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首发、未经治疗的青少年抑郁症患者的疾病严重程度和执行功能障碍与认知控制网络的内源性功能连接中断有关。

Disrupted intrinsic functional connectivity of the cognitive control network underlies disease severity and executive dysfunction in first-episode, treatment-naive adolescent depression.

机构信息

Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China.

Department of Radiology, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China.

出版信息

J Affect Disord. 2020 Mar 1;264:455-463. doi: 10.1016/j.jad.2019.11.076. Epub 2019 Nov 13.

Abstract

BACKGROUND

Previous neuroimaging studies have showed that imbalanced functional integration of distributed large-scale brain networks is associated with pathophysiological characteristics of major depressive disorder (MDD). However, the association between network integrative disturbances and clinical features and cognitive functions remains largely unclear in adolescent MDD. This study investigated the neural correlates of abnormal functional connectivity networks with clinical and cognitive characteristics in adolescent MDD.

METHODS

Twenty-eight first-episode, treatment-naive adolescents with MDD and 24 well-matched healthy controls (HCs) underwent functional magnetic resonance imaging (fMRI) and a battery of cognitive tests. A seed-based functional connectivity (FC) approach was used to depict connectivity patterns of the cognitive control network (CCN), affective network (AN) and default mode network (DMN), whose between-group differences were correlated with clinical variables and cognitive functions in the patients.

RESULTS

Compared with the HCs, the MDD patients exhibited impaired executive functions. The FC analysis revealed lower CCN FC with the temporal, parietal and frontal regions and the limbic system, higher AN FC with the temporal and occipital regions and the cerebellum, and lower DMN FC with the cerebellum and insula. Interestingly, the decreased CCN FC was related to disease severity (with the inferior frontal gyrus) and executive dysfunctions (with the middle cingulate gyrus and supramarginal gyrus) in the patients.

LIMITATIONS

The main limitations were the relatively small sample size and suboptimal imaging parameters.

CONCLUSION

Functional alteration of CCN during the developmentally sensitive period may be important in the neurobiology of adolescent MDD.

摘要

背景

先前的神经影像学研究表明,分布式大脑网络功能整合失衡与重度抑郁症(MDD)的病理生理特征有关。然而,青少年 MDD 患者的网络整合障碍与临床特征和认知功能之间的关联在很大程度上仍不清楚。本研究旨在探讨异常功能连接网络与青少年 MDD 患者临床和认知特征的神经相关性。

方法

28 名首发、未经治疗的青少年 MDD 患者和 24 名年龄、性别相匹配的健康对照组(HCs)接受了功能磁共振成像(fMRI)和一系列认知测试。采用基于种子的功能连接(FC)方法描绘认知控制网络(CCN)、情感网络(AN)和默认模式网络(DMN)的连接模式,其组间差异与患者的临床变量和认知功能相关。

结果

与 HCs 相比,MDD 患者的执行功能受损。FC 分析显示,MDD 患者的 CCN 与颞叶、顶叶和额叶以及边缘系统的 FC 降低,与颞叶和枕叶以及小脑的 AN FC 升高,与小脑和岛叶的 DMN FC 降低。有趣的是,CCN FC 的降低与患者的疾病严重程度(与额下回有关)和执行功能障碍(与中扣带回和缘上回有关)有关。

局限性

主要的局限性是样本量相对较小和成像参数不理想。

结论

在发育敏感时期,CCN 的功能改变可能在青少年 MDD 的神经生物学中具有重要意义。

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