Correlation Study Of Depression With Energy Metabolism And Cerebral Ischemic In Bilateral Prefrontal

Objective: To study the relationship between energy metabolism products,cerebral ischemia and MDD,explore the pathogenesis of depression and provide imaging basis for clinical diagnosis.Methods: According to the 24-item Hamilton Depression Scale(HAMD-24)scoring standard,79 untreated MDD patients and 60 people without MDD were recruited to the First Affiliated Hospital of Shihezi University from October 1,2020 to October 1,2022 as health control group(HC).HC group was divided into non-ischemic group and ischemic group;MDD group was divided into non-ischemic group and ischemic group.The name,sex,age,weight and education level were counted.Routine magnetic resonance plain scan and magnetic resonance spectroscopy were performed.The area under the peak of creatine(Cr),N-acetylaspartate(NAA)and choline(Cho)in the white matter area of the bilateral prefrontal lobe were measured,and the ratio of NAA/Cr,Cho/Cr was obtained.SPSS 26.0 statistical software was used,and independent sample t-test and χ2 Inspection;The measurement data were tested by independent sample t test,and those that conform to the normal distribution were expressed by mean ± standard deviation.For the indicators with P<0.05,the ROC curve analysis was performed,and the area under the ROC curve(AUC),negative predictive value and positive predictive value were calculated.For the indicators with significant differences,the multiple logistic regression analysis was performed,and the model was established for prediction.The ROC curve analysis was performed on the prediction model,and the significance level was set at 0.05.Results: 1.In MDD group,there was a correlation between the frontal lobe and frontal parietal lobe cerebral ischemia,and there was a significant independent correlation with depression(P<0.05).2.Compared with the HC group,the NAA/Cr,Cho/Cr energy metabolism in the white matter of both prefrontal lobes in the MDD group was abnormal,and the metabolite level was lower than that in the control group(P<0.05).3.Compared with the MDD group without cerebral ischemia,the level of NAA/C metabolites in the white matter of both prefrontal lobes in the MDD group without cerebral ischemia was lower than that in the control group(P<0.05);The level of Cho/Cr in the white matter of bilateral prefrontal lobes in the MDD group without cerebral ischemia was lower than that in the control group,with no significant difference(P=0.05).4.Compared the HC group with cerebral ischemia and the MDD group without cerebral ischemia,the level of NAA/Cr metabolites in the prefrontal white matter of the MDD group without cerebral ischemia was lower than that of the control group,and the level of Cho/Cr metabolites in the prefrontal white matter of the MDD group without cerebral ischemia was higher than that of the control group(P<0.05).5.Compared with the MDD group with cerebral ischemia,the level of NAA/Cr metabolites in the prefrontal white matter of the MDD group with cerebral ischemia was lower than that of the control group,and the level of Cho/Cr metabolites in the prefrontal white matter of the MDD group with cerebral ischemia was higher than that of the control group(P<0.05).6.There was no significant difference in the levels of NAA/Cr,Cho/Cr metabolites in the brain between the people with cerebral ischemia and the people without cerebral ischemia in HC group(P>0.05).7.There was no significant difference in the levels of NAA/Cr,Cho/Cr metabolites in the brain between the people with cerebral ischemia and the people without cerebral ischemia in the MDD group(P>0.05).Conclusion: The energy metabolism of NAA/Cr,Cho/Cr in the white matter of bilateral prefrontal lobes of MDD patients is abnormal.The ratio of metabolites in left and right prefrontal lobe is higher than that in right prefrontal lobe,and there is lateralization.There is a correlation between the cerebral ischemic focus of frontal lobe and frontoparietal lobe and MDD.Abnormal brain structure and function may be one of the pathological mechanisms of depression.Magnetic resonance spectroscopy can be used as an effective basis for the auxiliary diagnosis of depression.