Liu Penghong, Li Gaizhi, Zhang Aixia, Sun Ning, Kang Lijun, Yang Chunxia, Wang Yanfang, Zhang Kerang
Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China.
Department of Psychiatry, Shanxi Medical University, Taiyuan, 030001, People's Republic of China.
Neuropsychiatr Dis Treat. 2019 May 9;15:1181-1191. doi: 10.2147/NDT.S197351. eCollection 2019.
It is common that major depressive disorder (MDD) is accompanied by gastrointestinal (GI) symptoms. However, few studies have focused on the clinical characteristics and its possible mechanism, while brain gray matter (GM) structure is important in the pathogenesis of GI symptoms. In this study, we aimed to investigate the basic clinical characteristics and regional GM volume changes in MDD accompanied by GI symptoms. Patients with MDD (n=49) and age, gender, and educational level-matched healthy controls (n=30) were recruited. Patients with MDD were divided into two groups based on the GI status: MDD with (n=27) and without (n=22) GI symptoms. The 24-item Hamilton Depression Rating Scale (HAMD) was administered. T1-weighted anatomical images were obtained and analyzed. Correlation analysis was used to identify the possible associations between changed regional GM volume and GI symptoms and depressive symptoms. The HAMD reductive ratio for 2 weeks of treatment in the GI symptoms group was significantly higher than the non-GI symptoms group (<0.05). The regional GM volume showed significant differences among the three groups (Gaussian Random Field [GRF] correction, voxel-<0.01, cluster- <0.05). Compared with non-GI symptoms group, GI symptoms group exhibited significantly increased GM volume in the left hippocampus, left parahippocampal gyrus, right parahippocampal gyrus; and decreased GM volume in the right middle frontal gyrus, right precentral gyrus, right cuneus, right precuneus, right superior occipital gyrus (GRF correction, voxel- <0.01, cluster- <0.05). These altered brain areas were correlated with the GI symptoms, not depressive symptoms. The changed regional brain GM volume in GI-MDD group may be the pathogenesis for the GI symptoms. In addition, the GI symptoms may predict the prognosis of MDD.
重度抑郁症（MDD）常伴有胃肠道（GI）症状。然而，很少有研究关注其临床特征及其可能的机制，而脑灰质（GM）结构在GI症状的发病机制中很重要。在本研究中，我们旨在调查伴有GI症状的MDD的基本临床特征和脑区GM体积变化。招募了MDD患者（n = 49）以及年龄、性别和教育水平匹配的健康对照者（n = 30）。根据GI状况将MDD患者分为两组：伴有（n = 27）和不伴有（n = 22）GI症状的MDD。采用24项汉密尔顿抑郁量表（HAMD）进行评估。获取并分析T1加权解剖图像。采用相关性分析来确定脑区GM体积变化与GI症状和抑郁症状之间的可能关联。GI症状组治疗2周后的HAMD减分率显著高于非GI症状组（<0.05）。三组之间脑区GM体积存在显著差异（高斯随机场[GRF]校正，体素<0.01，簇<0.05）。与非GI症状组相比，GI症状组左侧海马、左侧海马旁回、右侧海马旁回的GM体积显著增加；右侧额中回、右侧中央前回、右侧楔叶、右侧楔前叶、右侧枕上回的GM体积减小（GRF校正，体素<0.01，簇<0.05）。这些脑区改变与GI症状相关，而非抑郁症状。GI-MDD组脑区GM体积的改变可能是GI症状的发病机制。此外，GI症状可能预测MDD的预后。
