儿童期起病抑郁症患者杏仁核的功能连接。
Functional connectivity of the amygdala in early-childhood-onset depression.
机构信息
Department of Psychology, Washington University in St. Louis, MO 63110, USA.
出版信息
J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):1027-41.e3. doi: 10.1016/j.jaac.2011.07.019. Epub 2011 Sep 3.
OBJECTIVE
Adult major depressive disorder (MDD) is associated with reduced cortico-limbic functional connectivity thought to indicate decreased top-down control of emotion. However, it is unclear whether such connectivity alterations are also present in early-childhood-onset MDD.
METHOD
A total of 51 children 7 through 11 years of age who had been prospectively studied since preschool age, completed resting state functional magnetic resonance imaging (fMRI) and were assigned to one of four groups: 1) C-MDD (N = 13), those children with a personal history of early-childhood-onset MDD; 2) M-MDD (N = 11), those with a maternal history of affective disorders; 3) CM-MDD (N = 13), those with both maternal and early-childhood-onset MDD; or 4) CON (N = 14), those without either a personal or maternal history of MDD. We used seed-based resting state functional connectivity (rsfcMRI) analysis in an independent sample of adults to identify networks showing both positive (e.g., limbic regions) and negative (e.g., dorsal frontal/parietal regions) connectivity with the amygdala. These regions were then used in region-of-interest-based analyses of our child sample.
RESULTS
We found a significant interaction between maternal affective disorder history and the child's MDD history for both positive and negative rsfcMRI networks. Specifically, when compared with CON, we found reduced connectivity between the amygdala and the "negative network" in children with C-MDD, M-MDD, and CM-MDD. Children with either C-MDD or a maternal history of MDD (but not CM-MDD) displayed reduced connectivity between the amygdala and the "positive network."
CONCLUSIONS
Our finding of an attenuated relationship between the amygdala, a region affected in MDD and involved in emotion processing, and cognitive control regions is consistent with a hypothesis of altered regulation of emotional processing in C-MDD, suggesting developmental continuity of this alteration into early childhood.
目的
成人重度抑郁症（MDD）与皮质-边缘功能连接减少有关，这被认为是情绪的自上而下控制减弱的标志。然而，目前尚不清楚这种连接改变是否也存在于儿童期发病的 MDD 中。
方法
共有 51 名 7 至 11 岁的儿童自学前年龄开始接受前瞻性研究，完成了静息态功能磁共振成像（fMRI）检查，并被分为以下四组之一：1）C-MDD（N=13），即有儿童期发病的 MDD 个人病史的儿童；2）M-MDD（N=11），即有情感障碍家族史的儿童；3）CM-MDD（N=13），即有家族和儿童期发病的 MDD 的儿童；或 4）CON（N=14），即无 MDD 个人或家族病史的儿童。我们使用基于种子的静息状态功能连接（rsfcMRI）分析在成人的独立样本中识别出与杏仁核呈正相关（如边缘区域）和负相关（如背侧额顶区域）的网络。然后，我们使用这些区域在儿童样本的基于感兴趣区域的分析中。
结果
我们发现，在儿童 MDD 病史与母亲情感障碍病史之间，正性和负性 rsfcMRI 网络均存在显著的交互作用。具体而言，与 CON 相比，我们发现 C-MDD、M-MDD 和 CM-MDD 患儿的杏仁核与“负性网络”之间的连接减少。有 C-MDD 或 MDD 家族史的儿童（但不是 CM-MDD）的杏仁核与“正性网络”之间的连接减少。
结论
我们发现，杏仁核与情绪处理相关，并且与认知控制区域有关，在 MDD 中受影响，而与杏仁核的关系减弱，这与儿童期发病的 MDD 中情绪处理调节改变的假设一致，表明这种改变的发展连续性进入了儿童早期。
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