Liu Chun-Hong, Ma Xin, Yuan Zhen, Song Lu-Ping, Jing Bing, Lu Hong-Yu, Tang Li-Rong, Fan Jin, Walter Martin, Liu Cun-Zhi, Wang Lihong, Wang Chuan-Yue
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, China.
Department of Psychiatry and Radiology, Beijing Anding Hospital, Capital Medical University, China.
J Clin Psychiatry. 2017 Apr;78(4):e372-e382. doi: 10.4088/JCP.15m10022.
To investigate alterations in resting-state spontaneous brain activity in patients with major depressive disorder (MDD) experiencing multiple episodes.
Between May 2007 and September 2014, 24 recurrent and 22 remitted patients diagnosed with MDD with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and 69 healthy controls matched for age, sex, and educational level participated in this study. Among them, 1 healthy control was excluded due to excessive head motion. The fractional amplitude of low-frequency fluctuation (fALFF) was assessed for all recruited subjects during the completion of resting-state functional magnetic resonance imaging. Relationships between fALFF and clinical measurements, including number of depressive episodes and illness duration, were examined.
Compared to patients with remitted MDD and to healthy controls, patients with recurrent MDD exhibited decreased fALFF in the right posterior insula and right precuneus and increased fALFF in the left ventral anterior cingulate cortex. Decreased fALFF in the right precuneus and increased fALFF in the right middle insula were correlated with the number of depressive episodes in the recurrent MDD groups (r = -0.75, P < .01 and r = 0.78, P < .01, respectively) and remitted MDD groups (r = -0.63, P < .01 and r = 0.41, P = .03, respectively). In addition to regions in the default mode network (DMN) and salience network, the altered resting-state activity in the middle temporal and visual cortices was also identified.
Altered resting-state activity was observed across several neural networks in patients with recurrent MDD. Consistent with the emerging theory that altered DMN activity is a risk factor for depression relapses, the association between reduced fALFF in the right precuneus and number of depressive episodes supports the role of the DMN in the pathology of recurrent depression.
研究经历多次发作的重度抑郁症（MDD）患者静息态自发脑活动的改变。
2007年5月至2014年9月期间，24例复发型和22例缓解型MDD患者通过《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈（SCID-I）确诊，69例年龄、性别和教育水平匹配的健康对照参与本研究。其中，1例健康对照因头部运动过度被排除。在静息态功能磁共振成像完成过程中，对所有招募的受试者评估低频波动分数振幅（fALFF）。检查fALFF与临床测量指标之间的关系，包括抑郁发作次数和病程。
与缓解型MDD患者和健康对照相比，复发型MDD患者右侧后岛叶和右侧楔前叶的fALFF降低，左侧腹侧前扣带回皮质的fALFF增加。右侧楔前叶fALFF降低和右侧岛叶中部fALFF增加与复发型MDD组（分别为r = -0.75，P <.01和r = 0.78，P <.01）和缓解型MDD组（分别为r = -0.63，P <.01和r = 0.41，P =.03）的抑郁发作次数相关。除了默认模式网络（DMN）和突显网络中的区域外，还发现颞中回和视觉皮质的静息态活动发生改变。
复发型MDD患者在多个神经网络中观察到静息态活动改变。与DMN活动改变是抑郁症复发危险因素的新理论一致，右侧楔前叶fALFF降低与抑郁发作次数之间的关联支持了DMN在复发性抑郁症病理中的作用。
