The Changes Of Brain Function In Patients With Post-stroke Depression Based On Resting State Functional Magnetic Resonance Imaging

Objective:The aim of this study was to investigate the changes of brain function in patients with post-stroke depression on resting state functional magnetic resonance imaging(rs-f MRI).Material and Methods:In this study,28 subjects were selected from the inpatient Department of Neurology,the First Hospital of Jilin University,the patients with post-stroke depression and the healthy volunteers whose age and gender were completely matched with the patient group.The patients with HAMD-17 score less than 7 who met the inclusion criteria of the control group were the normal control group;the patients with HAMD-17 score greater than or equal to 7who met the inclusion criteria of the post-stroke depression group were the post-stroke depression group.The general data of the subjects were collected and scored with HAMD-17,HAMA,PHQ-9,GAD-7 and MMSE respectively.Using Philips 3.0T,rs-f MRI was performed on 28 subjects,and the data were preprocessed.SPSS 20.0 was used to analyze the general data of 28 subjects(P < 0.05).Matlab(r2011a)was used to test the data of f ALFF,Re Ho and FC in patients and normal control group by single sample t-test.The results were tested by double sample t-test between the two groups.The brain areas of f ALFF,Re Ho and FC enhanced and weakened were obtained.The final results were presented by dpabi software,Brain Net viewer software and mricron software,with statistical difference(P < 0.01).Results:There was no significant difference between the normal control group and the patient group(P > 0.05).In this study,male patients accounted for the majority of PSD patients,which was 2.5 times of female patients;most PSD patients were over 60 years old,accounting for 42.6% of the patients;most of them were primary school or below,accounting for 35.7%;farmers accounted for 35.7%,and unemployment accounted for28.6%.There were significant differences in HAMD-17,HAMA,PHQ-9 and GAD-7between the two groups(P < 0.05),but no significant difference in MMSE(P > 0.05).According to HAMD-17 score,mild depression accounted for 85.7%,moderate depression accounted for 14.3%.PHQ-9 scores showed that 85.7% of the patients were mild depression,7.15% were moderate depression,and 7.15% were moderate to severe depression.HAMA score showed that patients with mild anxiety accounted for 50%,and patients with moderate anxiety accounted for 50%.GAD-7 score showed that 71.4% of patients had no anxiety and28.6% had mild anxiety.Among the 14 patients in this study,10 patients complained of emotional symptoms,accounting for 71.4% of the total number;the other 4 patients complained of somatic symptoms,including dizziness,insomnia,early awakening,attention and memory loss,accounting for 28.6%.RS-fMRI data analysis between the two groups: the f ALFF value of the left caudate nucleus of the patient group was higher than that of the normal control group;the f ALFF value of the left cuneiform lobe was lower than that of the normal control group;the Re Ho value of the left inferior temporal gyrus and the right medial and paraccingulate gyrus of the patient group was higher than that of the normal control group;the Re Ho value of the right cortex around the talus fissure of the patient group was lower than that of the normal control group;the difference between the right precuneus and the posterior cingulate gyrus of the patient group was statistically significant The FC values of left angular gyrus and posterior cingulate gyrus increased.Compared with the normal control group,as shown in Figure 4.33 and figure 4.34,the FC of most brain regions in the figure and the posterior cingulate gyrus decreased,but the FC of the left medial temporal lobe(Brodmann: BA48)was the most significant,that is,the functional connection between the left medial temporal lobe(Brodmann: BA48)and the posterior cingulate gyrus decreased most significantly.Conclusions:(1)The dysfunction of left caudate nucleus,left cuneiform lobe,left inferior temporal gyrus,right medial and paraccingulate gyrus,left medial temporal lobe(Brodmann: Ba48)and posterior cingulate gyrus in PSD patients is related to depression;The abnormal function of left cuneiform lobe,right cortical area around talus fissure,right precuneus lobe,left angular gyrus and posterior cingulate gyrus lead to cognitive and emotional symptoms in PSD patients;The dysfunction of the left caudate nucleus is related to sleep disorder in PSD patients;The function of left cuneiform lobe,right precuneus lobe and posterior cingulate gyrus is abnormal.Some of these PSD patients have comorbidity with anxiety,which may lead to increased vigilance.(2)RS-f MRI can objectively evaluate the function of patients,help the detection rate of PSD,provide new insights for the potential mechanism of post-stroke depression,and provide more accurate theoretical basis for the treatment of post-stroke depression.