Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
Zhumadian Psychiatric Hospital, Zhumaidan, Henan 463000, China.
J Affect Disord. 2020 Nov 1;276:411-417. doi: 10.1016/j.jad.2020.07.067. Epub 2020 Jul 20.
The aim of this study includes: (1) using resting-state functional magnetic resonance imaging (rsfMRI) to explore the aberrant brain regional spontaneous brain activities in acute major depressive disorder (MDD) patients; (2) to determine whether the abnormalities could be restored after 6 months of antidepressant treatment; (3) to investigate whether the differences in regional spontaneous brain activities are associated with clinical variables in MDD.
RsfMRI scanning was performed in 149 MDD patients and 122 healthy control (HC) subjects at baseline. After 6 months of antidepressant treatment, rsfMRI scanning was reperformed in remitted MDD patients (MDD-R) (n=63). The characteristics of the amplitude of low-frequency fluctuations (ALFF), and the relationship between the fMRI representatives and clinical variables in the MDD group were analyzed.
(1) Compared to healthy controls, significantly decreased ALFF in the right precuneus/posterior cingulate cortex (PCUN/PCC) was detected in MDD. (2) The ALFF value of precuneus in MDD-R group did not change significantly after a 6-month antidepressant treatment and was still lower than the HC group when remission was achieved (P = 0.002). (3) No correlations were found between ALFF in the right PCUN/PCC and Hamilton Depression Rating Scale(HAMD) total score, illness duration, age of onset, and the number of episodes in the baseline MDD group. The ALFF change was not correlated with depressive symptom improvement in MDD-R group.
The reduction of ALFF in the precuneus persisted in MDD who achieved clinical remission, suggesting that the decreased ALFF in PCUN/PCC may be a trait marker of MDD.
本研究旨在：（1）运用静息态功能磁共振成像（rsfMRI）技术，探讨急性重度抑郁症（MDD）患者脑区自发活动的异常；（2）确定抗抑郁治疗 6 个月后这些异常是否能够得到恢复；（3）探讨脑区自发活动的差异是否与 MDD 的临床变量相关。
在基线时对 149 例 MDD 患者和 122 例健康对照（HC）受试者进行 rsfMRI 扫描。在经过 6 个月的抗抑郁治疗后，对缓解的 MDD 患者（MDD-R）（n=63）重复 rsfMRI 扫描。分析 MDD 组 fMRI 代表指标的特征及其与临床变量的关系。
（1）与健康对照组相比，MDD 患者右侧楔前叶/后扣带回（PCUN/PCC）的低频振幅（ALFF）显著降低。（2）在抗抑郁治疗 6 个月后，MDD-R 组的楔前叶 ALFF 值没有明显变化，当病情缓解时仍低于 HC 组（P=0.002）。（3）在基线 MDD 组中，右侧 PCUN/PCC 的 ALFF 与汉密尔顿抑郁评定量表（HAMD）总分、病程、发病年龄和发作次数均无相关性。MDD-R 组的 ALFF 变化与抑郁症状改善无关。
在达到临床缓解的 MDD 患者中，楔前叶的 ALFF 减少持续存在，提示 PCUN/PCC 的 ALFF 减少可能是 MDD 的特征性标志物。
