Chen Hui Juan, Wang Yun Fei, Qi Rongfeng, Schoepf U Joseph, Varga-Szemes Akos, Ball B Devon, Zhang Zhe, Kong Xiang, Wen Jiqiu, Li Xue, Lu Guang Ming, Zhang Long Jiang
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.
Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29401, USA.
Mol Neurobiol. 2017 Apr;54(3):2223-2233. doi: 10.1007/s12035-016-9811-8. Epub 2016 Mar 3.
The purpose of this study was to investigate patterns in the amygdala-based emotional processing circuit of hemodialysis patients using resting-state functional MR imaging (rs-fMRI). Fifty hemodialysis patients (25 with depressed mood and 25 without depressed mood) and 26 healthy controls were included. All subjects underwent neuropsychological tests and rs-fMRI, and patients also underwent laboratory tests. Functional connectivity of the bilateral amygdala was compared among the three groups. The relationship between functional connectivity and clinical markers was investigated. Depressed patients showed increased positive functional connectivity of the left amygdala with the left superior temporal gyrus and right parahippocampal gyrus (PHG) but decreased amygdala functional connectivity with the left precuneus, angular gyrus, posterior cingulate cortex (PCC), and left inferior parietal lobule compared with non-depressed patients (P < 0.05, AlphaSim corrected). Depressed patients had increased positive functional connectivity of the right amygdala with bilateral supplementary motor areas and PHG but decreased amygdala functional connectivity with the right superior frontal gyrus, superior parietal lobule, bilateral precuneus, and PCC (P < 0.05, AlphaSim corrected). After including anxiety as a covariate, we discovered additional decreased functional connectivity with anterior cingulate cortex (ACC) for bilateral amygdala (P < 0.05, AlphaSim corrected). For the depressed, neuropsychological test scores were correlated with functional connectivity of multiple regions (P < 0.05, AlphaSim corrected). In conclusion, functional connectivity in the amygdala-prefrontal-PCC-limbic circuits was impaired in depressive hemodialysis patients, with a gradual decrease in ACC between controls, non-depressed, and depressed patients for the right amygdala. This indicates that ACC plays a role in amygdala-based emotional regulatory circuits in these patients.
本研究旨在利用静息态功能磁共振成像（rs-fMRI）探究血液透析患者基于杏仁核的情绪加工回路模式。纳入了50名血液透析患者（25名有抑郁情绪，25名无抑郁情绪）和26名健康对照者。所有受试者均接受神经心理学测试和rs-fMRI检查，患者还接受了实验室检查。比较了三组之间双侧杏仁核的功能连接性。研究了功能连接性与临床指标之间的关系。与无抑郁情绪的患者相比，抑郁患者左侧杏仁核与左侧颞上回和右侧海马旁回（PHG）的正性功能连接增加，但杏仁核与左侧楔前叶、角回、后扣带回皮质（PCC）和左侧顶下小叶的功能连接减少（P<0.05，经AlphaSim校正）。抑郁患者右侧杏仁核与双侧辅助运动区和PHG的正性功能连接增加，但杏仁核与右侧额上回、顶上小叶、双侧楔前叶和PCC的功能连接减少（P<0.05，经AlphaSim校正）。将焦虑作为协变量纳入后，我们发现双侧杏仁核与前扣带回皮质（ACC）的功能连接进一步降低（P<0.05，经AlphaSim校正）。对于抑郁患者，神经心理学测试分数与多个区域的功能连接相关（P<0.05，经AlphaSim校正）。总之，抑郁性血液透析患者杏仁核-前额叶-PCC-边缘系统回路的功能连接受损，右杏仁核在对照组、无抑郁患者和抑郁患者之间ACC逐渐降低。这表明ACC在这些患者基于杏仁核的情绪调节回路中起作用。
