School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
J Magn Reson Imaging. 2021 May;53(5):1375-1386. doi: 10.1002/jmri.27466. Epub 2020 Dec 10.
Alterations in gray matter (GM) have been recognized as playing an important role in the neurobiological mechanism underlying major depressive disorder (MDD) and antidepressant responses. However, little is known about white matter (WM) connectivity in MDD, leaving an incomplete understanding of the pathophysiology of the disorder.
To examine the functional connectivity (FC) of WM, GM, and WM-GM in MDD patients and explore the relationship between FC and antidepressant response.
Longitudinal study.
In all, 129 MDD patients and 89 healthy controls (HC).
FIELD STRENGTH/SEQUENCE: Whole-brain blood oxygen level-dependent (BOLD) single-shot echo planar imaging was acquired at 3.0T.
At baseline, all participants received Hamilton depression rating scale (HAMD) assessment and an fMRI scan. After 2- and 8-week antidepressant treatment, patients completed the HAMD again. The HAMD reductive rate of 2- and 8-weeks were calculated.
The comparisons of age, education, HAMD scores, and FC values (false discovery rate correction) between patients and controls were calculated with a two-sample t-test. The chi-square test was employed to compare the differences of gender between these two groups. Correlations between FC and HAMD, as well as the reductive rate of HAMD, were analyzed with Pearson or Spearman correlation. Receiver operator curve analysis was performed to predict the antidepressant response.
Compared to HC, MDD patients exhibited widespread decreases in FC of WM-GM. Furthermore, 28 GM regions and 11 WM bundles had lower connectivity in MDD patients. At baseline, four FC of WM-GM showed negative correlations with the HAMD scores. Six FC of WM-GM correlated with the 2-week reductive rate of HAMD. Moreover, FC in GM, WM, and WM-GM also exhibited significantly positive correlations with an 8-week reductive rate of HAMD.
The FC of WM-GM was decreased in MDD and may play a role in its pathophysiology and antidepressant responses.
灰质（GM）的改变已被认为在重度抑郁症（MDD）和抗抑郁反应的神经生物学机制中起着重要作用。然而，对于 MDD 中的白质（WM）连接性知之甚少，这使得对该疾病的病理生理学的理解并不完整。
研究 MDD 患者 WM、GM 和 WM-GM 的功能连接（FC），并探讨 FC 与抗抑郁反应的关系。
纵向研究。
共 129 名 MDD 患者和 89 名健康对照者（HC）。
磁场强度/序列：在 3.0T 上采集全脑血氧水平依赖（BOLD）单次回波平面成像。
在基线时，所有参与者都接受了汉密尔顿抑郁评定量表（HAMD）评估和 fMRI 扫描。在 2 周和 8 周抗抑郁治疗后，患者再次完成 HAMD。计算 2 周和 8 周的 HAMD 减分率。
采用两样本 t 检验比较患者和对照组之间的年龄、教育程度、HAMD 评分和 FC 值（错误发现率校正）。采用卡方检验比较两组之间的性别差异。采用 Pearson 或 Spearman 相关分析 WM-GM 的 FC 与 HAMD 之间以及与 HAMD 减分率之间的相关性。采用受试者工作特征曲线分析来预测抗抑郁反应。
与 HC 相比，MDD 患者 WM-GM 的 FC 普遍降低。此外，MDD 患者有 28 个 GM 区域和 11 个 WM 束的连接性降低。在基线时，有 4 个 WM-GM 的 FC 与 HAMD 评分呈负相关。有 6 个 WM-GM 的 FC 与 2 周 HAMD 减分率相关。此外，GM、WM 和 WM-GM 的 FC 也与 8 周 HAMD 减分率呈显著正相关。
MDD 患者 WM-GM 的 FC 降低，可能在其病理生理学和抗抑郁反应中起作用。
2 级。
2 级。
