Department of Psychiatry, Academic Medical Center , Amsterdam , Netherlands ; Brain Imaging Center, Academic Medical Center , Amsterdam , Netherlands.
Department of Psychiatry, Academic Medical Center , Amsterdam , Netherlands ; Brain Imaging Center, Academic Medical Center , Amsterdam , Netherlands ; Department of Psychiatry, Mood and Anxiety Disorders, University Medical Center Groningen, University of Groningen , Groningen , Netherlands.
Front Psychiatry. 2015 Mar 2;6:28. doi: 10.3389/fpsyt.2015.00028. eCollection 2015.
Approximately one-third of patients with major depressive disorder (MDD) do not achieve remission after various treatment options and develop treatment resistant depression (TRD). So far, little is known about the pathophysiology of TRD. Studies in MDD patients showed aberrant functional connectivity (FC) of three "core" neurocognitive networks: the salience network (SN), cognitive control network (CCN), and default mode network (DMN). We used a cross-sectional design and performed resting-state FC MRI to assess connectivity of the SN, CCN, and both anterior and posterior DMN in 17 severe TRD, 18 non-TRD, and 18 healthy control (HC) subjects. Relative to both non-TRD and HC subjects, TRD patients showed decreased FC between the dorsolateral prefrontal cortex and angular gyrus, which suggests reduced FC between the CCN and DMN, and reduced FC between the medial prefrontal cortex and precuneus/cuneus, which suggests reduced FC between the anterior and posterior DMN. No significant differences in SN FC were observed. Our results suggest that TRD is characterized by a disturbance in neurocognitive networks relative to non-TRD and HC.
大约三分之一的重度抑郁症(MDD)患者在各种治疗选择后未达到缓解,并发展为难治性抑郁症(TRD)。迄今为止,人们对 TRD 的病理生理学知之甚少。在 MDD 患者中的研究表明,三个“核心”神经认知网络的功能连接异常:显着性网络(SN)、认知控制网络(CCN)和默认模式网络(DMN)。我们使用横断面设计并进行静息状态功能磁共振成像(FC MRI),以评估 17 例重度 TRD、18 例非 TRD 和 18 例健康对照组(HC)受试者的 SN、CCN 以及前后 DMN 的连接。与非 TRD 和 HC 受试者相比,TRD 患者的背外侧前额叶皮层和角回之间的 FC 降低,这表明 CCN 和 DMN 之间的 FC 降低,以及内侧前额叶皮层和楔前叶/楔叶之间的 FC 降低,这表明前后 DMN 之间的 FC 降低。SN FC 无显着差异。我们的研究结果表明,TRD 的特征是神经认知网络相对于非 TRD 和 HC 发生紊乱。
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