MUSTAFA KOÇ, Ömer Cihat KULOĞLU, HANEFİ YILDIRIM, Murat ATMACA

Sosyal anksiyete bozukluğu hastalarında MRI ile hipokampus ve amigdala volüm değişikliklerinin araştırılması

Amaç: Çalışmamızda sosyal anksiyete bozukluğu (SAB) hastaları ile sağlıklı gönüllülerin, hipokampus ve amigdaladaki volüm değişikliklerinin araştırılması amaçlandı. Yöntem: Hastanemiz psikiyatri kliniğinde SAB tanısı ile ayaktan ve yatarak tedavi gören toplam 22 hasta çalışmaya alındı. Kontrol grubu, dışlama ölçütlerini taşımayan 20 sağlıklı gönüllüden oluştu. Dışlama ölçütleri şunlardı: Depresyon ve diğer komorbiditelerin varlığı, diyabetes mellitus, kronik böbrek yetmezliği ve hipertansiyon gibi ciddi sistemik hastalıklar, sağlıklı bir görüşmeyi önleyen düşük eğitim düzeyi ve zeka geriliğinin olması. Görüntülemeden önce önleyici önlemler uygulanmadı. Tüm hastalarda hipokampus ve amigdala hacmi MR incelemelerinde ölçüldü. Damardan kontrast madde verilmedi. Bulgular: Hasta grubunda sağ ve sol hipokampus volümü sırasıyla 3.47±0.57 cm3, 3.04±0.48 cm3 bulundu. Kontrol grubunda sağ ve sol hipokampus volümü sırasıyla 3.00±0.24 cm3, 2.98±0.27 cm3 ölçüldü. Hasta grubunda sağ ve sol hipokampus volümünde kontrol grubuna göre istatistiksel olarak anlamlı bir artış gözlendi. Hasta grubunda sağ ve sol amigdala volümü sırası ile 2.05±0.36 cm3 ve 2.04±0.37 cm3, kontrol grubunda sağ ve sol amigdala volümü sırası ile 2.03±0.25cm3 and 1.98±0.33 cm3 ölçüldü. Hasta ve kontrol grubu amigdala volümleri arasında istatistiksel olarak anlamlı bir farklılık yoktu. Ancak hasta grubunda amigdala korelasyonu bozulmuş olarak saptandı. Sonuç: Bu çalışma ile SAB'nin fizyopatolojisi ile ilişkili olabilecek amigdala ve hipokampal yapılara ait anormallikler gösterilmiştir.

The investigation of hippocampus and amygdala volume changes with MRI in patients with social anxiety disorder

Objective: The purpose was to investigate the volume changes of hippocampus and amygdala in Social anxiety disorder (SAD) patients and healthy subjects. Methods: A total of 22 patients diagnosed with SAD, who were being treated as either inpatients or outpatients at the psychiatric clinic of our hospital, were enrolled in the study. The control group consisted of a total of 20 healthy volunteers who don't have exclusion criteria. Exclusion criteria were as follows: the presence of depression and other comorbidities, severe systemic diseases including diabetes mellitus, chronic renal failure, and hypertension, a low level of education preventing a healthy interview, and the presence of mental retardation. No preliminary preventive measures were implemented before imaging. The volume of hippocampus and amygdala in all patients was measured on MRI examinations. No intravenous contrast agent was administered. Results: The mean volume of right hippocampus and left hippocampus in patient group were 3.47±0.57 cm3 and 3.44±0.48 cm3, respectively. The mean volume of right hippocampus and left hippocampus in control group were 3.00±0.24 cm3 and 2.98±0.27 cm3, respectively. The right and left hippocampus volume of patient group was significantly higher than control group. The mean volume of right and left amygdala in patient group were 2.05±0.36 cm3 and 2.04±0.37 cm3, respectively. The mean volume of right and left amygdala in control group were 2.03±0.25cm3 and 1.98±0.33 cm3, respectively. The amygdala volume of patient and control group was not significantly different. By the way the correlation of amygdala in patient group was impaired. Conclusion: Our study revealed abnormalities of amygdala and hippocampus which may be associated with physiopathology of SAD.

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