Lu Jie, Duan Yanping, Zuo Zhentao, Xu Wenrui, Zhang Xuewei, Li Chen, Xue Rong, Lu Hanzhang, Zhang Weihong
Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No1. Shuaifuyuan Street, Dongcheng District, Beijing, China.
Department of Psychology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Orphanet J Rare Dis. 2017 May 25;12(1):103. doi: 10.1186/s13023-017-0658-5.
Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is a rare disease and there is no related literature concerning psychiatric symptoms in SAPHO patients. Thus, we believe that this will be the first paper to explore the episode and the neurobiological basis of depression symptoms in SAPHO patients using resting state functional magnetic resonance imaging (rs-fMRI). Twenty-eight SAPHO patients and fifteen age- and gender- matched normal controls (NC) were consecutively submitted to psychiatric evaluation and rs-fMRI scanning.
46.2% (13/28) of SAPHO patients were diagnosed as depression. The local spontaneous activity study showed that depressed SAPHO (D-SAPHO) patients had decreased amplitude of low-frequency fluctuation (ALFF) in the bilateral ventrolateral prefrontal cortex (VLPFC, attributed to the anatomical structures of Brodmann's area 47, 45 and 44) and right dorsolateral prefrontal cortex (DLPFC, attributed to the anatomical structures of Brodmann's area 8, 9 and 46), increased ALFF in the bilateral middle temporal gyrus, when compared to non-depressed SAPHO (ND-SAPHO) patients. The functional connectivity (FC) study disclosed that D-SAPHO patients had an increased FC in the anterior portions of default mode network (DMN) (the bilateral inferior frontal cortex, anterior cingulate cortex and insula cortex), and a decreased FC in the posterior areas of DMN (left middle occipital cortex), when compared to ND-SAPHO patients. Furthermore, correlation analysis revealed that both ALFF and FC values were significantly correlated with depression scores of SAPHO patients.
These results prompt us to understand the underlying pathophysiological mechanism of depression in SAPHO syndrome, and demonstrate that abnormal brain functional areas may serve as effective biological indicators to monitor depression in the future.
滑膜炎-痤疮-脓疱病-骨肥厚-骨炎（SAPHO）综合征是一种罕见疾病，目前尚无关于SAPHO患者精神症状的相关文献。因此，我们认为本文将是第一篇使用静息态功能磁共振成像（rs-fMRI）探索SAPHO患者抑郁症状发作情况及神经生物学基础的论文。28例SAPHO患者和15例年龄及性别匹配的正常对照（NC）连续接受了精神评估和rs-fMRI扫描。
46.2%（13/28）的SAPHO患者被诊断为抑郁症。局部自发活动研究显示，与非抑郁性SAPHO（ND-SAPHO）患者相比，抑郁性SAPHO（D-SAPHO）患者双侧腹外侧前额叶皮质（VLPFC，对应于Brodmann 47区、45区和44区的解剖结构）和右侧背外侧前额叶皮质（DLPFC，对应于Brodmann 8区、9区和46区的解剖结构）的低频振幅（ALFF）降低，双侧颞中回的ALFF增加。功能连接（FC）研究表明，与ND-SAPHO患者相比，D-SAPHO患者默认模式网络（DMN）前部（双侧额下回、前扣带回皮质和岛叶皮质）的FC增加，DMN后部（左侧枕中皮质）的FC降低。此外，相关性分析显示，ALFF和FC值均与SAPHO患者的抑郁评分显著相关。
这些结果促使我们了解SAPHO综合征中抑郁的潜在病理生理机制，并表明脑功能异常区域可能成为未来监测抑郁的有效生物学指标。
