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Neuroscientific Investigation of the Pathophysiology of Mood Disorder and Suicide Behavior

情绪障碍和自杀行为病理生理学的神经科学研究

基本信息

批准号：
11470200
负责人：
MIKUNI Masahiko
金额：
$ 9.6万
依托单位：
Gunma University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2001
项目状态：
已结题

项目摘要

We have investigated disorder-specific pathophysiology of mood disorder, including suicide behavior, by using ^<18>F-FDG-Positron Emission Tomography (PET) and combined endocrinological examination of dexamethasone (DEX) and corticotropin-releasing hormone (CRH). Drug-naive 24 patients with major depression and 10 patients who were investigated by brain imaging analysis and neuroendocrinological examination at pre-treatment and at post-treatment when they were well responded to antidepressant treatment, are included in this study. 75 % of 24 mood disorder patients were non-suppressor in DEX/CRH examination, who have had more frequently the past history of suicide attempt than suppressor. After recovery from depression, most of non-suppressors were changed to suppressors, but 20 % of mood disorders were still non-suppressor, suggesting that some parts of non-suppressor are trait marker of mood disorder or susceptive factor of mood disorder.On the other hand, ^<18>F-FDG-PET study has reveal that left pre-frontal cortex and right superior temporal gyrus of mood disorder patients are significantly decreased to take up ^<18>F-FDG than healthy controls, whereas para-hippocampal gyrus is increased in ^<18>F-FDG intake. These pathological alterations during depressive phase were normalized after recovery from depression, except right superior temporal gyrus. In addition, SPM analysis has clearly demonstrated that ^<18>F-FDG intake into right para-hippocampal gyrus was smaller in non-suppressor than in suppressor. Further studies are needed to clarify the histological alterations in left pre-frontal cortex, right superior temporal gyrus, and right para-hippocampal gyrus from postmortem brain of mood disorder.

我们通过使用^<18 b> f - fdg -正电子发射断层扫描（PET）和地塞米松（DEX）和促肾上腺皮质激素释放激素（CRH）的联合内分泌检查，研究了包括自杀行为在内的情绪障碍的疾病特异性病理生理学。本研究纳入24例未接受药物治疗的重度抑郁症患者和10例在治疗前和治疗后经脑成像分析和神经内分泌检查对抗抑郁药物治疗有良好反应的患者。24例情绪障碍患者中75%的DEX/CRH检查为非抑制性，既往有自杀企图史者多于抑制性者。抑郁症康复后，大部分非抑制性基因转化为抑制性基因，但20%的情绪障碍患者仍为非抑制性基因，提示部分非抑制性基因是情绪障碍的特质标志或情绪障碍的易感因素。另一方面，^<18 b> F-FDG- pet研究显示，情绪障碍患者左侧前额叶皮层和右侧颞上回摄取^<18>F-FDG的量明显低于健康对照组，而海马旁回摄取^<18>F-FDG的量明显增加。抑郁症恢复后，除右侧颞上回外，其余病理改变均恢复正常。此外，SPM分析清楚地表明，非抑制组的右侧海马旁回的F-FDG摄入量小于抑制组。心境障碍患者死后大脑左前额叶皮层、右颞上回和右海马旁回的组织学改变尚需进一步研究。