Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
Psychiatry Res. 2013 Sep 30;213(3):179-85. doi: 10.1016/j.pscychresns.2013.05.004. Epub 2013 Jul 10.
Altered function in the limbic-cortical-striatial-pallidal-thalamic (LCSPT) circuit has been implicated in the pathophysiology of major depressive disorder (MDD). This study evaluated volumetric differences in subcortical volumes between depressed subjects with MDD (N=142), subjects with MDD in remission (N=72), and healthy controls (N=169). Participants underwent magnetic resonance imaging (MRI) scanning, and subcortical volumes were extracted using FMRIB's Integrated Registration and Segmentation Tool (FIRST), University of Oxford, UK. The depressed MDD subjects exhibited significantly smaller volumes in the bilateral thalamus and hippocampus compared to control subjects, and the differences in the bilateral thalamus remained significant after controlling for total intracranial volume. In a smaller subset of healthy controls and depressed MDD subjects matched to the remitted MDD subjects, significant differences in volume were observed across groups in the bilateral thalamus, as well as the right lateralized caudate, hippocampus, and pallidum; these were primarily accounted for by differences between the depressed MDD subjects versus both the remitted and healthy subjects, though none of these changes remained significant after controlling for total intracranial volume (TIV). Volumetric reductions in the thalamus and hippocampus may contribute to dysfunction within subcortical-cortical networks, consistent with previous evidence of metabolic and hemodynamic abnormalities in these regions in MDD.
边缘皮质纹状体苍白球丘脑(LCSPT)回路功能改变与重度抑郁症(MDD)的病理生理学有关。本研究评估了 MDD 抑郁患者(N=142)、MDD 缓解患者(N=72)和健康对照者(N=169)亚皮质体积之间的差异。参与者接受了磁共振成像(MRI)扫描,并使用英国牛津大学的 FMRIB 的综合注册和分割工具(FIRST)提取亚皮质体积。与对照组相比,抑郁 MDD 患者的双侧丘脑和海马体积明显较小,且在控制总颅内体积后,双侧丘脑的差异仍然显著。在健康对照组和与 MDD 缓解患者相匹配的较小的 MDD 健康患者亚组中,观察到双侧丘脑以及右侧偏侧尾状核、海马体和苍白球的体积在组间存在显著差异;这些差异主要是由抑郁 MDD 患者与缓解和健康患者之间的差异引起的,尽管在控制总颅内体积(TIV)后,这些变化均无统计学意义。丘脑和海马体的体积减少可能导致皮质下-皮质网络功能障碍,这与 MDD 患者在这些区域存在代谢和血液动力学异常的先前证据一致。