Shen Zhongxia, Zhu Jianying, Ren Lie, Qian Mingcai, Shao Yongliang, Yuan Yonggui, Shen Xinhua
School of Medicine, Southeast University, Nanjing, China.
Department of Neurosis and Psychosomatic Diseases, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou, China.
Ann Transl Med. 2020 Oct;8(20):1319. doi: 10.21037/atm-20-6448.
Generalized anxiety disorder (GAD) is a common affective disorder characterized by comprehensive anxiety with dysregulation of brain activity which can be reflected by functional magnetic resonance imaging (f-MRI). We aimed to examine abnormal aberrant amplitude low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) in GAD and evaluate their ability to predict treatment remission.
Using resting-state fMRI (Rs-fMRI), we examined ALFF and ReHo in 30 GAD patients and 30 healthy control (HC) participants. Using on DEPASF4.3 Advanced Edition, voxel-based two-sample -test analysis was performed on the ALFF and ReHo maps to compare GAD to HC groups, and to compare remitters (n=9) and non-remitters (n=21). Pearson's correlation analysis was used to explore the relationship between baseline Hamilton Anxiety Rating Scale (HAM-A) scores/illness duration and mean ALFF/ReHo values. The severity of GAD symptoms was rated with HAM-A. Remission was defined as HAM-A ≤7 by week 8.
Compared to the HC group, GAD patients showed lower ALFF in the right postcentral and right precentral gyrus; lower ReHo in the right precentral, right postcentral, and left precentral gyrus; and higher ReHo in the left posterior cingulate cortex. ALFF values for left postcentral gyrus was negatively correlated with baseline HAM-A, while that of the middle frontal gyrus was positively correlated with baseline HAM-A scores. ReHo value of the left postcentral gyrus was negatively correlated with baseline HAM-A, while that of the right middle frontal gyrus was positively correlated with baseline HAM-A scores. ALFF of the right frontal_superior_orbital and right frontal-medial-orbital cortex was positively correlated with illness duration. ReHo of the left supplementary motor area cortex was negatively correlated with illness duration. Remitters showed higher ALFF in the left hippocampus and higher ReHo value in the right postcentral cortex compared to nonremitters.
These results suggest that altered regional brain activity and local synchronization may be related to the pathophysiology of GAD and have certain value in predicting remission in treatment.
广泛性焦虑障碍（GAD）是一种常见的情感障碍，其特征为全面性焦虑且伴有大脑活动失调，这可通过功能磁共振成像（f-MRI）反映出来。我们旨在研究GAD患者异常的低频振幅波动（ALFF）和局部一致性（ReHo），并评估它们预测治疗缓解的能力。
使用静息态功能磁共振成像（Rs-fMRI），我们检测了30例GAD患者和30名健康对照（HC）参与者的ALFF和ReHo。使用DEPASF4.3高级版，对ALFF和ReHo图谱进行基于体素的双样本t检验分析，以比较GAD组和HC组，并比较缓解者（n = 9）和未缓解者（n = 21）。采用Pearson相关分析来探讨基线汉密尔顿焦虑量表（HAM-A）评分/病程与平均ALFF/ReHo值之间的关系。用HAM-A评定GAD症状的严重程度。缓解定义为第8周时HAM-A≤7。
与HC组相比，GAD患者右侧中央后回和右侧中央前回的ALFF较低；右侧中央前回、右侧中央后回和左侧中央前回的ReHo较低；左侧扣带回后部的ReHo较高。左侧中央后回的ALFF值与基线HAM-A呈负相关，而额中回的ALFF值与基线HAM-A评分呈正相关。左侧中央后回的ReHo值与基线HAM-A呈负相关，而右侧额中回的ReHo值与基线HAM-A评分呈正相关。右侧额上眶和右侧额内侧眶皮质的ALFF与病程呈正相关。左侧辅助运动区皮质的ReHo与病程呈负相关。与未缓解者相比，缓解者左侧海马的ALFF较高，右侧中央后皮质的ReHo值较高。
这些结果表明区域脑活动和局部同步性改变可能与GAD的病理生理学有关，并且在预测治疗缓解方面具有一定价值。
