Neuroscience and Aphasia Research Unit, University of Manchester, Manchester, UK.
Department of Biomedical Sciences, Korea University College of Medicine, Seoul, South Korea.
J Affect Disord. 2014 Dec;169:179-87. doi: 10.1016/j.jad.2014.08.018. Epub 2014 Aug 20.
Voxel-based morphometry (VBM) has demonstrated structural brain changes between patients with Major Depressive Disorder (MDD) and healthy individuals. The initial response to antidepressants is crucial to predict prognosis in the treatment of MDD. The aim of the present study was to investigate gray matter abnormalities predicting antidepressant responsiveness and the relationships between volumetric differences and clinical/cognitive traits in MDD patients.
Fifty MDD patients who received 8 week period antidepressant treatment and 29 healthy controls participated in this study. VBM was applied to assess structural changes between MDD groups and control group. Neuropsychological tests were conducted on all participants.
Both treatment responsive and non-responsive patients showed a significant volume reduction of the left insular, but only non-responsive patients had decreased volume in the right superior frontal gyrus compared to healthy controls. The comparison between treatment responsive and non-responsive patient groups demonstrated a significant difference in gray matter volume in the lingual gyrus. The larger volume of lingual gryus predicted early antidepressant response, which was attributable to better performance in neuropsychological tests.
This study included a small sample size and the patients received various antidepressants and benzodiazepines.
Our findings suggest that the patients who responded poorly to antidepressants were morphologically and cognitively impaired, whereas the treatment responsive patients showed less structural changes and relatively preserved cognitive functions. The lingual gyrus may be a possible candidate region to predict antidepressant responsiveness and maintained cognition in MDD.
体素形态测量学（VBM）已经证明了重度抑郁症（MDD）患者与健康个体之间的大脑结构变化。抗抑郁药的初始反应对于预测 MDD 治疗的预后至关重要。本研究的目的是研究预测抗抑郁反应的灰质异常，并探讨 MDD 患者的体积差异与临床/认知特征之间的关系。
本研究纳入了 50 名接受 8 周抗抑郁治疗的 MDD 患者和 29 名健康对照者。采用 VBM 评估 MDD 组与对照组之间的结构变化。所有参与者均进行神经心理学测试。
无论是治疗反应良好还是反应不佳的患者，左侧脑岛的体积均明显减小，但只有治疗反应不佳的患者右侧额上回的体积与健康对照组相比有所减小。治疗反应良好与反应不佳的患者组之间的比较显示，舌回的灰质体积存在显著差异。舌回的体积越大，预测早期抗抑郁反应的效果越好，这归因于神经心理学测试中的表现更好。
本研究样本量较小，患者接受了各种抗抑郁药和苯二氮䓬类药物治疗。
我们的研究结果表明，抗抑郁药反应不佳的患者在形态学和认知方面受损，而治疗反应良好的患者则表现出较少的结构变化和相对保留的认知功能。舌回可能是预测 MDD 抗抑郁反应和维持认知功能的候选区域。
