Department of Psychiatry, University of Calgary , Calgary, AB , Canada ; Department of Clinical Neuroscience, University of Calgary , Calgary, AB , Canada ; Mathison Centre for Mental Health Research and Education, University of Calgary , Calgary, AB , Canada ; Hotchkiss Brain Institute, University of Calgary , Calgary, AB , Canada.
Department of Psychiatry, University of Calgary , Calgary, AB , Canada.
Front Psychiatry. 2014 Feb 19;5:17. doi: 10.3389/fpsyt.2014.00017. eCollection 2014.
Imaging studies of major depressive disorder (MDD) have demonstrated enhanced resting-state activity of the amygdala as well as exaggerated reactivity to negative emotional stimuli relative to healthy controls (HCs). However, the abnormalities in the intrinsic connectivity of the amygdala in MDD still remain unclear. As the resting-state activity and functional connectivity (RSFC) reflect fundamental brain processes, we compared the RSFC of the amygdala between unmedicated MDD patients and HCs. Seventy-four subjects, 55 adults meeting the DSM-IV criteria for MDD and 19 HCs, underwent a resting-state 3-T functional magnetic resonance imaging scan. An amygdala seed-based low frequency RSFC map for the whole brain was generated for each group. Compared with HCs, MDD patients showed a wide-spread reduction in the intrinsic connectivity of the amygdala with a variety of brain regions involved in emotional processing and regulation, including the ventrolateral prefrontal cortex, insula, caudate, middle and superior temporal regions, occipital cortex, and cerebellum, as well as increased connectivity with the bilateral temporal poles (p < 0.05 corrected). The increase in the intrinsic connectivity of amygdala with the temporal poles was inversely correlated with symptom severity and anxiety scores. Although the directionality of connections between regions cannot be inferred from temporal correlations, the reduced intrinsic connectivity of the amygdala predominantly with regions involved in emotional processing may reflect impaired bottom-up signaling for top-down cortical modulation of limbic regions leading to abnormal affect regulation in MDD.
重性抑郁障碍(MDD)的影像学研究表明,与健康对照者(HCs)相比,杏仁核的静息状态活动增强,对负性情绪刺激的反应过度。然而,MDD 患者杏仁核的内在连接异常仍不清楚。由于静息状态活动和功能连接(RSFC)反映了基本的大脑过程,我们比较了未用药 MDD 患者和 HCs 之间杏仁核的 RSFC。74 名受试者,55 名符合 DSM-IV 重性抑郁障碍标准的成年人和 19 名 HCs,接受了 3-T 磁共振成像静息状态功能扫描。为每组生成了一个杏仁核种子为基础的全脑低频 RSFC 图谱。与 HCs 相比,MDD 患者表现出杏仁核内在连接的广泛减少,涉及到多种情绪处理和调节的脑区,包括腹外侧前额叶皮层、岛叶、尾状核、中颞叶和上颞叶、枕叶和小脑,以及与双侧颞极的连接增加(p<0.05 校正)。杏仁核与颞极的内在连接增加与症状严重程度和焦虑评分呈负相关。虽然不能从时间相关性推断出区域之间连接的方向,但杏仁核与情绪处理相关脑区的内在连接减少可能反映了边缘区的自上而下皮质调节的下传信号受损,导致 MDD 中异常的情感调节。