Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Psychiatry, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan.
Psychiatry Clin Neurosci. 2015 Jun;69(6):360-8. doi: 10.1111/pcn.12255. Epub 2014 Dec 29.
The DSM-IV recognizes some subtypes of major depressive disorder (MDD). It is known that the effectiveness of antidepressants differs among the MDD subtypes, and thus the differentiation of the subtypes is important. However, little is known as to structural brain changes in MDD with atypical features (aMDD) in comparison with MDD with melancholic features (mMDD), which prompted us to examine possible differences in white matter integrity assessed with diffusion tensor imaging (DTI) between these two subtypes.
Subjects were 21 patients with mMDD, 24 with aMDD, and 37 age- and sex-matched healthy volunteers whose DTI data were obtained by 1.5 tesla magnetic resonance imaging. We compared fractional anisotropy and mean diffusivity value derived from DTI data on a voxel-by-voxel basis among the two diagnostic groups and healthy subjects.
There were significant decreases of fractional anisotropy and increases of mean diffusivity in patients with MDD compared with healthy subjects in the corpus callosum, inferior fronto-occipital fasciculus, and left superior longitudinal fasciculus. However, we detected no significant difference in any brain region between mMDD and aMDD.
Our results suggest that patients with MDD had reduced white matter integrity in some regions; however, there was no major difference between aMDD and mMDD.
DSM-IV 承认了一些重性抑郁障碍(MDD)的亚型。已知抗抑郁药在 MDD 亚型中的疗效不同,因此区分亚型很重要。然而,与具有忧郁特征的 MDD(mMDD)相比,具有非典型特征的 MDD(aMDD)的结构脑变化知之甚少,这促使我们检查这两种亚型之间弥散张量成像(DTI)评估的白质完整性是否存在差异。
研究对象为 21 名 mMDD 患者、24 名 aMDD 患者和 37 名年龄和性别匹配的健康志愿者,他们的 DTI 数据通过 1.5T 磁共振成像获得。我们比较了两个诊断组和健康对照组的 DTI 数据的体素间各向异性分数和平均弥散度值。
与健康对照组相比,MDD 患者的胼胝体、下额枕束和左侧上纵束的各向异性分数降低,平均弥散度增加。然而,我们在 mMDD 和 aMDD 之间的任何脑区都没有发现显著差异。
我们的结果表明,MDD 患者在一些区域的白质完整性降低;然而,aMDD 和 mMDD 之间没有明显的区别。