Research Progress in Brain Imaging and Nuclear Brain Imaging Technology of Depression

doi:10.12114/j.issn.1007-9572.2021.00.441

Abstract

Abstract: Because of high prevalence，recurrence，misdiagnosis and suicide rate，depression can cause heavy burden for the families of patients and even the whole society.The developments of neuroscience and brain imaging technology have provided new methods and ideas for the identification，diagnosis，pathogenesis and treatment for depression in recent years，and also the scientific basis for the development of physical therapy of depression.Current imaging studies of depression mainly contain brain imaging and nuclear brain imaging technology.This paper mainly reviewed the latest research progress of the two technologies mentioned above and analyzed the advantages，disadvantages and existing problems of the two technologies，in order to provide a reference for better diagnosis and treatment of depression.

Key words: Depressive disorder, Neuroimaging, Functional neuroimaging, Brain imaging, Nuclear brain imaging, Review

摘要： 抑郁症患病率、复发率、误诊率和自杀率均较高，给患者家庭及社会带来深重负担。近年来神经科学及脑影像学的发展为抑郁症的辨识、诊断、发病机制及治疗研究提供了新的方法与思路，也为抑郁症的物理治疗学发展提供了科学依据。目前，抑郁症的影像学研究主要分为脑成像技术、核脑影像成像技术两大类。本文主要分析了近年来抑郁症脑成像技术和核脑影像成像技术的研究进展及其优劣势、存在的问题等，以期为临床更好地对抑郁症进行诊疗提供参考。

关键词: 抑郁症, 神经成像, 功能性神经成像, 脑成像, 核脑影像成像, 综述

WANG Xinyuan,LIU Yan,TAN Xi. Research Progress in Brain Imaging and Nuclear Brain Imaging Technology of Depression　[J]. Chinese General Practice, 2021, 24(21): 2701-2706. DOI: 10.12114/j.issn.1007-9572.2021.00.441.
王馨苑,刘琰,谭曦. 抑郁症脑成像技术和核脑影像成像技术的研究进展[J]. 中国全科医学, 2021, 24(21): 2701-2706. DOI: 10.12114/j.issn.1007-9572.2021.00.441.

