Park Hye Youn, Jang Ye Eun, Sunwoo Leonard, Yoon In-Young, Park Bumhee
Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.
Front Psychiatry. 2022 May 17;13:817527. doi: 10.3389/fpsyt.2022.817527. eCollection 2022.
This study was performed to investigate altered regional gray matter volume (rGMV) and structural covariance related to somatic symptom disorder (SSD) and longitudinal changes after treatment. Additionally, this study examined the relationships of structural alteration with its phenotypic subtypes.
Forty-three unmedicated patients with SSD and thirty normal controls completed psychological questionnaires and neurocognitive tests, as well as brain magnetic resonance imaging. Voxel-based morphometry and structural covariances were compared between groups and between subgroups within the SSD group. After 6 months of treatment, SSD patients were followed up for assessments.
Patients with SSD exhibited attenuated structural covariances in the pallidal-cerebellar circuit (FDR < 0.05-0.1), as well as regions in the default mode and sensorimotor network (FDR < 0.2), compared to normal controls. The cerebellar rGMVs were negatively correlated with the severity of somatic symptoms. In subgroup analyses, patients with somatic pain showed denser structural covariances between the bilateral superior temporal pole and left angular gyrus, the left middle temporal pole and left angular gyrus, and the left amygdala and right inferior orbitofrontal gyrus, while patients with headache and dizziness had greater structural covariance between the right inferior temporal gyrus and right cerebellum (FDR < 0.1-0.2). After 6 months of treatment, patients showed improved symptoms, however there was no significant structural alteration.
The findings suggest that attenuated structural covariance may link to dysfunctional brain network and vulnerability to SSD; they also suggested that specific brain regions and networks may contribute to different subtypes of SSD.
本研究旨在调查与躯体症状障碍（SSD）相关的区域灰质体积（rGMV）改变和结构协方差，以及治疗后的纵向变化。此外，本研究还考察了结构改变与其表型亚型之间的关系。
43例未接受药物治疗的SSD患者和30名正常对照者完成了心理问卷、神经认知测试以及脑磁共振成像检查。比较了两组之间以及SSD组内各亚组之间基于体素的形态学和结构协方差。治疗6个月后，对SSD患者进行随访评估。
与正常对照相比，SSD患者在苍白球-小脑回路（FDR<0.05-0.1）以及默认模式和感觉运动网络中的区域（FDR<0.2）表现出结构协方差减弱。小脑rGMV与躯体症状的严重程度呈负相关。在亚组分析中，躯体疼痛患者在双侧颞上极与左侧角回、左侧颞中极与左侧角回以及左侧杏仁核与右侧眶额下回之间表现出更密集的结构协方差，而头痛和头晕患者在右侧颞下回与右侧小脑之间具有更大的结构协方差（FDR<0.1-0.2）。治疗6个月后，患者症状有所改善，但结构无明显改变。
研究结果表明，结构协方差减弱可能与脑网络功能障碍和SSD易感性有关；还表明特定的脑区和网络可能导致SSD的不同亚型。
