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首发未用药的重性抑郁障碍患者大脑半球间静息态功能连接减少。

Decreased interhemispheric resting-state functional connectivity in first-episode, drug-naive major depressive disorder.

机构信息

Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Mar 5;41:24-9. doi: 10.1016/j.pnpbp.2012.11.003. Epub 2012 Nov 16.

Abstract

BACKGROUND

Major depressive disorder (MDD) is shown to have structural and functional abnormalities in specific brain areas and connections by recent neuroimaging studies. However, little is known about the alterations of the interhemispheric resting-state functional connectivity (FC) in patients with MDD. In the present study, we used a newly developed voxel-mirrored homotopic connectivity (VMHC) method to investigate the interhemispheric FC of the whole brain in patients with MDD at rest.

METHODS

Twenty-four first-episode, drug-naive patients with MDD and 24 age-, gender-, and education-matched healthy subjects underwent a resting-state functional magnetic resonance imaging (fMRI). An automated VMHC approach was used to analyze the data.

RESULTS

Patients with MDD showed lower VMHC than healthy subjects in the medial prefrontal cortex (MPFC) and the posterior cingulate cortex/precuneus (PCC/PCu), two core regions within default mode network (DMN). Both left and right MPFC showed reduced FC with the other frontal areas and with right anterior cingulate gyrus (ACC), while PCC/PCu exhibited abnormal FC with the frontal areas and thalamus in patient group. Significant positive correlation was observed between VMHC in MPFC and persistent error response of Wisconsin Card Sorting Test (WCST-Pre) in patients. Further ROC analysis revealed that VMHC in the MPFC and PCC/PCu could be used to differentiate the patients from healthy subjects with relatively high sensitivity and specificity.

CONCLUSIONS

Our results suggest that decreased VMHC in brain regions within DMN may underlie the pathogenesis of MDD.

摘要

背景

最近的神经影像学研究表明,重度抑郁症(MDD)患者存在特定脑区和连接的结构和功能异常。然而,目前对于 MDD 患者大脑半球间静息状态功能连接(FC)的改变知之甚少。在本研究中,我们使用一种新开发的体素镜像同伦连接(VMHC)方法来研究 MDD 患者静息状态下全脑的半球间 FC。

方法

24 例首发、未用药的 MDD 患者和 24 名年龄、性别和教育程度匹配的健康对照者接受了静息态功能磁共振成像(fMRI)检查。采用自动 VMHC 方法对数据进行分析。

结果

与健康对照组相比,MDD 患者的内侧前额叶皮质(MPFC)和后扣带回皮层/楔前叶(PCC/PCu)的 VMHC 降低,这两个区域是默认模式网络(DMN)的核心区域。左右 MPFC 与其他额叶区域和右侧前扣带回的 FC 均降低,而 PCC/PCu 与额叶和丘脑的 FC 异常。患者组中 MPFC 的 VMHC 与威斯康星卡片分类测试(WCST-Pre)的持续错误反应呈显著正相关。进一步的 ROC 分析显示,MPFC 和 PCC/PCu 的 VMHC 可以区分患者和健康对照组,具有较高的敏感性和特异性。

结论

我们的研究结果表明,DMN 内脑区的 VMHC 降低可能是 MDD 发病机制的基础。

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