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抗抑郁治疗后,观察到重度抑郁症患者每四周大脑功能发生变化。

Brain functional alterations observed 4-weekly in major depressive disorder following antidepressant treatment.

机构信息

Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan.

Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan.

出版信息

J Affect Disord. 2019 Jun 1;252:25-31. doi: 10.1016/j.jad.2019.04.001. Epub 2019 Apr 3.

DOI:10.1016/j.jad.2019.04.001
PMID:30959413
Abstract

BACKGROUND

Major depressive disorder (MDD) is a heterogeneous condition. Identifying the brain responses to antidepressant treatment is of particular interest as these may represent potential neural networks related to treatment response, forming one aspect of the biological markers of MDD. Near-infrared spectroscopy (NIRS) is suitable for repeated measurements with short intervals because of its noninvasiveness, and can provide detailed time courses of functional alterations in prefrontal regions.

METHODS

We conducted a 12-week longitudinal study to explore prefrontal hemodynamic changes at 4-week intervals following sertraline treatment in 11 medication-naïve participants with MDD using 52-channel NIRS.

RESULTS

While all participants achieved remission after treatment, intra-class correlation coefficient of oxygenated hemoglobin [oxy-Hb] values throughout the 12-week observation was moderate at the spatially and temporally contiguous cluster located in the left inferior frontal and temporal gyri. There was a significant negative correlation between mean [oxy-Hb] values in the significant cluster at 4 weeks and changes in Hamilton Rating Scale for Depression total score from 4 to 8 weeks (r = -0.73, P = 0.011) and from 4 to 12 weeks (r = -0.63, P = 0.039).

LIMITATIONS

Without healthy controls for comparison, we were unable to fully evaluate whether improvement of [oxy-Hb] activations after treatment in MDD reached normal levels or not.

CONCLUSION

Our NIRS findings of detailed prefrontal hemodynamic alterations over short interval observations such as 4 weeks may have revealed potential trait marker for MDD and biological maker for predicting clinical response to sertraline treatment in MDD.

摘要

背景

重度抑郁症(MDD)是一种异质性疾病。识别抗抑郁治疗的大脑反应尤其有趣,因为这些反应可能代表与治疗反应相关的潜在神经网络,这是 MDD 生物学标志物的一个方面。近红外光谱(NIRS)因其非侵入性而适合进行短时间间隔的重复测量,并且可以提供前额区域功能变化的详细时间过程。

方法

我们进行了一项为期 12 周的纵向研究,使用 52 通道 NIRS,在 11 名未经药物治疗的 MDD 患者中,每 4 周间隔一次,在舍曲林治疗后,探讨前额叶血流动力学变化。

结果

虽然所有患者在治疗后均达到缓解,但在空间和时间上连续的左额下回和颞叶处的含氧血红蛋白[oxy-Hb]值的组内相关系数在整个 12 周观察期间中等。在第 4 周时,在显著簇中的平均[oxy-Hb]值与汉密尔顿抑郁量表总分从第 4 周到第 8 周(r=-0.73,P=0.011)和从第 4 周到第 12 周(r=-0.63,P=0.039)的变化之间存在显著负相关。

局限性

由于没有健康对照组进行比较,我们无法全面评估 MDD 患者治疗后[oxy-Hb]激活的改善是否达到正常水平。

结论

我们在 NIRS 中发现的前额叶血流动力学的详细变化,在 4 周等短时间间隔观察中可能揭示了 MDD 的潜在特征标记和预测 MDD 患者对舍曲林治疗的临床反应的生物学标记。

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