Olvet Doreen M, Delaparte Lauren, Yeh Fang-Cheng, DeLorenzo Christine, McGrath Patrick J, Weissman Myrna M, Adams Phillip, Fava Maurizio, Deckersbach Thilo, McInnis Melvin G, Carmody Thomas J, Cooper Crystal M, Kurian Benji T, Lu Hanzhang, Toups Marisa S, Trivedi Madhukar H, Parsey Ramin V
Department of Psychiatry, Stony Brook University, Stony Brook, New York.
Department of Psychology, Stony Brook University, Stony Brook, New York.
Depress Anxiety. 2016 Jan;33(1):56-65. doi: 10.1002/da.22445. Epub 2015 Oct 19.
Major depressive disorder (MDD) is a debilitating disorder characterized by widespread brain abnormalities. The literature is mixed as to whether or not white matter abnormalities are associated with MDD. This study sought to examine fractional anisotropy (FA) in white matter tracts in individuals with MDD using diffusion tensor imaging (DTI).
139 participants with MDD and 39 healthy controls (HC) in a multisite study were included. DTI scans were acquired in 64 directions and FA was determined in the brain using four methods: region of interest (ROI), tract-based spatial statistics (TBSS), and diffusion tractography. Diffusion connectometry was used to identify white matter pathways associated with MDD.
There were no significant differences when comparing FA in MDD and HC groups using any method. In the MDD group, there was a significant relationship between depression severity and FA in the right medial orbitofrontal cortex, and between age of onset of MDD and FA in the right caudal anterior cingulate cortex using the ROI method. There was a significant relationship between age of onset and connectivity in the thalamocortical radiation, inferior longitudinal fasciculus, and cerebellar tracts using diffusion connectometry.
The lack of group differences in FA and connectometry analysis may result from the clinically heterogenous nature of MDD. However, the relationship between FA and depression severity may suggest a state biomarker of depression that should be investigated as a potential indicator of response. Age of onset may also be a significant clinical feature to pursue when studying white matter tracts.
重度抑郁症(MDD)是一种使人衰弱的疾病,其特征是大脑普遍存在异常。关于白质异常是否与MDD相关,文献中的观点不一。本研究旨在使用扩散张量成像(DTI)检查MDD患者白质束中的分数各向异性(FA)。
在一项多中心研究中纳入了139名MDD患者和39名健康对照者(HC)。在64个方向上进行DTI扫描,并使用四种方法在大脑中确定FA:感兴趣区域(ROI)、基于束的空间统计学(TBSS)和扩散束描记法。使用扩散连接ometry来识别与MDD相关的白质通路。
使用任何方法比较MDD组和HC组的FA时,均无显著差异。在MDD组中,使用ROI方法时,右侧眶额内侧皮质的FA与抑郁严重程度之间存在显著关系,右侧尾侧前扣带回皮质的FA与MDD发病年龄之间存在显著关系。使用扩散连接ometry时,发病年龄与丘脑皮质辐射、下纵束和小脑束的连接性之间存在显著关系。
FA和连接ometry分析中缺乏组间差异可能是由于MDD临床异质性所致。然而,FA与抑郁严重程度之间的关系可能提示一种抑郁状态生物标志物,应作为反应的潜在指标进行研究。发病年龄在研究白质束时也可能是一个重要的临床特征。