Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands.
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
Eur Arch Psychiatry Clin Neurosci. 2022 Aug;272(5):849-858. doi: 10.1007/s00406-021-01347-8. Epub 2021 Nov 8.
Cross-sectional Diffusion Tensor Imaging (DTI) studies have reported alterations in white matter (WM) microstructure in adolescents with internalizing psychopathology. Yet, longitudinal studies investigating the course of WM microstructure are lacking. This study explored WM alterations and its relation to clinical symptoms over time in adolescents with internalizing disorders. DTI scans were acquired at baseline and after three months in 22 adolescents with clinical depression and comorbid anxiety (INT), and 21 healthy peers (HC) (age: 12-18). Tract-based spatial statistics was used for three voxelwise analyses: i) changes in WM microstructure between and within the INT and HC group; ii) associations between changes in symptom severity and changes in WM microstructure within youths with INT; and iii) associations between baseline WM parameters with changes in symptom severity within youths with INT. Data did not reveal changes in WM microstructure between or within groups over three months' time nor associations between changes in WM microstructure and changes in self-reported symptoms (analyses corrected for age, gender and puberty stage). Lower baseline levels of fractional anisotropy (FA) in the right posterior corona radiata (PCR) and right cingulum were associated with a higher decrease of depressive symptoms within the INT group. Post hoc analysis of additional WM parameters in the significant FA clusters showed that higher levels of baseline mean diffusivity and radial diffusivity in the PCR were associated with a lower decrease in depressive symptoms. Baseline WM microstructure characteristics were associated with a higher decrease in depressive symptoms over time. These findings increase our understanding of neurobiological mechanisms underlying the course of internalizing disorders in adolescents.
横断面弥散张量成像（DTI）研究报告称，有内化性精神病理学的青少年的白质（WM）微观结构发生了改变。然而，缺乏关于 WM 微观结构随时间变化的纵向研究。本研究探讨了内化障碍青少年 WM 改变及其与临床症状的关系。在 22 名患有临床抑郁症和共病焦虑症的青少年（INT）和 21 名健康同龄人（HC）（年龄：12-18 岁）中，在基线和 3 个月时采集了 DTI 扫描。使用基于体素的空间统计学进行了三项基于体素的分析：i）INT 和 HC 组之间和组内 WM 微观结构的变化；ii）INT 组内症状严重程度变化与 WM 微观结构变化之间的关联；iii）INT 组内基线 WM 参数与症状严重程度变化之间的关联。数据未显示 3 个月内 WM 微观结构在组间或组内的变化，也未显示 WM 微观结构变化与自我报告症状变化之间的关联（分析校正了年龄、性别和青春期阶段）。右后冠状辐射（PCR）和右扣带的基线分数各向异性（FA）水平较低与 INT 组内抑郁症状的下降幅度较大有关。在显著 FA 簇中对其他 WM 参数的事后分析表明，PCR 中基线平均弥散度和径向弥散度较高与抑郁症状下降幅度较小有关。基线 WM 微观结构特征与抑郁症状随时间的下降幅度较大有关。这些发现增加了我们对青少年内化性精神障碍发病机制的神经生物学机制的理解。
