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青年无药物治疗的重度抑郁症患者腹侧被盖区和中缝背核静息态功能磁共振成像的频谱动力学

Spectral Dynamics of Resting State fMRI Within the Ventral Tegmental Area and Dorsal Raphe Nuclei in Medication-Free Major Depressive Disorder in Young Adults.

作者信息

Wohlschläger Afra, Karne Harish, Jordan Denis, Lowe Mark J, Jones Stephen E, Anand Amit

机构信息

Department of Diagonistic and Interventional Neuroradiology and TUMNIC, Technische Universität München, Munich, Germany.

Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States.

出版信息

Front Psychiatry. 2018 May 11;9:163. doi: 10.3389/fpsyt.2018.00163. eCollection 2018.

Abstract

Dorsal raphe nucleus (DRN) and ventral tegmental area (VTA) are major brainstem monamine nuclei consisting of serotonin and dopamine neurons respectively. Animal studies show that firing patterns in both nuclei are altered when animals exhibit depression like behaviors. Functional MRI studies in humans have shown reduced VTA activation and DRN connectivity in depression. This study for the first time aims at investigating the functional integrity of local neuronal firing concurrently in both the VTA and DRN in humans using spectral analysis of resting state low frequency fluctuation fMRI. A total of 97 medication-free subjects-67 medication-free young patients (ages 18-30) with major depressive disorder and 30 closely matched healthy controls were included in the study to detect aberrant dynamics in DRN and VTA. For the investigation of altered localized dynamics we conducted power spectral analysis and above this spectral cross correlation between the two groups. Complementary to this, spectral dependence of permutation entropy, an information theoretical measure, was compared between groups. Patients displayed significant spectral slowing in VTA vs. controls ( = 0.035, corrected). In DRN, spectral slowing was less pronounced, but the amount of slowing significantly correlated with 17-item Hamilton Depression Rating scores of depression severity ( = 0.038). Signal complexity as assessed via permutation entropy showed spectral alterations inline with the results on spectral slowing. Our results indicate that altered functional dynamics of VTA and DRN in depression can be detected from regional fMRI signal. On this basis, impact of antidepressant treatment and treatment response can be assessed using these markers in future studies.

摘要

背侧中缝核(DRN)和腹侧被盖区(VTA)是主要的脑干单胺能核团,分别由5-羟色胺能神经元和多巴胺能神经元组成。动物研究表明,当动物表现出类似抑郁的行为时,这两个核团的放电模式都会发生改变。对人类进行的功能磁共振成像研究显示,在抑郁症患者中,VTA激活减少,DRN的连接性降低。本研究首次旨在利用静息态低频波动功能磁共振成像的频谱分析,同时研究人类VTA和DRN中局部神经元放电的功能完整性。该研究共纳入了97名未服用药物的受试者,其中包括67名年龄在18至30岁之间、未服用药物的重度抑郁症年轻患者以及30名年龄匹配的健康对照者,以检测DRN和VTA中的异常动力学。为了研究局部动力学的改变,我们进行了功率谱分析,并在此基础上对两组之间进行了频谱互相关分析。与此互补的是,还比较了两组之间排列熵的频谱依赖性,排列熵是一种信息理论测量方法。与对照组相比,患者的VTA出现了明显的频谱减慢(P = 0.035,校正后)。在DRN中,频谱减慢不太明显,但减慢程度与抑郁严重程度的17项汉密尔顿抑郁量表评分显著相关(P = 0.038)。通过排列熵评估的信号复杂性显示,频谱改变与频谱减慢的结果一致。我们的结果表明,抑郁症患者VTA和DRN的功能动力学改变可以从局部功能磁共振成像信号中检测到。在此基础上,未来的研究可以使用这些标志物来评估抗抑郁治疗的影响和治疗反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f54/5958223/bd3ca09d1f5f/fpsyt-09-00163-g0001.jpg

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