References

［1］HUANG Y，WANG Y，WANG H，et al．Prevalence of mental disorders in China：a cross-sectional epidemiological study［J］．Lancet Psychiatry，2019，6（3）：211-224．DOI：10.1016/S2215-0366（18）30511-X.
［2］抑郁研究所．2019中国抑郁症领域蓝皮书［M］．梅斯医学，2020.
［3］贾富仓，翁旭初.脑功能成像原理和技术［EB/OL］．（2013-10-29）［2020-10-21］．https：//wenku.baidu.com/view/e4de75f876eeaeaad1f3304b.html.
［4］车文博.心理咨询大百科全书［M］．杭州：浙江科学技术出版社，2001：241.
［5］DAS J，YADAV S.Resting state quantitative electroencephalogram power spectra in patients with depressive disorder as compared to normal controls：an observational study［J］．Indian J Psychol Med，2020，42（1）：30-38．DOI：10.4103/IJPSYM.IJPSYM_568_17.
［6］刘潇雅，刘爽，郭冬月，等．抑郁症脑电特异性研究进展［J］．中国生物医学工程学报，2020，39（3）：351-361．DOI：10.3969/j.issn.0258-8021.2020.03.13.
LIU X Y，LIU S，GUO D Y，et al．Research progress in electroencephalography of depression［J］．Chinese Journal of Biomedical Engineering，2020，39（3）：351-361．DOI：10.3969/j.issn.0258-8021.2020.03.13.
［7］李成，肖正军.首发抑郁症患者治疗前后脑电图变化的研究［J］．中国民康医学，2011，23（17）：2103-2104，2111．DOI：10.3969/j.issn.1672-0369.2011.17.004.
LI C，XIAO Z J.The study of electroencephalogran in first-episode depression before and after therapy［J］．Medical Journal of Chinese People's Health，2011，23（17）：2103-2104，2111．DOI：10.3969/j.issn.1672-0369.2011.17.004.
［8］王萍.抑郁症患者脑电图与经颅多普勒结果分析［J］．中国伤残医学，2012，20（4）：83-84．DOI：10.3969/j.issn.1673-6567.2012.04.068.
［9］杨志寅.诊断学大辞典［M］．北京：华夏出版社，2004：1093.
［10］黎柱培，梁光辉，蔡玉珍，等．抑郁障碍患者事件相关电位的临床研究［J］．海南医学，2020，31（12）：1545-1548．DOI：10.3969/j.issn.1003-6350.2020.12.015.
LI Z P，LIANG G H，CAI Y Z，et al．Clinical study of event-related potentials in patients with depression［J］．Hainan Medical Journal，2020，31（12）：1545-1548．DOI：10.3969/j.issn.1003-6350.2020.12.015.
［11］郭珊珊，王彦芳.首发抑郁障碍患者认知功能的危险因素探索［J］．校园心理，2020，18（4）：303-307．DOI：10.19521/j.cnki.1673-1662.2020.04.010.
［12］刘贺，南彩，马思梦，等．抑郁症患者事件相关电位P300与健康问卷-9评分的相关性及其临床意义分析［J］．神经损伤与功能重建，2020，15（2）：91-94．DOI：10.16780/j.cnki.sjssgncj.2020.02.008.
LIU H，NAN C，MA S M，et al．Cognitive impairment and event-related potential P300 change in depression patients based on Patient Health Questionnaire-9［J］．Neural Injury and Functional Reconstruction，2020，15（2）：91-94．DOI：10.16780/j.cnki.sjssgncj.2020.02.008.
［13］张妤婷，陈凌，陈克龙，等．事件相关电位P300与轻度抑郁症患者认知功能的相关性研究［J］．中国现代医生，2020，58（12）：9-12.
ZHANG Y T，CHEN L，CHEN K L，et al．Correlation between event-related potential P300 and cognitive function in patients with mild depression［J］．China Modern Doctor，2020，58（12）：9-12.
［14］DAI Q，FENG Z.More excited for negative facial expressions in depression：evidence from an event-related potential study［J］．Clin Neurophysiol，2012，123（11）：2172-2179．DOI：10.1016/j.clinph.2012.04.018.
［15］李红，杨小光，郑文瑜，等．抑郁倾向对个体情绪调节目标的影响——来自事件相关电位的证据［J］．心理学报，2019，51（6）：637-647．DOI：10.3724/SP.J.1041.2019.00637.
LI H，YANG X G，ZHENG W Y，et al．Emotional regulation goals of young adults with depression inclination：an event-related potential study［J］．Acta Psychologica Sinica，2019，51（6）：637-647．DOI：10.3724/SP.J.1041.2019.00637.
