Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.
Department of Neurology, School of Medicine, ZhongDa Hospital, Southeast University, Nanjing, China.
Brain Imaging Behav. 2021 Jun;15(3):1420-1426. doi: 10.1007/s11682-020-00341-3.
This study aimed to examine the cerebral cortex characteristics (thickness, surface area, and curvature) in patients with major depressive disorder (MDD), and explore whether these cortex characteristics are predictors for the antidepressant therapeutic effect. 105 patients with MDD and 49 healthy controls (HCs) were recruited. Both groups were given magnetic resonance image (MRI) scans at baseline period, and then the cerebral cortex characteristics (thickness, surface area, and curvature) were calculated using the DPABISurf software. The Hamilton Depression Scale-24 (HAMD-24) reductive rate was used to measure antidepressant therapeutic effect and Snaith Hamilton Rating Scale (SHAPS) reduction was performed to assess the change of anhedonia after treatment of 8 weeks. Correlation analysis was performed to identify the relationship between cortex characteristics and antidepressant therapeutic effect in patients with MDD. There were no significant differences in the cortical curvature and surface area between MDD and HC groups, while significant decreases were found in the cortical thickness of inferior frontal cortex (IFC), premotor cortex (PMC), orbital and medial prefrontal cortex (OMPFC) in the left hemisphere of MDD group, comparing with HC group (P < 0.05 for all, corrected by threshold-free cluster enhancement). In MDD group, the cortical thickness of left PMC had significant positive correlations with 8-week HAMD-24 reduction (r = 0.228, P = 0.020) and HAMD-24 reductive rate (r = 0.193, P = 0.048); and a negative correlation with the 8-week SHAPS reduction (r = -0.240, P = 0.018). Decreased cortical thickness in left PMC may be a predictor of therapeutic effect in MDD. Determining the cortical thickness of this region before treatment can provide certain reference value for clinical antidepressant treatment.
本研究旨在探讨重度抑郁症（MDD）患者大脑皮质的特征（厚度、表面积和曲率），并探索这些皮质特征是否可作为抗抑郁治疗效果的预测指标。共招募了 105 名 MDD 患者和 49 名健康对照者（HCs）。两组在基线期均进行磁共振成像（MRI）扫描，然后使用 DPABISurf 软件计算大脑皮质特征（厚度、表面积和曲率）。采用汉密尔顿抑郁量表 24 项（HAMD-24）减分率评估抗抑郁治疗效果，采用 Snaith 汉密尔顿抑郁量表（SHAPS）减分评估治疗 8 周后的快感缺失变化。对 MDD 患者皮质特征与抗抑郁治疗效果之间的关系进行相关性分析。MDD 组与 HCs 组的皮质曲率和表面积无显著差异，而 MDD 组左半球的额下回皮质（IFC）、运动前皮质（PMC）、眶额和内侧前额皮质（OMPFC）皮质厚度明显降低，与 HCs 组相比（所有校正阈值自由聚类增强，P 值均<0.05）。在 MDD 组中，左侧 PMC 皮质厚度与 8 周 HAMD-24 减分呈显著正相关（r=0.228，P=0.020）和 HAMD-24 减分率呈显著正相关（r=0.193，P=0.048）；与 8 周 SHAPS 减分呈显著负相关（r=-0.240，P=0.018）。左侧 PMC 皮质厚度降低可能是 MDD 治疗效果的预测指标。在治疗前确定该区域的皮质厚度可为临床抗抑郁治疗提供一定的参考价值。
