目的运用基于体素分析法(VBA) 探讨早期梗塞后抑郁症(PSD)观看情绪图 片后的脑白质微观结构。方法 对21例梗 塞后抑郁症患者(PSD)和22例梗塞后无 抑郁症组(PSND)、20例正常对照组(NC) 受试者观看情绪图片后行全脑弥散张量 成像扫描。应用VBA方法对PSD组和2个 对照组的FA值进行组间比较。结果 PSD 组－NC组差异显著的脑区主要有双侧额 叶、顶叶(皮层为主)，胼胝体前部、体 部及压部，扣带回体部，放射冠，基底 节区(丘脑、豆状核、左侧内囊)，双侧 小脑半球(P<0.05)；PSD组－PSND组差异 显著的脑区主要有双侧额顶叶内侧皮层 (P<0.05)；PSND组－NC组差异显著的脑区 主要有双侧扣带回，左侧胼胝体前部及压 部(P<0.05)。结论 早期PSD患者存在脑白 质损伤，观看情绪图片后主要表现为边 缘系统-皮质-纹状体-苍白球-背侧丘脑 (LCSPT)神经环路的损伤, 提示早期PSD可 能与神经网络损伤程度有关。

Objective To investigate the microstructural abnormalities of white matter in patients with post-stroke depression(PSD) by using the method of voxel-based analysis(VBA). Methods Whole brain diffusion tensor imaging(DTI) was performed in 21 patients with PSD and 22 stroke patients without depression group (PSND), 20 healthy volunteers as control group (NC). Fractional anisotropy(FA) values were compared between PSD group and 2 control groups by VBA. Results The FA values differences with statistical significance of brain regions were found in following (P<0.05): between the PSD group and the NC group, mainly include bilateral frontal lobe and parietal lobe (cortex mainly), the anterior, body and splenium parts of the corpus callosum, the body of cingulate gyrus, corona radiata, basal ganglia(Thalamus, putamen, left internal capsule) and bilateral cerebellar hemisphere(P<0.05), between the PSD group-PSND group, mainly include bilateral medial frontal lobe and parietal lobe cortex (P<0.05), between the PSND group-NC group, mainly include bilateral cingulate gyrus, left anterior and splenium parts of corpus callosum (P<0.05). Conclusion The microstructural abnormalities of white matter were found in patients with early PSD, and mainly expressed as the injury of the nerve loop of the limbic system- cortex-striatum-globus pallidus-dorsal thalamus(LCSPT), which suggested that early PSD may be related to the degree of neural network damage.