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在重度抑郁症患者中,大脑的结构改变先于功能改变:来自多模态连接的证据。

Structural alterations of the brain preceded functional alterations in major depressive disorder patients: Evidence from multimodal connectivity.

机构信息

School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R. China.

College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, 310027, P.R. China.

出版信息

J Affect Disord. 2019 Jun 15;253:107-117. doi: 10.1016/j.jad.2019.04.064. Epub 2019 Apr 10.

Abstract

BACKGROUND

Recent studies showed that major depressive disorder (MDD) has been involved in abnormal functional and structural connections in specific brain regions. However, comprehensive researches on MDD-related alterations in the topological organization of brain functional and structural networks are still limited.

METHODS

Functional network (FN) was constructed from resting-state functional MRI temporal series correlations and structural network (SN) was established by Diffusion tensor imaging (DTI) data in 58 MDD patients and 71 healthy controls (HC). The measurements of the network properties were calculated for two networks respectively. Correlations were conducted between altered network parameters and Hamilton depression scale (HAMD) score. Additionally, network resilient analysis were conducted on FN and SN.

RESULTS

The losses of small-worldness charateristics and the decline of nodal efficiency across FN and SN were found in MDD patients. Based on network-based statistic (NBS) approach, the decreased connections in MDD patients were mainly found in the superior occipital gyrus, superior temporal gyrus for FN and SN, while the increased connections were distributed in putamen, superior frontal gyrus only for SN. Compared with the FN, the SN showed less resilient to targeted or random node failure. Besides, altered edges in NBS and regions with decreased nodal efficiency were negatively associated with HAMD score in MDD patients.

LIMITATIONS

The samples size is small and most of the MDD patients take different antidepressant medications.

CONCLUSIONS

Alterations of SN in the brain of MDD patients preceded that of FN to some extent, and reorganization of the brain network was a mechanism which compensated for functional and structural alterations during disease progression.

摘要

背景

最近的研究表明,重度抑郁症(MDD)与特定脑区的功能和结构连接异常有关。然而,关于 MDD 相关的脑功能和结构网络拓扑组织改变的综合研究仍然有限。

方法

在 58 名 MDD 患者和 71 名健康对照者(HC)中,通过静息态功能磁共振成像时间序列相关构建功能网络(FN),通过弥散张量成像(DTI)数据构建结构网络(SN)。分别计算了两个网络的网络特性测量值。将改变的网络参数与汉密尔顿抑郁量表(HAMD)评分进行相关性分析。此外,还对 FN 和 SN 进行了网络弹性分析。

结果

MDD 患者的 FN 和 SN 均出现小世界特性丧失和节点效率降低。基于基于网络的统计学(NBS)方法,MDD 患者的连接减少主要发生在 FN 和 SN 的顶枕叶和颞上回,而增加的连接主要分布在 SN 的壳核和额上回。与 FN 相比,SN 对靶向或随机节点失效的弹性较小。此外,NBS 中改变的边缘和节点效率降低的区域与 MDD 患者的 HAMD 评分呈负相关。

局限性

样本量小,大多数 MDD 患者服用不同的抗抑郁药物。

结论

MDD 患者脑区的 SN 改变在一定程度上先于 FN,脑网络的重组是疾病进展过程中对功能和结构改变进行补偿的一种机制。

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