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首发、未经治疗的重度抑郁症患者在静息状态下是否存在小脑代偿作用?

Is there a cerebellar compensatory effort in first-episode, treatment-naive major depressive disorder at rest?

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 Oct 1;46:13-8. doi: 10.1016/j.pnpbp.2013.06.009. Epub 2013 Jun 23.

DOI:10.1016/j.pnpbp.2013.06.009
PMID:23800464
Abstract

BACKGROUND

This study was undertaken to explore whether there is a cerebellar compensatory response in patients with first-episode, treatment-naive major depressive disorder (MDD). The cerebellar compensatory response is defined as a cerebellar hyperactivity which would be inversely correlated with both the activation of the functionally connected cerebral regions and the depression severity.

METHODS

Resting-state functional magnetic resonance imaging (fMRI) data of 24 patients with MDD and 24 healthy subjects were analyzed with the fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC) methods. The structural images were processed with the voxel-based morphometry (VBM) method.

RESULTS

Compared to healthy controls, depressed patients had significantly increased fALFF in the left Crus I and the left cerebellar lobule VI. FC analysis of these two seeded regions found that depressed patients had increased FC between the left Crus I and the right hippocampus, but had decreased FC between the left Crus I and the left inferior parietal lobule (IPL), and between the left cerebellar lobule VI and bilateral inferior temporal gyrus. No correlation was observed between the abnormal fALFF of the seeds and their connected regions and the depression severity or the executive function. The VBM results did not show significant reduction in gray or white matter volume in any above-mentioned region.

CONCLUSIONS

Our findings suggest that increased cerebellar activity at resting state may be a disease state phenomenon but not a compensatory response to the dysfunction of the default mode network (DMN) in MDD.

摘要

背景

本研究旨在探讨首发、未经治疗的重度抑郁症(MDD)患者是否存在小脑代偿反应。小脑代偿反应定义为小脑过度活跃,与功能连接的大脑区域的激活以及抑郁严重程度呈负相关。

方法

对 24 例 MDD 患者和 24 例健康对照者的静息态功能磁共振成像(fMRI)数据进行了分数低频波动(fALFF)和功能连接(FC)分析。结构图像采用基于体素的形态学(VBM)方法进行处理。

结果

与健康对照组相比,抑郁患者左侧 Crus I 和左侧小脑 VI 的 fALFF 显著增加。对这两个种子区域的 FC 分析发现,抑郁患者左侧 Crus I 与右侧海马之间的 FC 增加,但左侧 Crus I 与左侧顶下小叶(IPL)和左侧小脑 VI 与双侧颞下回之间的 FC 降低。种子区域异常的 fALFF 与其连接区域与抑郁严重程度或执行功能之间无相关性。VBM 结果未显示任何上述区域灰质或白质体积有明显减少。

结论

我们的研究结果表明,静息状态下小脑活动增加可能是一种疾病状态现象,而不是 MDD 中默认模式网络(DMN)功能障碍的代偿反应。

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