Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, P.R. China.
J Magn Reson Imaging. 2019 Jun;49(6):1760-1768. doi: 10.1002/jmri.26520. Epub 2018 Oct 8.
Previous studies had proved that hippocampal volume has predictive value for antidepressant response in patients with major depressive disorder (MDD). However, the exact subregion of the hippocampus relevant to the predictive role of antidepressants response is not known.
To explore which hippocampal subfield volumes might predict an early response to first-time use of antidepressants in drug-naïve MDD patients.
Prospective.
Thirty-eight drug-naïve MDD patients (mean illness duration = 1.6 years) and 55 healthy control subjects (HCS).
FIELD STRENGTH/SEQUENCE: 3.0T MRI, T -weighted, 3D, SPGR sequence.
The hippocampal subfields and total intracranial volume were measured with FreeSurfer. The response to antidepressants was evaluated by the reduction rate of the Hamilton Rating Scale for Depression score (RRS) after a 6-week routine clinical antidepressant treatment.
The relationship between hippocampal subfield volumes and RRS was explored using partial correlation analysis. Volume differences among early responding patients (ERP), nonresponding patients (NRP), and HCS were examined by multivariate analysis of covariance. Receiver operating characteristic (ROC) curve analysis was used to evaluate the sensitivity and specificity of volumes as predictors.
NRP had significantly larger volumes than both ERP and HCS in bilateral subiculum, cornu ammonis (CA) 1 and left CA2/3, CA4/dentate gyrus (DG) (all P < 0.01, false discovery rate corrected). Significant negative correlations were found between the RRS and volumes of left subiculum (P = 0.004), CA2/3 (P = 0.008), and CA4/DG (P = 0.004) in the whole MDD group. ROC analysis demonstrated that the left subiculum exhibited the highest accuracy for differentiating NRP from ERP, with a sensitivity of 76.9% and specificity of 80%.
These findings propose that volumes of certain hippocampal subfields may be associated with antidepressant treatment and this has potential use in clinical applications for treatment selection in patients with MDD at an early stage.
2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;49:1760-1768.
先前的研究已经证明，海马体积对重度抑郁症（MDD）患者的抗抑郁反应具有预测价值。然而，与抗抑郁反应的预测作用相关的确切海马亚区尚不清楚。
探讨哪些海马亚区体积可能预测首次使用抗抑郁药治疗药物初治 MDD 患者的早期反应。
前瞻性。
38 名药物初治 MDD 患者（平均患病时间为 1.6 年）和 55 名健康对照组（HCS）。
磁场强度/序列：3.0T MRI，T1 加权，3D，SPGR 序列。
使用 FreeSurfer 测量海马亚区和总颅内体积。通过汉密尔顿抑郁量表评分（HAMD）降低率（RRS）评估抗抑郁治疗 6 周后的抗抑郁反应。
采用偏相关分析探讨海马亚区体积与 RRS 的关系。采用多元协方差分析比较早期反应患者（ERP）、非反应患者（NRP）和 HCS 之间的海马亚区体积差异。采用受试者工作特征（ROC）曲线分析评估体积作为预测因子的敏感性和特异性。
NRP 的双侧海马伞、角回（CA）1 和左侧 CA2/3、CA4/齿状回（DG）的体积明显大于 ERP 和 HCS（均 P<0.01，假发现率校正）。在整个 MDD 组中，RRS 与左侧海马伞（P=0.004）、CA2/3（P=0.008）和 CA4/DG（P=0.004）的体积呈显著负相关。ROC 分析表明，左侧海马伞区分 NRP 和 ERP 的准确率最高，敏感性为 76.9%，特异性为 80%。
这些发现表明，某些海马亚区的体积可能与抗抑郁治疗相关，这可能有助于在 MDD 早期阶段对患者进行治疗选择。
2 技术功效：4 级 JMRI 2019；49：1760-1768。
