Zhou Ming, Hu Xinyu, Lu Lu, Zhang Lianqing, Chen Lizhou, Gong Qiyong, Huang Xiaoqi
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2017 Apr 3;75:157-164. doi: 10.1016/j.pnpbp.2017.02.001. Epub 2017 Feb 4.
Numerous neuroimaging studies have been undertaken to detect cerebral intrinsic activity in major depressive disorder (MDD) with resting state fMRI (rs-fMRI). However, the inconsistent results have hindered our understanding of the exact neuropathology related to MDD. The current meta-analysis used state-of-the-art conjunction analysis techniques to systematically review and summarize all available neuroimaging studies using rs-fMRI with amplitude of low frequency fluctuation (ALFF) and/or fractional ALFF (fALFF) on MDD patients and further explored the effect of antidepressants on the intrinsic activity of the brain. The anisotropic effect size version of signed differential mapping (AES-SDM) was applied to investigate changes in ALFF/fALFF in depression. We performed a subgroup analysis and group comparison on medicated and drug naïve patients to detect drug effect on MDD patients and conjunction analysis to identify congruent results between the two methods. Meta-regression was used to explore the effects of demographics and clinical characteristics. Adult MDD patients showed a robust increase in intrinsic activity in the resting state in the anterior cingulate cortex (ACC) in both ALFF (P<0.001) and fALFF (P<0.01) studies. The subgroup analysis demonstrated that the increased activity in the ACC was prominent in medicated patients only and not seen in drug-naïve MDD patients, while medication-naïve patients showed a specific decreased activity in the cerebellum (P<0.01). Group comparison showed that the intrinsic ACC activity is elevated in medicated MDD patients compared with drug naïve MDD patients. Meta-regression analysis demonstrated that the increased ACC activation was positively correlated with illness duration (P<0.001). Our findings suggest that increased activity of the ACC is more likely to be associated with antidepressant treatment, while decreased intrinsic activity of the cerebellum might be a specific biomarker for current MDD.
众多神经影像学研究已采用静息态功能磁共振成像（rs-fMRI）来检测重度抑郁症（MDD）患者的大脑内在活动。然而，结果的不一致阻碍了我们对与MDD相关的确切神经病理学的理解。当前的荟萃分析使用了最先进的联合分析技术，系统地回顾和总结了所有使用rs-fMRI以及低频振幅（ALFF）和/或分数ALFF（fALFF）对MDD患者进行的神经影像学研究，并进一步探讨了抗抑郁药对大脑内在活动的影响。应用符号差异映射的各向异性效应大小版本（AES-SDM）来研究抑郁症中ALFF/fALFF的变化。我们对接受药物治疗和未接受药物治疗的患者进行了亚组分析和组间比较，以检测药物对MDD患者的影响，并进行联合分析以确定两种方法之间的一致结果。使用元回归来探索人口统计学和临床特征的影响。在ALFF（P<0.001）和fALFF（P<0.01）研究中，成年MDD患者在前扣带回皮质（ACC）的静息态内在活动均显著增加。亚组分析表明，ACC活动增加仅在接受药物治疗的患者中显著，而在未接受药物治疗的MDD患者中未观察到，而未接受药物治疗的患者在小脑显示出特定的活动减少（P<0.01）。组间比较显示，与未接受药物治疗的MDD患者相比，接受药物治疗的MDD患者ACC的内在活动升高。元回归分析表明，ACC激活增加与病程呈正相关（P<0.001）。我们的研究结果表明，ACC活动增加更可能与抗抑郁治疗相关，而小脑内在活动减少可能是当前MDD的一种特定生物标志物。
