Gao Liang, Xue Qiang, Gong Shun, Li Gaoyi, Tong Wusong, Fan Mingxia, Chen Xianzhen, Yin Jia, Song Yu, Chen Songyu, Huang Jingrong, Wang Chengbin, Dong Yan
Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Neurosurgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
Front Neurol. 2022 Apr 5;13:719778. doi: 10.3389/fneur.2022.719778. eCollection 2022.
Although there are a certain number of studies dedicated to the disturbances of the dopaminergic system induced by traumatic brain injury (TBI), the associations of abnormal dopaminergic systems with post-traumatic anxiety and depressive disorders and their underlying mechanisms have not been clarified yet. In the midbrain, dopaminergic neurons are mainly situated in the substantia nigra (SN) and the ventral tegmental area (VTA). Thus, we selected SN and VTA as regions of interest and performed a seed-based global correlation to evaluate the altered functional connectivity throughout the dopaminergic system post-TBI.
Thirty-three individuals with TBI and 21 healthy controls were recruited in the study. Anxiety and depressive symptoms were examined by the Hospital Anxiety and Depression Scale. All MRI data were collected using a Siemens Prisma 3.0 Tesla MRI system. The volume of SN and the global functional connectivity of the SN and VTA were analyzed.
In the present study, patients with TBI reported more anxiety and depressive symptoms. More importantly, some structural and functional alterations, such as smaller SN and reduced functional connectivity in the left SN, were seen in individuals with TBI. Patients with TBI had smaller substantia nigra on both right and left sides, and the left substantia nigra was relatively small in contrast with the right one. Among these findings, functional connectivity between left SN and left angular gyrus was positively associated with post-traumatic anxiety symptoms and negatively associated with depressive symptoms.
The TBI causes leftward lateralization of structural and functional alterations in the substantia nigra. An impaired mesocortical functional connectivity might be implicated in post-traumatic anxiety and depression.
尽管有一定数量的研究致力于创伤性脑损伤（TBI）引起的多巴胺能系统紊乱，但异常多巴胺能系统与创伤后焦虑和抑郁障碍的关联及其潜在机制尚未阐明。在中脑，多巴胺能神经元主要位于黑质（SN）和腹侧被盖区（VTA）。因此，我们选择SN和VTA作为感兴趣区域，并进行基于种子点的全脑相关性分析，以评估TBI后整个多巴胺能系统功能连接的改变。
本研究招募了33名TBI患者和21名健康对照者。采用医院焦虑抑郁量表检查焦虑和抑郁症状。所有MRI数据均使用西门子Prisma 3.0特斯拉MRI系统采集。分析了SN的体积以及SN和VTA的全脑功能连接。
在本研究中，TBI患者报告了更多的焦虑和抑郁症状。更重要的是，在TBI患者中观察到一些结构和功能改变，如SN较小以及左侧SN的功能连接减少。TBI患者双侧黑质较小，且左侧黑质相对于右侧较小。在这些发现中，左侧SN与左侧角回之间的功能连接与创伤后焦虑症状呈正相关，与抑郁症状呈负相关。
TBI导致黑质结构和功能改变向左侧化。中皮质功能连接受损可能与创伤后焦虑和抑郁有关。