［16］GOTLIB I H，GOODMAN S H，HUMPHREYS K L.Studying the intergenerational transmission of risk for depression：current status and future directions［J］．Curr Dir Psychol Sci，2020，29（2）：096372142090159．DOI：10.1177/0963721420901590.
［17］何伋，路英智，李浒，等．神经精神病学辞典［M］．海口：南海出版公司，2008：400.
［18］冯毅刚，管玉芳，沈拾亦，等．抑郁症患者静息态枕叶θ，α频段能量偏侧化与视觉注意功能损伤的相关研究［J］．暨南大学学报（自然科学与医学版），2019，40（6）：525-530．DOI：10.11778/j.jdxb.2019.06.008.
FENG Y G，GUAN Y F，SHEN S Y，et al．Correlation between resting-state energy lateralization of θ and α bands in occipital region and visual attention impairment in patients with major depressive disorder［J］．Journal of Jinan University（Natural Science and Medicine Edition），2019，40（6）：525-530．DOI：10.11778/j.jdxb.2019.06.008.
［19］林品华.抑郁症患者Go/No-go任务态大脑偏侧化的脑磁图研究［D］．南京：南京大学，2019.
LIN P H.Task-related of Go/No-go task with band asymmetry in major depressive disorder：a MEG study［D］．Nanjing：Nanjing University，2019.
［20］贾凤南，汤浩，史家波，等．抑郁症患者个体化脑磁频谱活动与临床症状的相关性［J］．临床精神医学杂志，2015，25（3）：145-148.
JIA F N，TANG H，SHI J B，et al．Reiationship between magnetoencephaiography spectrum individuai spectrai power of depressed patients and the severity of ciinicai symptom ciusters［J］．Journal of Clinical Psychiatry，2015，25（3）：145-148.
［21］闫伟，谢世平，王沛弟.抑郁症的脑磁图研究进展［J］．临床精神医学杂志，2009，19（5）：348-350.
［22］蒋辉，潘丽，腾良峰，等．重复经颅磁刺激治疗在抑郁患者的疗效研究［J］．当代医学，2018，24（25）：39-41.
JIANG H，PAN L，TENG L F，et al．The efficacy of repetitive transcranial magnetic stimulation in the treatment of depressive patients［J］．Contemporary Medicine，2018，24（25）：
39-41.
［23］王心蕊，依桂花.重复经颅磁刺激在抑郁患者治疗中的应用效果［J］．系统医学，2019，4（7）：32-34．DOI：10.19368/j.cnki.2096-1782.2019.07.032.
WANG X R，YI G H.Application effect of repeated transcranial magnetic stimulation in the treatment of depressed patients［J］．Systems Medicine，2019，4（7）：32-34．DOI：10.19368/j.cnki.2096-1782.2019.07.032.
［24］刘思红，李春丽.重复经颅磁刺激联合抗抑郁药治疗对抑郁症首发患者的早期疗效及认知功能改善的观察［J］．心理月刊，2020，15（16）：53．DOI：10.19738/j.cnki.psy.2020.16.037
［25］邱建成，胡亚兰.高频与低频重复经颅磁刺激治疗抑郁症的临床效果及脑电波变化［J］．交通医学，2020，34（3）：283-284．DOI：10.19767/j.cnki.32-1412.2020.03.020.
［26］付可登，李松华，胡媛媛，等．高频重复经颅磁刺激对重度抑郁患者血清mir-124、mir-214及炎性因子水平的影响［J］．中国现代医生，2020，58（16）：103-106.
FU K D，LI S H，HU Y Y，et al．Effects of high-frequency repetitive transcranial magnetic stimulation on serum levels of mir-124，mir-214 and inflammatory factors in patients with severe depression［J］．China Modern Doctor，2020，58（16）：
103-106.
［27］曹朝霞，张彦峰，韩雅迪，等．功能性近红外光谱成像技术在脑功能成像中的应用研究进展［J］．甘肃中医药大学学报，2018，35（3）：99-103．DOI：10.16841/j.issn1003-8450.2018.03.26.
CAO Z X，ZHANG Y F，HAN Y D，et al．Application of functional near-infrared spectroscopy in cerebral function imaging［J］．Journal of Gansu University of Chinese Medicine，2018，35（3）：99-103．DOI：10.16841/j.issn1003-8450.2018.03.26.
［28］FU L，XIANG D，XIAO J，et al．Reduced prefrontal activation during the Tower of London and verbal fluency task in patients with bipolar depression：a multi-channel NIRS study［J］．Front Psychiatry，2018，9：214．DOI：10.3389/fpsyt.2018.00214.
［29］HOLPER L，LAN M J，BROWN P J，et al．Brain cytochrome-c-oxidase as a marker of mitochondrial function：a pilot study in major depression using NIRS［J］．Depress Anxiety，2019，36（8）：766-779．DOI：10.1002/da.22913.
