From the Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou (X-fZ, LW, C-jL, WW); and Sichuan Provincial Rehabilitation Hospital affiliated with Chongqing Medical University, Chengdu (XH), China.
Am J Phys Med Rehabil. 2019 Apr;98(4):303-310. doi: 10.1097/PHM.0000000000001081.
OBJECTIVE: Poststroke depression (PSD) is an important complication that affects stroke rehabilitation. Abnormal cortical-subcortical connectivity may be associated with the development of PSD. However, few studies have focused on the emotional network of PSD in the temporal lobe lesions. The aim of is study was to investigate amygdala-cortical functional connectivity (FC) in the temporal lobe in individuals with and without PSD. DESIGN: Twenty-three patients with PSD and 21 stroke patients without depression were recruited to undergo functional magnetic imaging scanning. RESULTS: In stroke patients with depression, the left amygdala had increased FC with the bilateral precuneus and right orbital frontal lobe but decreased FC with the right putamen. The right amygdala had increased FC with the right temporal pole, right rectus gyrus, and left orbital frontal lobe but decreased FC with the right primary sensory area (S1). Correlative analyses revealed that the amygdala's FCs with the right orbital frontal lobe, right insular cortex, and right cingulate cortex were correlated with the Hamilton Depression Rating Scale score. CONCLUSION: The current study identified mood affected through the fronto-limbic-striatal circuit in PSD. Hyperconnectivity between the amygdala, default mode network, and salience network might be related to depressive symptoms, which may provide novel insight into the underlying neuropathologic mechanisms of PSD in temporal lobe lesions.
目的: 卒中后抑郁(PSD)是影响卒中康复的重要并发症。皮质下连接的异常可能与 PSD 的发展有关。然而,很少有研究关注颞叶病变患者 PSD 的情绪网络。本研究旨在探讨 PSD 患者和无抑郁卒中患者的杏仁核-皮质功能连接(FC)。 设计: 招募了 23 例 PSD 患者和 21 例无抑郁卒中患者进行功能磁共振成像扫描。 结果: 在抑郁性卒中患者中,左侧杏仁核与双侧楔前叶和右侧眶额回的 FC 增加,而与右侧壳核的 FC 减少。右侧杏仁核与右侧颞极、右侧直回和左侧眶额回的 FC 增加,与右侧初级感觉区(S1)的 FC 减少。相关分析显示,杏仁核与右侧眶额回、右侧岛叶和右侧扣带回的 FC 与汉密尔顿抑郁评定量表评分相关。 结论: 本研究通过额-边缘-纹状体回路确定了 PSD 中的情绪变化。杏仁核与默认模式网络和突显网络之间的过度连接可能与抑郁症状有关,这可能为颞叶病变 PSD 的潜在神经病理机制提供新的见解。
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