Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
J Affect Disord. 2021 Dec 1;295:1079-1086. doi: 10.1016/j.jad.2021.08.115. Epub 2021 Sep 4.
It is well known that the thalamus is not a unitary and homogeneous entity but a complex and highly connected archeocortical structure. Although many neuroimaging studies have reported alterations in the thalamus in major depressive disorder (MDD), the structural alterations in thalamic subfields remain unclear. This study aimed to investigate changes in gray matter volume (GMV) in thalamic subfields in MDD patients.
The present study included structural images of 848 MDD patients and 794 age-matched normal controls (NC) from 17 study sites of the REST-meta-MDD consortium. We performed voxel-based morphometric analyses to calculate the GMV in the entire thalamus and its subfields using three different automated anatomical labeling atlases and subsequently compared the differences between first-episode drug-naïve major depressive disorder (FEDN), recurrent major depressive disorder (RMDD), and NC groups. We also evaluated the relationships between thalamic GMV and clinical symptoms in MDD patients.
Compared to NC, the FEDN patients showed increased GMV in thalamic subfields but not in the entire thalamus, while RMDD patients showed no significant alterations in GMV in the entire thalamus and its subfields. Moreover, the mean GMV in the right anterior thalamus and left anteroventral thalamus in RMDD patients were mildly positively correlated with the Hamilton Anxiety Rating Scale scores.
The main limitations are a single-modal analysis based on T1-weighted MR images and a cross-sectional design.
Our findings suggest that FEDN and RMDD patients show heterogeneous alterations across thalamic subfields, which may help us understand the pathophysiological mechanisms of MDD.
众所周知,丘脑不是一个单一且均质的实体,而是一个复杂且高度连接的古皮质结构。尽管许多神经影像学研究报告了重性抑郁障碍(MDD)患者丘脑的改变,但丘脑亚区的结构改变仍不清楚。本研究旨在探讨 MDD 患者丘脑亚区灰质体积(GMV)的变化。
本研究纳入了来自 17 个 REST-meta-MDD 合作研究中心的 848 例 MDD 患者和 794 名年龄匹配的正常对照(NC)的结构图像。我们使用三种不同的自动解剖学标记图谱进行基于体素的形态计量学分析,以计算整个丘脑及其亚区的 GMV,随后比较首发未经药物治疗的重性抑郁障碍(FEDN)、复发性重性抑郁障碍(RMDD)和 NC 组之间的差异。我们还评估了 MDD 患者丘脑 GMV 与临床症状之间的关系。
与 NC 相比,FEDN 患者丘脑亚区的 GMV 增加,但整个丘脑的 GMV 没有变化,而 RMDD 患者整个丘脑及其亚区的 GMV 没有明显变化。此外,RMDD 患者右侧前丘脑和左侧前腹侧丘脑的平均 GMV 与汉密尔顿焦虑量表评分呈轻度正相关。
主要局限性在于基于 T1 加权磁共振图像的单模态分析和横断面设计。
我们的发现表明,FEDN 和 RMDD 患者丘脑亚区存在异质性改变,这可能有助于我们理解 MDD 的病理生理机制。