Department of Psychosomatics & Psychiatry, Institute of Psychosomatic Medicine, Affiliated Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China; Department of Psychiatry, Columbia University College of Physicians and Surgeons, The New York State Psychiatric Institute, New York, NY 10032, United States.
Lab of Image Science and Technology, School of Computer Science and Engineering, Key Laboratory of Computer Network and Information Integration, Ministry of Education, Southeast University, Nanjing 210009, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jul 13;85:39-45. doi: 10.1016/j.pnpbp.2018.03.026. Epub 2018 Mar 30.
The aim of this study is to identify the difference of temporal variability among major depressive disorder (MDD) patients (with different early antidepressant responses) and healthy controls (HC), and further explore the relationship between pre-treatment temporal variability and early antidepressant response. At baseline, 77 treatment-naïve inpatients with MDD and 42 matched HC received clinical assessments and 3.0 Tesla resting-state functional magnetic resonance imaging scans. After 2 weeks' antidepressant treatment, the patients were subgrouped into responsive depression (RD, n = 40) and non-responding depression (NRD, n = 37) based on the reduction of Hamilton depression rating scale (HAMD). The temporal variability of 90 brain nodes was calculated for further analysis. Compared with the HC group, both the RD and NRD subjects showed greater baseline temporal variability (i.e., greater dynamic) in the left inferior occipital gyrus. Significantly greater temporal variability in the left pallidum was found in the RD group than the NRD and the HC groups, and the higher variability of left pallidum correlated positively with the HAMD reduction. Moreover, the pooled MDD (i.e., RD and NRD) group showed greater baseline temporal variability in the right inferior frontal gyrus, the left inferior occipital gyrus, the bilateral fusiform gyri and the left Heschl gyrus than the HC group. The distinctive pattern of dynamically reorganized networks may provide a crucial scaffold to facilitate early antidepressant response, and the temporal variability may serve as a promising indicator for the personalized therapy of MDD.
本研究旨在识别不同抗抑郁药早期反应的重度抑郁症（MDD）患者（患者）与健康对照者（HC）之间的时间变异性差异，并进一步探讨治疗前时间变异性与早期抗抑郁反应之间的关系。在基线时，77 名未经治疗的 MDD 住院患者和 42 名匹配的 HC 接受了临床评估和 3.0T 静息态功能磁共振成像扫描。经过 2 周的抗抑郁治疗后，根据汉密尔顿抑郁量表（HAMD）评分的降低，将患者分为反应性抑郁症（RD，n=40）和非反应性抑郁症（NRD，n=37）。进一步分析了 90 个脑节点的时间变异性。与 HC 组相比，RD 和 NRD 受试者在左侧枕下回均表现出更大的基线时间变异性（即更大的动态性）。RD 组的左侧苍白球的时间变异性明显大于 NRD 组和 HC 组，且左侧苍白球的变异性与 HAMD 评分的降低呈正相关。此外，汇集的 MDD（即 RD 和 NRD）组在右侧额下回、左侧枕下回、双侧梭状回和左侧海氏回的基线时间变异性大于 HC 组。动态重新组织网络的独特模式可能为促进早期抗抑郁反应提供重要的支架，而时间变异性可能作为 MDD 个体化治疗的有前途的指标。
