Center for Psychopharmacologic Research & Treatment, University of Massachusetts Medical School, Worcester, MA, 01655, USA.
Center for Comparative Neuroimaging, University of Massachusetts Medical School, Worcester, MA, 01604, USA.
Neuropsychopharmacology. 2018 Jun;43(7):1573-1580. doi: 10.1038/s41386-018-0023-y. Epub 2018 Feb 5.
Diffusion tensor imaging (DTI) studies in depression show decreased structural connectivity in the left anterior limb of the internal capsule and the genu of the corpus callosum but no such studies exist in peripartum depression (PPD), which affects 1 in 8 women. We analyzed fractional anisotropy (FA) as a measure of white matter integrity of these two tracts using tract-based spatial statistics (TBSS). We then conducted an exploratory whole-brain analysis to identify additional regions implicated in PPD. Seventy-five pregnant, medication-free women were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) and Structured Clinical Interview (SCID) for DSM-IV-TR in pregnancy and in the postpartum. Structural MRI and DTI sequences were acquired in forty-four women within 2-8 weeks postpartum. TBSS data were analyzed between healthy comparison postpartum women (HCW) and women who developed PPD to determine differences in white matter integrity within the left anterior limb of the internal capsule and the genu of the corpus callosum, then analyzed across participants to explore correlation between FA and the EPDS score. An exploratory whole-brain analysis was also conducted to identify other potential regions showing differences in white matter integrity between groups, as well as correlation between EPDS and FA across groups. All results were corrected for multiple comparisons and analyses conducted using FSL, p < 0.05, K > 10. In comparison to HCW, women with PPD had significantly lower FA in left anterior limb of the internal capsule (p = 0.010). FA was negatively correlated with EPDS scores in the left anterior limb of the internal capsule (p = 0.019). In the whole-brain analysis, FA in the right retrolenticular internal capsule (p = 0.03) and two clusters within the body of the corpus callosum (p = 0.044, p = 0.050) were negatively correlated with EPDS; there were no between-group differences in FA. Reduced FA in the left anterior limb of the internal capsule suggests disruption of fronto-subcortical circuits in PPD. A negative correlation between FA within the body of the corpus callosum and EPDS total score could additionally reflect disrupted interhemispheric structural connectivity in women with depressive symptoms.
弥散张量成像（DTI）研究表明，抑郁症患者的左侧内囊前肢和胼胝体膝部结构连接减少，但在产后抑郁症（PPD）中尚无此类研究，每 8 名女性中就有 1 名患有产后抑郁症。我们使用基于束的空间统计学（TBSS）分析了这两个束的各向异性分数（FA），作为白质完整性的测量。然后，我们进行了一项探索性的全脑分析，以确定与 PPD 相关的其他区域。对 75 名接受药物治疗的孕妇进行了爱丁堡产后抑郁量表（EPDS）和结构临床访谈（SCID）评估，以评估她们在怀孕期间和产后的抑郁情况。在产后 2-8 周内，44 名孕妇接受了结构 MRI 和 DTI 序列采集。TBSS 数据在健康对照组产后妇女（HCW）和出现 PPD 的妇女之间进行分析，以确定内囊前肢和胼胝体膝部白质完整性的差异，然后在所有参与者中进行分析，以探索 FA 与 EPDS 评分之间的相关性。还进行了一项探索性的全脑分析，以确定两组之间在白质完整性方面存在差异的其他潜在区域，以及两组之间 EPDS 和 FA 之间的相关性。所有结果均经多次比较校正，分析采用 FSL 进行，p<0.05，K>10。与 HCW 相比，PPD 妇女的内囊前肢 FA 明显降低（p=0.010）。FA 与内囊前肢的 EPDS 评分呈负相关（p=0.019）。在全脑分析中，右侧视束内囊（p=0.03）和胼胝体体部的两个簇（p=0.044，p=0.050）的 FA 与 EPDS 呈负相关；两组间 FA 无差异。内囊前肢 FA 降低提示 PPD 患者额皮质下回路中断。胼胝体体部 FA 与 EPDS 总分呈负相关，可能反映了有抑郁症状的女性半球间结构连接中断。
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