| BackgroundWith the development of medical science progress and people’s understanding of cerebral vascular accident gradually, stroke itself caused the mortality and disability rate was significantly decreased, and the behavior and psychological disorders of depression after stroke caused has become an important factor in the delay of patients with neurological function and daily life ability recovery. Mental and behavioral disorders in patients with Post-stroke depression become an important factor in delaying the patient neurological recovery and activities of daily living, and to explore the etiology of Post-stroke depression and its early screening become a hotspot in recent years.ObjectivesTo identify the metabolite levels in thalamus in patients withPost-stroke depression by proton magnetic resonance spectroscopy (1H-MRS). To explore the biochemical metabolite levels in the thalamus in patients with post-stroke depression and the correlation with the clinical severity of symptoms. And then explore the possible biological mechanisms of post-stroke depression, provide a theoretical basis for early clinical intervention and risk assessment of adverse events.Methods36 patients with Post-stroke depression met with American Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-Ⅳ) with medicine-free for at least 7 days, 38 patients withstrokeand 35 normal controls were assessed in this study. All subjects were to be determined to examine the mini-mental status examination (mini-mental state examination, MMSE) and Hamilton Depression Rating Scale (Hamilton Depression Scale, HAMD) after they were selected in the group. A multi-voxel 1H-MRS was given to all the subjects on thalamus within 24 hours when they got in hospital.The NAA, Cho and Cr were monitored and the ratios of NAA/Cr and Cho/Cr were calculated by the computer comes with software in the left thalamus (left thalamus, LT) and right thalamus (right thalamus, RT).All data were entered into the computer, Spectral data were analyzed by the SPSS 16.0, using statistical description of a general, normality test, independent samplet test, analysis of variance, statistical analysis q test, Pearson correlation analysis and et al, testing standards set α= 0.05, both bilaterally test.Results1.Comparison among the three groups(1) comparison among groups:In left and right thalamus, the NAA/Cr ratio in The Research Group (1.11±0.33 and 1.30±0.40) demonstrated lower than that in The Case-control group (1.66±0.49 and 1.57±0.55) and in The normal control group (1.76±0.38 and 1.83±0.58) (all P<0.05). In leftthalamus,the Cho/Cr ratio in The Research Group (2.01±0.48) showed Higher than that in The Case-control group and in The normal control group (1.51±0.42 and 1.18±0.37)(all P<0.05). In right thalamus,the Cho/Cr ratio in The Research Group showed Higher than that in The normal control group (1.70±0.50 vs.1.21±0.46, P<0.05). But not showed Higher than that in The Case-control group (1.70±0.50 vs.1.74±0.48,P>0.05).(2) Within-groups comparison:In The Research Group, the NAA/Cr ratio In left thalamus, (1.11±0.38) demonstrated lower than that in right thalamus (1.30±0.40) (P<0.05). the Cho/Cr ratio In leftthalamus (2.01±0.48) showed Higher than that in right thalamus (1.51±0.42)(P<0.05). In The Case-control group and in The normal control group, therewere no significant differences in NAA/CrandCho/Cr between bilateral thalamus (all P>0.05).2. The comparison of the NAA/Cr ratio and the Cho/Cr ratio among the three groups of different sex.In the Three groups, therewere no significant differences in NAA/CrandCho/Cr in bilateral thalamus of different sex (all P>0.05).3. The comparison of the NAA/Cr ratio and the Cho/Cr ratio among the different degree of depression.In left and right thalamus, the NAA/Cr ratio in The Severe depression group (0.92±0.26 and 1.11±0.33) demonstrated lower than that in The Mild depression group (1.23±0.37 and 1.42±0.44) (all P<0.05). Therewere no significant differences in the Cho/Cr ratio among the different degree of depression (all P>0.05).4. The comparison of the NAA/Cr ratio and the Cho/Cr ratio among the different degree of depression.In bilateral thalamus, the NAA/Cr ratio in The Research Groupshowed a significant negative correlation with The HAMD scores (all P<0.05); But the Cho/Cr ratio not showed a significant correlation with The HAMD scores(all P>0.05).Conclusions1. The abnormalities in the thalamus in neuronal function and/or integrity are present atpost-stroke depression, while membrane metabolic disturbance and the proliferation of gliacyte may be not obvious.2. Abnormal metabolism of neurons in the thalamus may the neurobiological basis of post-stroke depression.3. the NAA/Cr ratio in thalamuscan be used as evaluation of post-stroke depression severity, Proton magnetic resonance spectroscopy could possibly be used as an effective means of screening for post-stroke depression. |
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