Zhang Yin-feng, Han Yu, Wang Yong-zhi, Zhang Yi-fan, Jia Hong-xiao, Jin Er-hu, Deng Li-gang, Li Li
Beijing Friendship Hospital Affiliated to the Capital Medical University, Beijing 100050, China.
Beijing Anding Hospital Affiliated to the Capital Medical University, Beijing 100088, China.
Complement Ther Med. 2015 Feb;23(1):7-13. doi: 10.1016/j.ctim.2014.12.010. Epub 2015 Jan 5.
Patients with major depression (MD) experience a variety of emotional and mental problems accompanied by characteristic clinical symptoms. Based on traditional Chinese medicine (TCM) notions, the clinical appearance of MD can be divided into two syndromes, namely a deficiency pattern (DP) and an excess pattern (EP), depending on the patient's clinical symptoms, pulse, and lingual signs. Brain functional neuroimaging has demonstrated cerebral activity abnormalities in MD patients. However, such abnormalities have not been linked to particular symptoms of MD. The objective of this work was to compare functional connectivity of the posterior cingulate cortex (PCC) across MD patients with DP, MD patients with EP, and normal control (NC) subjects in a resting-state functional magnetic resonance imaging (rs-fMRI) study.
Participants (24 DP patients, 21 EP patients, and 20 NCs) underwent rs-fMRI scans. Whole-brain functional connectivity of a seed in the PCC was then mapped for each subject. Functional connectivity differences among the three studied groups were analyzed statistically.
Compared to the NC group, DP patients had decreased functional connectivity of the PCC with the right middle temporal gyrus and bilateral precuneus, as well as increased functional connectivity of the PCC with the bilateral middle frontal gyrus. Meanwhile, compared to the NC group, the EP group had decreased functional connectivity of the PCC with both the middle temporal gyrus and bilateral precuneus, as well as increased functional connectivity of the PCC with the bilateral superior frontal gyrus. Relative to the DP group, the EP group had reduced functional connectivity of the PCC with the bilateral cerebellum and left superior frontal gyrus.
Functional connectivity changes differ between MD patients with different TCM syndrome types, suggesting that the TCM clinical syndromes of MD are associated with correlates in cerebral functional activity.
重度抑郁症（MD）患者会经历各种情绪和心理问题，并伴有特征性临床症状。根据中医理论，MD的临床表现可根据患者的临床症状、脉象和舌象分为两种证型，即虚证（DP）和实证（EP）。脑功能神经影像学已证实MD患者存在脑活动异常。然而，这些异常与MD的特定症状并无关联。本研究的目的是在静息态功能磁共振成像（rs-fMRI）研究中，比较DP型MD患者、EP型MD患者和正常对照（NC）受试者后扣带回皮质（PCC）的功能连接性。
参与者（24例DP患者、21例EP患者和20例NC受试者）接受rs-fMRI扫描。然后为每个受试者绘制PCC中一个种子点的全脑功能连接图。对三个研究组之间的功能连接差异进行统计学分析。
与NC组相比，DP患者PCC与右侧颞中回和双侧楔前叶的功能连接降低，以及PCC与双侧额中回的功能连接增加。同时，与NC组相比，EP组PCC与颞中回和双侧楔前叶的功能连接均降低，以及PCC与双侧额上回的功能连接增加。相对于DP组，EP组PCC与双侧小脑和左侧额上回的功能连接减少。
不同中医证型的MD患者功能连接变化不同，提示MD的中医临床证型与脑功能活动的相关性有关。
