Division of Child and Adolescent Psychiatry, University of California, San Francisco, San Francisco; Department of Psychiatry, University of California, San Francisco, San Francisco.
Biol Psychiatry. 2013 Dec 15;74(12):898-907. doi: 10.1016/j.biopsych.2013.05.036. Epub 2013 Jul 30.
Very few studies have been performed to understand the underlying neural substrates of adolescent major depressive disorder (MDD). Studies in depressed adults have demonstrated that the subgenual anterior cingulate cortex (sgACC) plays a pivotal role in depression and have revealed aberrant patterns of resting-state functional connectivity (RSFC). Here, we examine the RSFC of the sgACC in medication-naïve first-episode adolescents with MDD.
Twenty-three adolescents with MDD and 36 well-matched control subjects underwent functional magnetic resonance imaging to assess the RSFC of the sgACC.
We observed elevated connectivity between the sgACC and the insula and between the sgACC and the amygdala in the MDD group compared with the control subjects. Decreased connectivity between the sgACC and the precuneus was also found in the MDD group relative to the control subjects. Within the MDD group, higher levels of depression significantly correlated with decreased connectivity between the sgACC and left precuneus. Increased rumination was significantly associated with reduced connectivity between sgACC and the middle and inferior frontal gyri in the MDD group.
Our study is the first to examine sgACC connectivity in medication-naïve first-episode adolescents with MDD compared with well-matched control participants. Our results suggest aberrant functional connectivity among the brain networks responsible for salience attribution, executive control, and the resting-state in the MDD group compared with the control participants. Our findings raise the possibility that therapeutic interventions that can restore the functional connectivity among these networks to that typical of healthy adolescents might be a fruitful avenue for future research.
很少有研究致力于理解青少年重度抑郁症(MDD)的潜在神经基础。对抑郁成年人的研究表明,扣带回前下部(sgACC)在抑郁中起着关键作用,并揭示了静息状态功能连接(RSFC)的异常模式。在这里,我们检查了未经药物治疗的首发青少年 MDD 患者 sgACC 的 RSFC。
23 名 MDD 青少年和 36 名匹配良好的对照组受试者接受功能磁共振成像,以评估 sgACC 的 RSFC。
与对照组相比,我们观察到 MDD 组 sgACC 与岛叶之间以及 sgACC 与杏仁核之间的连接增强。与对照组相比,MDD 组 sgACC 与楔前叶之间的连接也减少了。在 MDD 组中,较高的抑郁水平与 sgACC 与左楔前叶之间的连接减少显著相关。在 MDD 组中,反刍思维与 sgACC 与中、下额回之间的连接减少显著相关。
我们的研究首次比较了未经药物治疗的首发青少年 MDD 患者与匹配良好的对照组参与者的 sgACC 连接。我们的结果表明,与对照组相比,MDD 组负责显着归因、执行控制和静息状态的大脑网络之间存在异常功能连接。我们的发现提出了一种可能性,即能够恢复这些网络之间的功能连接以达到健康青少年典型水平的治疗干预可能是未来研究的一个有前途的途径。