Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Anatomy, College of Medicine, Korea University, Seoul, Republic of Korea.
J Affect Disord. 2020 Mar 1;264:279-285. doi: 10.1016/j.jad.2020.01.011. Epub 2020 Jan 7.
Although structural alterations have been reported in patients with major depressive disorder (MDD), very few studies have compared the shape alterations of the subcortical regions between drug-naïve MDD patients and healthy controls (HCs). Therefore, we investigated and compared the subcortical shape alterations and volumetric changes between drug-naïve MDD patients and HCs in this study.
This study included 45 drug-naïve MDD patients and 83 HCs, who underwent three-dimensional (3-D) T1-weighted structural magnetic resonance imaging. Surface-based vertex analysis (SVA) was performed with automated segmentation of the bilateral caudate nuclei, putamina, nuclei accumbens, thalami, pallidum, hippocampi, amygdalae, and brainstem. SVA revealed regional contractions of the thalamus (bilateral medial and lateral nuclei) and right caudate nucleus (medial wall and anterosuperior areas) in the drug-naïve MDD patients when compared to HCs RESULTS: In volume analysis, the drug-naïve MDD patients showed a significant decrease in the volume of bilateral thalami compared with HCs (after Bonferroni correction p < 0.003). We identified morphometric contractions in bilateral thalami and right caudate nucleus in the drug-naïve MDD patients (p < 0.05).
The present study implied that with cortical shape changes, the subcortical brain alterations could contribute to emotional dysregulation in the drug-naïve MDD patients.
尽管已有研究报道重度抑郁症(MDD)患者存在结构改变,但很少有研究比较未经药物治疗的 MDD 患者和健康对照者(HCs)之间的皮质下区域形状改变。因此,我们在本研究中调查并比较了未经药物治疗的 MDD 患者和 HCs 之间的皮质下形状改变和体积变化。
本研究纳入了 45 例未经药物治疗的 MDD 患者和 83 例 HCs,所有患者均接受了三维(3-D)T1 加权结构磁共振成像检查。采用双侧尾状核、壳核、伏隔核、丘脑、苍白球、海马、杏仁核和脑干的自动分割进行基于表面的顶点分析(SVA)。SVA 显示与 HCs 相比,未经药物治疗的 MDD 患者的丘脑(双侧内侧和外侧核)和右侧尾状核(内侧壁和前上区域)出现了区域性收缩。
在体积分析中,未经药物治疗的 MDD 患者双侧丘脑的体积与 HCs 相比明显减小(经 Bonferroni 校正后 p<0.003)。我们发现未经药物治疗的 MDD 患者双侧丘脑和右侧尾状核的形态学收缩(p<0.05)。
本研究表明,随着皮质形状改变,皮质下脑改变可能导致未经药物治疗的 MDD 患者的情绪调节障碍。