Yin Yingying, Hou Zhenghua, Wang Xiaoquan, Sui Yuxiu, Yuan Yonggui
Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital, Medical School of Southeast University, and Institute of Neuropsychiatry of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, China.
J Neural Transm (Vienna). 2015 Jun;122(6):887-96. doi: 10.1007/s00702-014-1347-3. Epub 2014 Dec 3.
The objective of the study is to investigate the relationship between altered resting-state cortico-cerebellar functional connectivity (FC) and depression as well as cognitive impairment in late-onset depression (LOD). A total of 32 LOD and 39 well-matched normal controls (NCs) were recruited and underwent resting-state functional MRI (R-fMRI) scans. Seed-based correlation analysis was performed to explore the cortico-cerebellar FC. Hamilton Depression Rating Scale (HAMD) and mini-mental state examination (MMSE) were used to evaluate the depressive severity and cognitive impairment, respectively. A set of neuropsychological measurements was also applied to evaluate the detailed cognitions. Spearman correlations were applied to examine the depressive and cognitive association of these altered cortico-cerebellar networks. Compared with the NCs, LOD patients showed increased FC between the cerebellum and the right ventromedial frontal cortex (vmPFC), supplementary motor area (SMA), middle temporal gyrus (MTG), bilateral supramarginal gyrus (SMG), and anterior cingulated cortex (ACC). However, reduced cerebellar FC was observed in bilateral cerebellum, posterior cingulated cortex (PCC) and left dorsolateral prefrontal cortex (dlPFC). Moreover, the cerebellar FC with the vmPFC and ACC was positively correlated with HAMD score, whereas the cerebellar FC with the dlPFC and PCC was positively correlated with MMSE score in LOD patients. The cortico-cerebellar disconnections might underlie the pathogenesis of LOD. While depression mainly relates to the excessive cerebellar FC with the vmPFC and ACC, cognitive decline is primarily associated with the uncoupling of the cerebellar FC with the dlPFC and PCC.
本研究的目的是调查静息态皮质-小脑功能连接（FC）改变与晚发性抑郁症（LOD）中的抑郁以及认知障碍之间的关系。共招募了32例LOD患者和39例匹配良好的正常对照（NC），并对其进行静息态功能磁共振成像（R-fMRI）扫描。采用基于种子点的相关分析来探索皮质-小脑FC。分别使用汉密尔顿抑郁量表（HAMD）和简易精神状态检查表（MMSE）来评估抑郁严重程度和认知障碍。还应用了一组神经心理学测量方法来评估详细的认知情况。采用斯皮尔曼相关性分析来检验这些改变的皮质-小脑网络与抑郁和认知的相关性。与NC相比，LOD患者小脑与右侧腹内侧前额叶皮质（vmPFC）、辅助运动区（SMA）、颞中回（MTG）、双侧缘上回（SMG）和前扣带回皮质（ACC）之间的FC增加。然而，在双侧小脑、后扣带回皮质（PCC）和左侧背外侧前额叶皮质（dlPFC）中观察到小脑FC降低。此外，在LOD患者中，小脑与vmPFC和ACC的FC与HAMD评分呈正相关，而小脑与dlPFC和PCC的FC与MMSE评分呈正相关。皮质-小脑连接中断可能是LOD发病机制的基础。抑郁主要与小脑与vmPFC和ACC的FC过度有关，而认知下降主要与小脑与dlPFC和PCC的FC解耦有关。