［30］LIU X，SUN G，ZHANG X，et al．Relationship between the prefrontal function and the severity of the emotional symptoms during a verbal fluency task in patients with major depressive disorder：a multi-channel NIRS study［J］．Prog Neuropsychopharmacol Biol Psychiatry，2014，54：114-121．DOI：10.1016/j.pnpbp.2014.05.005.
［31］KAWANO M，KANAZAWA T，KIKUYAMA H，et al．Correlation between frontal lobe oxy-hemoglobin and severity of depression assessed using near-infrared spectroscopy［J］．J Affect Disord，2016，205：154-158．DOI：10.1016/j.jad.2016.07.013.
［32］张小芊，申晨煜，陈桂芳，等．伴自杀行为和自杀观念抑郁症患者前额叶近红外光图谱分析［J］．中华精神科杂志，2019，52（6）：403-407．DOI：10.3760/cma.j.issn.1006-7884.2019.06.008.
ZHANG X Q，SHEN C Y，CHEN G F，et al．Analyzing hemoglobin activation at prefrontal cortex for suicidal behavior and suicidal ideation in depressed patients［J］．Chinese Journal of Psychiatry，2019，52（6）：403-407．DOI：10.3760/cma.j.issn.1006-7884.2019.06.008.
［33］FU C，SHI D，GAO Y，et al．Functional assessment of prefrontal lobes in patients with major depression disorder using a dual-mode technique of 3D-arterial spin labeling and 18F-fluorodeoxyglucose positron emission tomography/computed tomography［J］．Exp Ther Med，2017，14（2）：1058-1064．DOI：10.3892/etm.2017.4594.
［34］SU L，CAI Y，XU Y，et al．Cerebral metabolism in major depressive disorder：a voxel-based meta-analysis of positron emission tomography studies［J］．BMC Psychiatry，2014，14（1）：321．DOI：10.1186/s12888-014-0321-9.
［35］HOLMES S E，HINZ R，CONEN S，et al．Elevated translocator protein in anterior cingulate in major depression and a role for inflammation in suicidal thinking：a positron emission tomography study［J］．Biol Psychiatry，2018，83（1）：61-69．DOI：10.1016/j.biopsych.2017.08.005.
［36］LI H，SAGAR A P，KéRI S.Microglial markers in the frontal cortex are related to cognitive dysfunctions in major depressive disorder［J］．J Affect Disord，2018，241：305-310．DOI：10.1016/j.jad.2018.08.021.
［37］罗振业，齐张璋，邱少娟，等．阈下抑郁磁共振成像的研究进展［J］．中国神经精神疾病杂志，2020，46（6）：372-375．DOI：10.3969/j.issn.1002-0152.2020.06.014.
［38］刘耀中，柳昀哲，林碗君，等．抑郁障碍的核心脑机制——基于fMRI元分析的证据［J］．中国科学（生命科学），2015，45（12）：1214-1223．DOI：10.1360/N052015-00164.
LIU Y Z，LIU Y Z，LIN W J，et al．The core neural mechanisms underlying depression disorder：a meta-analysis of fMRI studies［J］．Science in China（Series C），2015，45（12）：1214-1223．DOI：10.1360/N052015-00164.
［39］LAI C H.The neural markers of MRI to differentiate depression and panic disorder［J］．Prog Neuropsychopharmacol Biol Psychiatry，2019，91：72-78．DOI：10.1016/j.pnpbp.2018.04.013.
［40］KONG X M，XU S X，YAN S，et al．Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity（ReHo）and amplitude of low frequency fluctuations（ALFF）in elderly major depressive disorder patients：an exploratory study［J］．Psychiatry Res Neuroimaging，2017，264：13-21．DOI：10.1016/j.pscychresns.2017.04.001.
［41］王丽.抑郁症患者静息态的脑功能磁共振研究［D］．南京：南京医科大学，2009.
［42］杨蜀云，李仙，侯亚婷，等．重性抑郁障碍脑结构及静息态功能磁共振研究进展［J］．中国社区医师，2020，36（20）：7-8．DOI：10.3969/j.issn.1007-614x.2020.20.003.
