Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.
Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
J Magn Reson Imaging. 2023 Mar;57(3):899-906. doi: 10.1002/jmri.28346. Epub 2022 Jul 7.
Although progress has been made in exploring postpartum depression (PPD), the involvement of cerebral structure connectivity in PPD patients keeps unclear.
To explore structural connectivity alternations in mothers with PPD, diffusion tensor imaging (DTI) and automated fiber quantification (AFQ) were used to calculate brain white matter microstructure properties.
Cross-sectional.
A total of 51 women with first-episode, treatment-näive PPD, and 49 matched healthy postpartum women (HPW) controls.
A 3.0 T; single-shot echo-planar imaging sequence.
DTI measurements of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were obtained for 18 specific white matter tracts. The relationship between PDD symptoms, hormone levels, and postpartum days was also investigated.
Two sample t test and Pearson's correlation analysis. The analysis was performed by using a permutation-based multiple-comparison correction approach, with the threshold of P < 0.05 (family wise error corrected [FWE-corrected]) separately across the four different outcome measures.
Women with PPD showed significantly increased FA and AD in right anterior thalamic radiation (ATR) tract and significantly increased FA and significantly reduced RD in the cingulum tract, compared to women without PPD. The RD values of right cingulum were significantly positively correlated with postpartum days in HPW (r = 0.39). There were no significant relationships between brain measures and hormone levels in either patients or controls.
DTI measures have revealed altered integrity in the white matter of the cortical-thalamic circuits in women with PPD compared to HPW. Damage to these circuits may be a structural basis for the impaired emotional regulation and blunted mother-infant bonding in mothers with PPD and a potential target for the development of new treatments.
2 TECHNICAL EFFICACY: Stage 3.
尽管在探索产后抑郁症（PPD）方面已经取得了进展，但 PPD 患者的大脑结构连接的参与仍不清楚。
使用弥散张量成像（DTI）和自动纤维定量（AFQ）来计算脑白质微观结构特性，探讨 PPD 患者的结构连接变化。
横断面研究。
共有 51 名首次发作、未经治疗的 PPD 患者和 49 名匹配的健康产后妇女（HPW）对照组。
3.0T；单次激发回波平面成像序列。
对 18 条特定白质束进行 DTI 测量，得到各向异性分数（FA）、轴向扩散系数（AD）、径向扩散系数（RD）和平均扩散系数（MD）。还研究了 PDD 症状、激素水平和产后天数之间的关系。
两样本 t 检验和 Pearson 相关分析。使用基于置换的多重比较校正方法进行分析，对于四个不同的结果测量，阈值为 P<0.05（经家族-wise 错误校正 [FWE-corrected]）。
与无 PPD 的妇女相比，PPD 妇女右侧前丘脑辐射（ATR）束的 FA 和 AD 显著增加，胼胝体束的 FA 显著增加，RD 显著降低。HPW 中右侧胼胝体 RD 值与产后天数呈显著正相关（r=0.39）。在患者或对照组中，脑测量值与激素水平之间均无显著关系。
与 HPW 相比，PPD 妇女的皮质-丘脑回路白质的 DTI 测量值显示出完整性改变。这些回路的损伤可能是 PPD 母亲情绪调节受损和母婴联系减弱的结构基础，也是开发新治疗方法的潜在靶点。
2 级 技术功效：3 级。
