Li S Y, Zhu Y, Wang Y L, Lü P P, Zuo W B, Li F Y
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2017 Dec 5;97(45):3538-3542. doi: 10.3760/cma.j.issn.0376-2491.2017.45.005.
To study resting-state functional connectivity (FC) of default mode network (DMN) in adolescent patients with first-episode drug-naive major depressive disorder (MDD). We enrolled thirty first-episode and drug-naive adolescent MDD patients and twenty-nine adolescent healthy control (HC) participants in the First Affiliated Hospital of Zhengzhou University. There were no differences in age, sex, and education between the MDD and HC group. Resting-state functional magnetic resonance images (fMRI) was performed. We selected posterior cingulate cortex (PCC) and medial prefrontal cortex (MPFC) of DMN as regions of interests (ROI). The differences of these regions from the whole brain functional connectivity were analyzed. The relations between abnormalities in FCs of DMN and clinical variables were further investigated. Compared to the HCs, the MDD patients had congruently reduced FCs between the PCC and cerebellum, temporal cortices, occipital cortices, fusiform, dorsolateral prefrontal cortex. MPFC not only had reduced FCs with fusiform, temporal cortices, anterior cingulate cortex, but also had enhanced FCs with occipital cortices, parietal cortices, and precentral gyrus. In addition, the increased FC between the right MPFC and right precentral gyrus was positive correlated with Hamilton Rating Scale for Depression (HAMD) scores (=0.38, =0.04). The reduced FC between the left middle temporal gyrus and left PCC as well as the enhanced FC between the right middle cingulum and right MPFC were positive correlated with the duration of depression since onset (=0.39, =0.03; =0.38, =0.04). These findings show dysfunctional DMN connectivity of adolescent MDD patients. Neurodevelopmental abnormalities in DMN may present in adolescent MDD.
研究首发未用药青少年重度抑郁症（MDD）患者默认模式网络（DMN）的静息态功能连接（FC）。我们在郑州大学第一附属医院招募了30名首发未用药的青少年MDD患者和29名青少年健康对照（HC）参与者。MDD组和HC组在年龄、性别和教育程度上无差异。进行了静息态功能磁共振成像（fMRI）。我们选择DMN的后扣带回皮质（PCC）和内侧前额叶皮质（MPFC）作为感兴趣区域（ROI）。分析了这些区域与全脑功能连接的差异。进一步研究了DMN功能连接异常与临床变量之间的关系。与HC相比，MDD患者PCC与小脑、颞叶皮质、枕叶皮质、梭状回、背外侧前额叶皮质之间的功能连接一致降低。MPFC不仅与梭状回、颞叶皮质、前扣带回皮质的功能连接降低，而且与枕叶皮质、顶叶皮质和中央前回的功能连接增强。此外，右侧MPFC与右侧中央前回之间增加的功能连接与汉密尔顿抑郁量表（HAMD）评分呈正相关（r = 0.38，P = 0.04）。左侧颞中回与左侧PCC之间降低的功能连接以及右侧中央扣带回与右侧MPFC之间增强的功能连接与抑郁发作后的持续时间呈正相关（r = 0.39，P = 0.03；r = 0.38，P = 0.04）。这些发现表明青少年MDD患者的DMN连接功能失调。DMN中的神经发育异常可能在青少年MDD中出现。
