McLean Hospital, Belmont, MA 02478, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Psychol Med. 2023 Jul;53(10):4517-4527. doi: 10.1017/S0033291722001398. Epub 2022 Jun 7.
Major depressive disorder (MDD) is often accompanied by changes in appetite and weight. Prior task-based functional magnetic resonance imaging (fMRI) findings suggest these MDD phenotypes are associated with altered reward and interoceptive processing.
Using resting-state fMRI data, we compared the fractional amplitude of low-frequency fluctuations (fALFF) and seed-based connectivity (SBC) among hyperphagic ( = 77), hypophagic ( = 66), and euphagic ( = 42) MDD groups and a healthy comparison group ( = 38). We examined fALFF and SBC in a mask restricted to reward [nucleus accumbens (NAcc), putamen, caudate, ventral pallidum, and orbitofrontal cortex (OFC)] and interoceptive (anterior insula and hypothalamus) regions and also performed exploratory whole-brain analyses. SBC analyses included as seeds the NAcc and also regions demonstrating group differences in fALFF (i.e. right lateral OFC and right anterior insula). All analyses used threshold-free cluster enhancement.
Mask-restricted analyses revealed stronger fALFF in the right lateral OFC, and weaker fALFF in the right anterior insula, for hyperphagic MDD healthy comparison. We also found weaker SBC between the right lateral OFC and left anterior insula for hyperphagic MDD healthy comparison. Whole-brain analyses revealed weaker fALFF in the right anterior insula, and stronger SBC between the right lateral OFC and left precentral gyrus, for hyperphagic MDD healthy comparison. Findings were no longer significant after controlling for body mass index, which was higher for hyperphagic MDD.
Our results suggest hyperphagic MDD may be associated with altered activity in and connectivity between interoceptive and reward regions.
重度抑郁症（MDD）常伴有食欲和体重变化。先前基于任务的功能磁共振成像（fMRI）研究结果表明，这些 MDD 表型与奖赏和内脏加工改变有关。
我们使用静息态 fMRI 数据，比较了暴食（n = 77）、少食（n = 66）和正常进食（n = 42）MDD 组与健康对照组（n = 38）的低频振幅分数（fALFF）和基于种子的连接（SBC）。我们在一个限制于奖赏[伏隔核（NAcc）、壳核、尾状核、腹侧苍白球和眶额皮质（OFC）]和内脏（前岛叶和下丘脑）区域的掩模中检查了 fALFF 和 SBC，并且还进行了探索性全脑分析。SBC 分析包括 NAcc 作为种子，以及在 fALFF 上显示组间差异的区域（即右侧外侧 OFC 和右侧前岛叶）。所有分析均使用无阈值聚类增强。
掩蔽限制分析显示，暴食 MDD 组与健康对照组相比，右侧外侧 OFC 的 fALFF 更强，右侧前岛叶的 fALFF 更弱。我们还发现，暴食 MDD 组与健康对照组相比，右侧外侧 OFC 和左侧前岛叶之间的 SBC 较弱。全脑分析显示，暴食 MDD 组与健康对照组相比，右侧前岛叶的 fALFF 较弱，右侧外侧 OFC 和左侧中央前回之间的 SBC 较强。在控制体重指数后，这些发现不再显著，而暴食 MDD 的体重指数较高。
我们的结果表明，暴食型 MDD 可能与内脏和奖赏区域的活动和连接改变有关。
