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青少年和年轻成年人重度抑郁症患者白质微结构的改变:基于体素的弥散张量成像的荟萃分析。

Alterations in white matter microarchitecture in adolescents and young adults with major depressive disorder: A voxel-based meta-analysis of diffusion tensor imaging.

机构信息

Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.

Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.

出版信息

Psychiatry Res Neuroimaging. 2022 Jul;323:111482. doi: 10.1016/j.pscychresns.2022.111482. Epub 2022 Apr 17.

DOI:10.1016/j.pscychresns.2022.111482
PMID:35477111
Abstract

Adolescents and young adults are at a critical stage of life development, and depression can have serious consequences. In recent decades, an increasing number of diffusion tensor imaging (DTI) studies of major depressive disorder (MDD) have reported inconsistent alterations in white matter (WM) microarchitecture. To rule out the confounding effects of age, we conducted a meta-analysis of fractional anisotropy (FA) in adolescents and young adults with MDD to identify abnormalities in WM involved in the pathogenesis of MDD using anisotropic effect-size signed differential mapping (AES-SDM). The pooled meta-analysis revealed significantly lower FA mainly in the corpus callosum (CC) extending to the left anterior thalamic projections (ATP) and left cortico-spinal projection (CSP) in depressed adolescents and young adults than that in healthy controls. A reduction in FA was also identified in the right frontal orbito-polar tract (FOPT) extending to the right inferior fronto-occipital fasciculus (IFOF). In the meta-regression analysis, the mean age of patients, percentage of female patients and duration of depression were not linearly associated with abnormalities in FA. These results constitute robust evidence that abnormalities in WM microarchitecture in the interhemispheric connections and frontal-subcortical neuronal circuits may contribute to the pathogenesis of MDD during adolescence and young adulthood.

摘要

青少年和年轻人正处于生命发展的关键阶段,抑郁症可能会产生严重的后果。近几十年来,越来越多的弥散张量成像(DTI)研究重度抑郁症(MDD)报告称,白质(WM)微观结构发生了不一致的改变。为了排除年龄的混杂影响,我们对 MDD 青少年和年轻人的各向异性分数(FA)进行了荟萃分析,使用各向异性效应大小差异映射(AES-SDM)来识别与 MDD 发病机制相关的 WM 异常。荟萃分析显示,与健康对照组相比,抑郁的青少年和年轻人的胼胝体(CC)、左侧前丘脑投射(ATP)和左侧皮质脊髓投射(CSP)延伸部位的 FA 值明显降低。右侧额眶极纤维束(FOPT)延伸至右侧下额枕束(IFOF)的 FA 值也降低了。在元回归分析中,患者的平均年龄、女性患者的百分比和抑郁持续时间与 FA 的异常没有线性关联。这些结果有力地证明了半球间连接和额皮质下神经元回路的 WM 微观结构异常可能导致青少年和年轻人 MDD 的发病机制。

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