Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jul 1;44:51-7. doi: 10.1016/j.pnpbp.2013.01.010. Epub 2013 Jan 23.
Previous studies have commonly shown that patients with treatment-resistant depression (TRD) and treatment-sensitive depression (TSD) demonstrate a different cerebellar activity. No study has yet explored resting-state cerebellar-cerebral functional connectivity (FC) in these two groups. Here, seed-based FC approach was employed to test the hypothesis that patients with TRD and TSD had a different cerebellar-cerebral FC. The identified FC might be used to differentiate TRD from TSD.
Twenty-three patients with TRD, 22 patients with TSD, and 19 healthy subjects (HS) matched with age, gender, and education level participated in the scans. Seed-based connectivity analyses were performed by using cerebellar seeds.
Relative to HS, both patient groups showed significantly decreased cerebellar-cerebral FC with the prefrontal cortex (PFC) (superior, middle, and inferior frontal gyrus) and default mode network (DMN) [superior, middle, and inferior temporal gyrus, precuneus (PCu), and inferior parietal lobule (IPL)], and increased FC with visual recognition network (lingual gyrus, middle occipital gyrus, and fusiform) and parahippocampal gyrus. However, the TRD group exhibited a more decreased FC than the TSD group, mainly in connected regions within DMN [PCu, angular gyrus (AG) and IPL]. Further receiver operating characteristic curves (ROC) analyses showed that cerebellar-DMN couplings could be applied as markers to differentiate the two subtypes with relatively high sensitivity and specificity.
Both patient groups demonstrate similar pattern of abnormal cerebellar-cerebral FC. Decreased FC between the cerebellum and regions within DMN might be used to separate the two patient groups.
既往研究普遍表明，治疗抵抗性抑郁症（TRD）和治疗敏感性抑郁症（TSD）患者的小脑活动存在差异。目前尚无研究探讨这两组患者静息状态下小脑-大脑功能连接（FC）。本研究采用基于种子的 FC 方法来验证假设，即 TRD 和 TSD 患者存在不同的小脑-大脑 FC。所确定的 FC 可能用于区分 TRD 和 TSD。
23 例 TRD 患者、22 例 TSD 患者和 19 名年龄、性别和教育程度相匹配的健康对照者（HS）参与了扫描。采用小脑种子进行基于种子的连接分析。
与 HS 相比，两组患者的小脑-大脑 FC 均显著降低，与前额叶皮层（PFC）（额上、中、下回）和默认模式网络（DMN）[额上、中、下回、楔前叶（PCu）和顶下小叶（IPL）]相关，与视觉识别网络（舌回、中颞回和梭状回）和海马旁回的 FC 增加。然而，TRD 组的 FC 降低程度比 TSD 组更为显著，主要在 DMN 内的连接区域[PCu、角回（AG）和 IPL]。进一步的受试者工作特征曲线（ROC）分析表明，小脑-DMN 耦合可作为标记物，用于区分两种亚型，具有较高的敏感性和特异性。
两组患者均表现出相似的小脑-大脑 FC 异常模式。小脑与 DMN 内区域之间 FC 的降低可能用于区分这两种患者群体。
