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首次发作、未服用过药物的重度抑郁症患者与病情缓解者静息态脑功能异常的识别:一项为期3年的回顾性研究。

Identify abnormalities in resting-state brain function between first-episode, drug-naive major depressive disorder and remitted individuals: a 3-year retrospective study.

作者信息

Yang Chunxia, Zhang Aixia, Jia Aixiang, Ma Jack X, Sun Ning, Wang Yanfang, Li Xinrong, Liu Zhifen, Liu Sha, Xu Yong, Zhang Kerang

机构信息

Department of Psychiatry, First Hospital of Shanxi Medical University.

Department of Psychiatry, Second Hospital of Xinxiang College of Medicine, Xinxiang, People's Republic of China.

出版信息

Neuroreport. 2018 Aug 1;29(11):907-916. doi: 10.1097/WNR.0000000000001054.

DOI:10.1097/WNR.0000000000001054
PMID:29912848
Abstract

This study aims to identify and characterize neurobiological markers for major depressive disorder (MDD) from resting-state brain functional MRI. We examined the abnormality in the regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) in first-episode, drug-naive major depressive disorder (fMDD), and remitted major depressive disorder (rMDD) and correlated these fluctuations with clinical markers of MDD. We conducted a retrospective study and reviewed the medical records of 43 patients with fMDD. Overall, 13 of the 43 patients who had at least 3 years of follow-up care and the 17-item Hamilton Depression rating scale less than 7 took no antidepressants for more than half a year at the end of the 3-year follow-up. We further chose a group of 14 healthy controls matched for age, sex and education level with patients with rMDD. Multiple comparison analysis was performed for ALFF and ReHo. The statistical significance level was set at P value of less than 0.05. We examined whether there were differences among the three groups in the whole-brain ALFF and ReHo during resting state. Compared with healthy controls, patients with fMDD showed significant decrease of ReHo in the right anterior lobe of cerebellum and significant increase of ReHo in the right inferior temporal gyrus, and significant decrease of ALFF in the left inferior parietal lobule and right caudate nucleus. Compared with patients with rMDD, those with fMDD showed significant increase of ReHo in the right fusiform gyrus and the left middle temporal gyrus, and significant increase of ALFF in the right superior temporal gyrus. Compared with healthy controls, patients with rMDD showed significant increase of ReHo in the right supramarginal and significant decrease of ReHo in the right precuneus, and significant decrease of ALFF in the right lingual gyrus and in the left superior frontal lobe. Only patients with fMDD showed the relatively robust increase in intrinsic activity of temporal gyrus. The temporal gyrus may play a critical role in depressive symptomatology. Abnormal right fusiform gyrus, left middle temporal gyrus, and right superior temporal gyrus alterations were present only in patients with rMDD but not in patients with fMDD, indicating that these alterations may be a therapeutic target for MDD. Abnormal right supramarginal, right precuneus, right lingual gyrus and left superior frontal lobe alterations were present only in patients with rMDD and not in healthy control, and thus may be used as a state marker of MDD.

摘要

本研究旨在从静息态脑功能磁共振成像中识别并表征重度抑郁症(MDD)的神经生物学标志物。我们检测了首发、未用药的重度抑郁症(fMDD)患者以及缓解期重度抑郁症(rMDD)患者的局部一致性(ReHo)和低频振幅(ALFF)异常情况,并将这些波动与MDD的临床标志物进行关联。我们进行了一项回顾性研究,查阅了43例fMDD患者的病历。总体而言,43例患者中有13例至少接受了3年的随访,且在3年随访结束时17项汉密尔顿抑郁量表评分低于7分,其中有13例患者在半年多的时间里未服用抗抑郁药。我们进一步选择了一组14名健康对照者,其年龄、性别和教育水平与rMDD患者相匹配。对ALFF和ReHo进行了多重比较分析。统计学显著性水平设定为P值小于0.05。我们检测了静息状态下三组在全脑ALFF和ReHo方面是否存在差异。与健康对照者相比,fMDD患者小脑右前叶的ReHo显著降低,右下颞回的ReHo显著升高,左下顶叶和右侧尾状核的ALFF显著降低。与rMDD患者相比,fMDD患者右侧梭状回和左侧颞中回的ReHo显著升高,右侧颞上回的ALFF显著升高。与健康对照者相比,rMDD患者右侧缘上回的ReHo显著升高,右侧楔前叶的ReHo显著降低,右侧舌回和左侧额上回的ALFF显著降低。只有fMDD患者颞回的内在活动有相对明显的增加。颞回可能在抑郁症状学中起关键作用。右侧梭状回、左侧颞中回和右侧颞上回的异常改变仅出现在rMDD患者中,而在fMDD患者中未出现,这表明这些改变可能是MDD的治疗靶点。右侧缘上回、右侧楔前叶、右侧舌回和左侧额上回的异常改变仅出现在rMDD患者中,而在健康对照者中未出现,因此可能用作MDD的一种状态标志物。

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