Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Clinical Psychology, Graduate School of Education, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
J Affect Disord. 2019 Jan 15;243:249-254. doi: 10.1016/j.jad.2018.09.029. Epub 2018 Sep 17.
Long-term longitudinal studies are necessary to establish neuroimaging indicators which contribute to the detection of severity changes over time in patients with major depressive disorder (MDD).
One hundred sixty-five patients with MDD underwent clinical assessments and near-infrared spectroscopy (NIRS) examination at the initial evaluation (T0). After 1.5 years, 45 patients who visited for the follow-up evaluation (T1.5) were included in the analysis. The authors conducted analyses using the 17-item Hamilton Rating Scale for Depression (HAMD) scores and mean oxy-hemoglobin concentration ([oxy-Hb]) changes during a cognitive task in NIRS at T0 (T0_HAMD, T0_[oxy-Hb]) and at T1.5 (T1.5_HAMD, T1.5_[oxy-Hb]), and their intra-individual longitudinal changes (ΔHAMD = T1.5_HAMD - T0_HAMD, Δ[oxy-Hb] = T1.5_[oxy-Hb] - T0_[oxy-Hb]).
For severity-dependent regions, the Δ[oxy-Hb] in the right inferior frontal gyrus (IFG) was negatively correlated with the ΔHAMD. For severity-independent regions, the intra-class correlation coefficients between T0_ and T1.5_[oxy-Hb] were moderate in the bilateral middle frontal gyri (MFG).
The percentage of patients included in the follow-up examination was relatively small.
Brain activation in the right IFG and the bilateral MFG as measured by NIRS may differentially indicate clinical severity and trait-related abnormalities in MDD.
需要进行长期纵向研究,以确定神经影像学指标,这些指标有助于检测重度抑郁症(MDD)患者随时间的严重程度变化。
165 名 MDD 患者在初始评估(T0)时接受临床评估和近红外光谱(NIRS)检查。1.5 年后,有 45 名患者在随访评估(T1.5)时就诊,他们被纳入分析。作者使用 17 项汉密尔顿抑郁量表(HAMD)评分和 NIRS 在 T0(T0_HAMD、T0_[oxy-Hb])和 T1.5(T1.5_HAMD、T1.5_[oxy-Hb])时的认知任务中的平均氧合血红蛋白浓度([oxy-Hb])变化进行分析,以及它们的个体内纵向变化(ΔHAMD= T1.5_HAMD-T0_HAMD,Δ[oxy-Hb]= T1.5_[oxy-Hb]-T0_[oxy-Hb])。
对于严重程度相关的区域,右侧额下回(IFG)的Δ[oxy-Hb]与ΔHAMD 呈负相关。对于严重程度无关的区域,双侧额中回(MFG)T0_和 T1.5_[oxy-Hb]之间的组内相关系数为中度。
随访检查中包含的患者比例相对较小。
NIRS 测量的右侧 IFG 和双侧 MFG 的大脑激活可能分别表明 MDD 的临床严重程度和与特质相关的异常。