YANG S Y，LI X，HOU Y T，et al．Advances in brain structure and resting state functional magnetic resonance imaging of major depressive disorders［J］．Chinese Community Doctors，2020，36（20）：7-8．DOI：10.3969/j.issn.1007-614x.2020.20.003.
［43］陈暇女．基于静息态功能磁共振比率低频振幅对产后抑郁症患者脑自发神经活动的研究［D］．重庆：重庆医科大学，2020.
［44］冯晓荣，梁立华，吴明祥，等．抑郁症患者治疗前后的静息态fMRI比较探究［J］．中国医疗前沿，2013，8（10）：93，115．DOI：10.3969/j.issn.1673-5552.2013.10.0068.
［45］ALDERS G L，DAVIS A D，MACQUEEN G，et al．Escitalopram ameliorates differences in neural activity between healthy comparison and major depressive disorder groups on an fMRI emotional conflict task：a CAN-BIND-1 study［J］．J Affect Disord，2020，264：414-424．DOI：10.1016/j.jad.2019.11.068.
［46］王燕．首发重性抑郁障碍患者治疗前后情感任务态脑功能磁共振研究［D］．太原：山西医科大学，2012．DOI：10.7666/d.y2126765.
［47］宋筱蕾，穆新暖，于美霞，等．首发轻中度抑郁症患者治疗前后脑任务态功能磁共振研究［J］．临床放射学杂志，2019，38（7）：1174-1179.
SONG X L，MU X N，YU M X，et al．The study of brain fMRI in task state of first-episode patients with mild and moderate depression before and after treatment［J］．Journal of Clinical Radiology，2019，38（7）：1174-1179.
［48］SANTOS M A O，BEZERRA L S，CARVALHO A R M R，et al．Global hippocampal atrophy in major depressive disorder：a meta-analysis of magnetic resonance imaging studies［J］．Trends Psychiatry Psychother，2018，40（4）：369-378．DOI：10.1590/2237-6089-2017-0130.
［49］李月峰，居胜红，滕皋军，等．基于灰度差分法对首发轻度抑郁患者海马结构MRI信号的研究［J］．中华神经医学杂志，2017，16（2）：147-151．DOI：10.3760/cma.j.issn.1671-8925.2017.02.008.
LI Y F，JU S H，TENG G J，et al．Magnetic resonance signal of hippocampal structure in patients with mild onset depression based on gray scale difference method［J］．Chinese Journal of Neuromedicine，2017，16（2）：147-151．DOI：10.3760/cma.j.issn.1671-8925.2017.02.008.
［50］NARITA K，SUDA M，TAKEI Y，et al．Volume reduction of ventromedial prefrontal cortex in bipolarⅡ patients with rapid cycling：a voxel-based morphometric study［J］．Prog Neuropsychopharmacol Biol Psychiatry，2011，35（2）：439-445．DOI：10.1016/j.pnpbp.2010.11.030.
［51］TAKI Y，KINOMURA S，AWATA S，et al．Male elderly subthreshold depression patients have smaller volume of medial part of prefrontal cortex and precentral gyrus compared with age-matched normal subjects：a voxel-based morphometry［J］．J Affect Disord，2005，88（3）：313-320．DOI：10.1016/j.jad.2005.08.003.
［52］禚传君．不同类别抑郁的MRI特征及其对首发抑郁早期定性诊断研究的启示［J］．中华行为医学与脑科学杂志，2014，23（5）：477-478．DOI：10.3760/cma.j.issn.1674-6554.2014.05.030.
［53］ZHANG T，ZHAO B，SHI C，et al．Subthreshold depression may exist on a spectrum with major depressive disorder：evidence from gray matter volume and morphological brain network［J］．J Affect Disord，2020，266：243-251．DOI：10.1016/j.jad.2020.01.135.
［54］SAVITZ J B，NUGENT A C，BOGERS W．Habenula volume in bipolar disorder and major depressive disorder：a high-resolution magnetic resonance imaging study［J］．Biol Psychiatry，2011，69（4）：336-343．DOI：10.1016/j.biopsych.2010.09.027.
［55］DE DIEGO-ADELI?O J，CARCELLER M，SERRA-BLASCO M，et al．P.4.023 Habenular nuclei in different phases of major depressive disorder：a magnetic resonance imaging volumetric study［J］．European Neuropsychopharmacology，2013，23（Suppl 1）：S86-87．DOI：10.1016/S0924-977X（13）70098-1.

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