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重度抑郁症患者功能性残疾的神经生物标志物:一项结构神经影像学研究。

Neural biomarker of functional disability in major depressive disorder: A structural neuroimaging study.

机构信息

Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Department of EEG & Neuroimaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Robarts Research Institute& The Brain and Mind Institute, Western University, London, ON, Canada.

Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic disorders, Shanghai 201108, China.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2021 Dec 20;111:110337. doi: 10.1016/j.pnpbp.2021.110337. Epub 2021 Apr 24.

DOI:10.1016/j.pnpbp.2021.110337
PMID:33905754
Abstract

BACKGROUND

Most patients with the major depressive disorder (MDD) have varying degrees of impaired social functioning, and functional improvement often lags behind symptomatic improvement. However, it is still unclear if certain neurobiological factors underlie the deficits of social function in MDD. The aim of this study was to investigate the biomarkers of social function in MDD using structural magnetic resonance imaging (MRI).

METHODS

3T anatomical MRI was obtained from 272 subjects including 46 high-functioning (high-SF, Sheehan Disability Scale (SDS) rating < 18) and 63 low-functioning (low-SF, SDS score ≥ 18) patients with MDD and 163 healthy controls (HC). Voxel-based morphometry (VBM) was employed to locate brain regions with grey matter (GM) volume differences in relation to social function in MDD. Regions showing GM differences in relation to social function at baseline were followed up longitudinally in a subset of 38 patients scanned after 12-week treatment.

RESULTS

Volume of right parahippocampal gyrus (rPHG) was significantly reduced in low-SF patients with MDD when compared to high-SF ones (FDR-corrected p < 0.05). Over 12 weeks of follow-up, though SF improved overall, the high and low-SF subgroups continued to differ in their SF, but had no progressive changes in PHG volume.

LIMITATIONS

Limited functional assessment, high drop-out rate and median-based grouping method.

CONCLUSIONS

Greater GM volume (GMV) of the rPHG may mark better social function in patients with MDD.

摘要

背景

大多数患有重度抑郁症(MDD)的患者社会功能都有不同程度的受损,而功能的改善往往滞后于症状的改善。然而,目前尚不清楚是否存在某些神经生物学因素导致 MDD 患者的社会功能缺陷。本研究旨在使用结构磁共振成像(MRI)来探讨 MDD 患者社会功能的生物标志物。

方法

本研究纳入了 272 名受试者,包括 46 名高功能(高-SF,Sheehan 残疾量表(SDS)评分<18)和 63 名低功能(低-SF,SDS 评分≥18)的 MDD 患者以及 163 名健康对照(HC)。采用基于体素的形态学分析(VBM)来定位与 MDD 患者社会功能相关的灰质(GM)体积差异的脑区。在一组 38 名接受 12 周治疗后扫描的患者中,对与社会功能相关的基线 GM 差异进行了随访。

结果

与高-SF 患者相比,低-SF 的 MDD 患者右侧海马旁回(rPHG)的体积明显减小(经 FDR 校正后,p<0.05)。尽管在 12 周的随访中,SF 整体上有所改善,但高-SF 和低-SF 亚组的 SF 仍存在差异,而 PHG 体积没有进行性变化。

局限性

功能评估有限、高脱落率和基于中位数的分组方法。

结论

rPHG 的 GM 体积(GMV)较大可能预示着 MDD 患者的社会功能较好。

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