在一个大型青少年早期样本中（青少年大脑认知发展研究®），大脑结构与抑郁症的关联。
Brain structural associations with depression in a large early adolescent sample (the ABCD study®).
作者信息
Shen Xueyi, MacSweeney Niamh, Chan Stella W Y, Barbu Miruna C, Adams Mark J, Lawrie Stephen M, Romaniuk Liana, McIntosh Andrew M, Whalley Heather C
机构信息
Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom.
Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom.
出版信息
EClinicalMedicine. 2021 Nov 20;42:101204. doi: 10.1016/j.eclinm.2021.101204. eCollection 2021 Dec.
BACKGROUND
Depression is the leading cause of disability worldwide with > 50% of cases emerging before the age of 25 years. Large-scale neuroimaging studies in depression implicate robust structural brain differences in the disorder. However, most studies have been conducted in adults and therefore, the temporal origins of depression-related imaging features remain largely unknown. This has important implications for understanding aetiology and informing timings of potential intervention.
METHODS
Here, we examine associations between brain structure (cortical metrics and white matter microstructural integrity) and depression ratings (from caregiver and child), in a large sample ( = 8634) of early adolescents (9 to 11 years old) from the US-based, Adolescent Brain and Cognitive Development (ABCD) Study. Data was collected from 2016 to 2018.
FINDINGS
We report significantly decreased global cortical and white matter metrics, and regionally in frontal, limbic and temporal areas in adolescent depression (Cohen's = -0⋅018 to -0⋅041, β = -0·019 to -0⋅057). Further, we report consistently stronger imaging associations for caregiver-reported compared to child-reported depression ratings. Divergences between reports (caregiver vs child) were found to significantly relate to negative socio-environmental factors (e.g., family conflict, absolute β = 0⋅048 to 0⋅169).
INTERPRETATION
Depression ratings in early adolescence were associated with similar imaging findings to those seen in adult depression samples, suggesting neuroanatomical abnormalities may be present early in the disease course, arguing for the importance of early intervention. Associations between socio-environmental factors and reporter discrepancy warrant further consideration, both in the wider context of the assessment of adolescent psychopathology, and in relation to their role in aetiology.
FUNDING
Wellcome Trust (References: 104036/Z/14/Z and 220857/Z/20/Z) and the Medical Research Council (MRC, Reference: MC_PC_17209).
背景
抑郁症是全球致残的主要原因，超过50%的病例在25岁之前出现。抑郁症的大规模神经影像学研究表明该疾病存在明显的大脑结构差异。然而，大多数研究是在成年人中进行的，因此，与抑郁症相关的影像学特征的时间起源在很大程度上仍然未知。这对于理解病因和确定潜在干预的时机具有重要意义。
方法
在此，我们在美国青少年大脑与认知发展（ABCD）研究的大量早期青少年（9至11岁）样本（n = 8634）中，研究大脑结构（皮质指标和白质微观结构完整性）与抑郁症评分（来自照顾者和儿童）之间的关联。数据收集于2016年至2018年。
研究结果
我们报告青少年抑郁症患者的整体皮质和白质指标显著降低，在额叶、边缘叶和颞叶区域也有降低（科恩d值 = -0.018至 -0.041，β = -0.019至 -0.057）。此外，我们报告与儿童自我报告的抑郁症评分相比，照顾者报告的抑郁症评分与影像学的关联始终更强。发现报告（照顾者与儿童）之间的差异与负面社会环境因素（如家庭冲突，绝对β = 0.048至0.169）显著相关。
解读
青春期早期的抑郁症评分与成人抑郁症样本中的影像学发现相似，这表明神经解剖学异常可能在疾病过程早期就存在，这证明了早期干预的重要性。社会环境因素与报告差异之间的关联值得进一步考虑，无论是在青少年精神病理学评估的更广泛背景下，还是在它们在病因学中的作用方面。
资助
惠康信托基金会（参考文献：104036/Z/14/Z和220857/Z/20/Z）和医学研究理事会（MRC，参考文献：MC_PC_17209）。
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