Liu Chun-Hong, Ma Xin, Song Lu-Ping, Fan Jin, Wang Wei-Dong, Lv Xue-Yu, Zhang Yu, Li Feng, Wang Lihong, Wang Chuan-Yue
Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Laboratory of Brain Disorders, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
Behav Brain Res. 2015 Mar 15;281:339-47. doi: 10.1016/j.bbr.2014.11.047. Epub 2014 Dec 13.
Anxious depression is a distinct clinical subtype of major depressive disorder (MDD) characterized by palpitations, somatic complaints, altered interoceptive awareness, high risk of suicide, and poor response to pharmacotherapy. However, the neural mechanisms of anxious depression are still not well understood. In this study we investigated changes in neural oscillation during the resting-state of patients with anxious depression by measuring differences in the amplitude of low-frequency fluctuation (ALFF).
Resting-state functional magnetic resonance imaging was acquired in 31 patients with anxious depression, 18 patients with remitted depression, as well as 68 gender- and age-matched healthy participants. We compared the differences both in the ALFF and fractional ALFF (fALFF) among the three groups. We also examined the correlation between the ALFF/fALFF and the severity of anxiety as well as depression.
Anxious depression patients showed increased ALFF/fALFF in the right dorsal anterior insular cortex and decreased ALFF/fALFF in the bilateral lingual gyrus relative to remitted depression patients and healthy controls. The increased ALFF in the dorsal anterior insula was also positively correlated with stronger anxiety in the anxious depression group. Anxious depression patients also displayed increased fALFF in the right ventral anterior cingulate cortex (ACC) compared to remitted depression patients and healthy controls.
Our results suggest that alterations of the cortico-limbic networks, including the right dorsal anterior insula and right ventral ACC, may play a critical role in the physiopathology of anxious depression.
焦虑抑郁是重度抑郁症（MDD）一种独特的临床亚型，其特征为心悸、躯体不适、内感受性意识改变、自杀风险高以及药物治疗反应不佳。然而，焦虑抑郁的神经机制仍未完全明确。在本研究中，我们通过测量低频波动幅度（ALFF）的差异，研究了焦虑抑郁患者静息状态下的神经振荡变化。
对31例焦虑抑郁患者、18例缓解期抑郁症患者以及68名年龄和性别匹配的健康参与者进行静息态功能磁共振成像检查。我们比较了三组之间ALFF和分数ALFF（fALFF）的差异。我们还研究了ALFF/fALFF与焦虑和抑郁严重程度之间的相关性。
与缓解期抑郁症患者和健康对照组相比，焦虑抑郁患者右侧背侧前岛叶皮质的ALFF/fALFF增加，双侧舌回的ALFF/fALFF降低。背侧前岛叶ALFF增加也与焦虑抑郁组中更强的焦虑呈正相关。与缓解期抑郁症患者和健康对照组相比，焦虑抑郁患者右侧腹侧前扣带回皮质（ACC）的fALFF也增加。
我们的结果表明，包括右侧背侧前岛叶和右侧腹侧ACC在内的皮质-边缘网络改变可能在焦虑抑郁疾病的病理生理过程中起关键作用。
