摘要： 目的 初步探讨首发抑郁症患者执行词语流畅性任务时前额叶和双侧颞叶脑激活特征。方法 纳入2021年1-3月上海交通大学医学院附属瑞金医院收治的40例首发抑郁症患者以及性别、年龄、受教育程度相匹配的正常对照者，采用Zung氏抑郁自评量表（SDS）评估抑郁症状严重程度，功能性近红外光谱成像（fNIRS）技术检测执行词语流畅性任务期间前额叶和双侧颞叶脑区激活特征。Pearson相关分析探讨抑郁症患者前额叶和双侧颞叶氧合血红蛋白积分值与SDS评分的相关性。结果 抑郁症患者SDS评分高于正常对照者（68.38 ±12.91对35.98 ±6.83；t=11.832，P=0.000）。执行词语流畅性任务时，抑郁症患者前额叶［（35.25 ±41.74）mmol·mm对（149.91 ±54.88）mmol·mm；t=-8.140，P=0.000］和双侧颞叶［（84.05 ±59.23）mmol·mm对（211.01 ±81.27）mmol·mm；t=-6.250，P=0.000］氧合血红蛋白积分值低于正常对照者，组词数组间差异无统计学意义［（11.27 ±4.35）个对（11.92 ±5.55）个；t=-0.450，P=0.665］。Pearson相关分析结果显示，抑郁症患者双侧颞叶氧合血红蛋白积分值与SDS评分呈负相关（r=-0.330，P=0.039），而前额叶积分值与SDS评分无相关性（r=-0.210，P=0.184）。结论 首发抑郁症患者执行词语流畅性任务时，前额叶和双侧颞叶脑区激活下降，双侧颞叶氧合血红蛋白积分值与抑郁程度呈负相关。

关键词: 抑郁症, 认知障碍, 谱学, 近红外线, 神经心理学测验

Abstract: Objective To investigate the spatial pattern of the activation of the prefrontal and bilateral temporal cortex in first-episode depressive disorder patients during Verbal Fluency Test (VFT). Methods Forty first-episode patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) depressive disorder and 14 normal controls were both measured of spatial pattern in the prefrontal and bilateral temporal cortex by functional near-infrared spectroscopy (fNIRS) during VFT, at the same time, the number of words produced during VFT was recorded. The severity of depressive symptoms was assessed by Zung's Self-Rating Depression Scale (SDS). The spatial pattern of brain activation during VFT was compared between 2 groups, and the correlation between the oxyhemoglobin (HbO₂) integral value of prefrontal or bilateral temporal lobes and SDS score were explored by Pearson correlation analysis in depressive disorder group. Results SDS score of the depressive disorder patients was higher than that of control group (68.38 ±12.91 vs. 35.98 ±6.83; t=11.832, P=0.000). Compared with the control group, the scores of prefrontal and bilateral temporal lobes in depression group were significantly lower during VFT[(35.25 ±41.74) mmol·mm vs. (149.91 ±54.88) mmol·mm, t=-8.140, P=0.000; (84.05 ±59.23) mmol·mm vs. (211.01 ±81.27) mmol·mm, t=-6.250, P=0.000]. There was no significant difference in the number of words between 2 groups (11.27 ±4.35 vs. 11.92 ±5.55; t=-0.450, P=0.665). There was a negative correlation between the HbO₂ integral value of bilateral temporal lobes and SDS score in patients with depressive disorder (r=-0.330, P=0.039), and there was no significant correlation between the HbO₂ integral value of prefrontal lobe and SDS score (r=-0.210, P=0.184). Conclusions During the VFT, the decrease of prefrontal and bilateal temporal lobes activation and the bilateral temporal lobes HbO₂ integral value is negatively correlated with the degree of depression.

Key words: Depression disorder, Cognition disorders, Spectroscopy, near-infrared, Neuropsychological tests