo in the in the leftmiddle frontal gyrus, right middle frontal gyrus, bilateral inferior frontalgyrus, left medial frontal gyrus, left precuneus, left angular gyrus, leftanterior cingulate gyrus, superior temporal gyrus, right middle temporalgyrus, bilateral caudate,,and decreased ReHo in the superior temporal gyrus,right insula, right cingulate gyrus, bilateral cerebellar anterior lobe, leftcerebellar anterior lobe culmen,left caudate after the eighth MECT. Conclusions：The influence of single MECT on the brain function inmajor depressive patients is light and the stability is poor. After the eighthMECT, the abnormal function of brain in major depressive patients isreversed partially,and does not return to normal. MECT may be involved inthe repair of depression neuropathology loop, which has played a powerfuleffect in anti-depression treatment.