Stanford University School of Medicine, CA.
Stanford University School of Medicine, CA.
J Am Acad Child Adolesc Psychiatry. 2018 Oct;57(10):775-785.e3. doi: 10.1016/j.jaac.2018.06.017. Epub 2018 Aug 16.
Depression runs in families and has been associated with dysfunctional limbic connectivity. Whether aberrant limbic connectivity is a risk factor for or a consequence of depression is unclear. To examine this question, we compared resting state functional connectivity (RSFC) in youth with depressive disorders (DEP), healthy offspring of parents with depression (DEP-risk), and healthy comparison (HC) youth.
Magnetic resonance imaging at rest was acquired from 119 youth, aged 8 to 17 years (DEP, n = 41, DEP-risk, n = 39, and HC, n = 39) and analyzed using seed-based RSFC in bilateral amygdala and nucleus accumbens (NAcc), covarying for age, IQ, and sex.
We found distinct risk- and disorder-specific patterns of RSFC across groups. DEP-risk and DEP youth shared reduced negative amygdala-right frontal cortex RSFC and reduced positive amygdala-lingual gyrus RSFC compared to HC youth (p < .001). DEP-risk youth had weaker negative amygdala-precuneus RSFC compared to DEP and HC youth (p < .001), suggesting a resilience marker for depression. In contrast, DEP youth had increased positive NAcc-left frontal cortex RSFC and reduced positive NAcc-insula RSFC compared to DEP-risk and HC youth (p < .001), suggestive of disorder-specific features of depression. Greater depression severity was correlated with disorder-specific amygdala and NAcc RSFC (p < .05).
RSFC in the amygdala and NAcc may represent selective disorder- and risk-specific markers in youth with, and at familial risk for, depression. Longitudinal studies are needed to determine whether these patterns predict long-term clinical outcomes.
抑郁在家族中存在且与边缘系统功能连接障碍相关。边缘系统功能连接异常是抑郁的风险因素还是后果尚不清楚。为了探究这个问题，我们比较了患有抑郁障碍（DEP）的青年、父母患有抑郁的健康子女（DEP 风险）和健康对照（HC）青年的静息态功能连接（RSFC）。
对 119 名年龄在 8 至 17 岁的青少年（DEP，n=41；DEP 风险，n=39；HC，n=39）进行了静息态磁共振成像，并采用双侧杏仁核和伏隔核（NAcc）的基于种子的 RSFC 进行分析，同时协变量包括年龄、智商和性别。
我们发现三组之间的 RSFC 存在明显的风险和疾病特异性模式。与 HC 青年相比，DEP 风险和 DEP 青年的负性杏仁核-右侧额皮质 RSFC 和正性杏仁核-舌回 RSFC 均降低（p<0.001）。与 DEP 和 HC 青年相比，DEP 风险青年的负性杏仁核-楔前叶 RSFC 较弱（p<0.001），提示为抑郁的弹性标志物。相反，与 DEP 风险和 HC 青年相比，DEP 青年的正性 NAcc-左侧额皮质 RSFC 增加，正性 NAcc-岛叶 RSFC 降低（p<0.001），提示存在抑郁的特异性疾病特征。抑郁严重程度与疾病特异性杏仁核和 NAcc RSFC 呈正相关（p<0.05）。
杏仁核和 NAcc 的 RSFC 可能代表患有和有抑郁家族风险的青年中具有选择性的疾病和风险特异性标志物。需要进行纵向研究以确定这些模式是否可以预测长期的临床结局。
