Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China.
Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2023 Jan 10;120:110621. doi: 10.1016/j.pnpbp.2022.110621. Epub 2022 Aug 27.
Previous neuroimaging has paid little attention to the differences in brain network integration between patients with treatment-resistant depression(TRD) and non-TRD (nTRD), and the relationship between their impaired brain network integration and clinical symptoms has not been elucidated.
Eighty one major depressive disorder (MDD) patients (40 in TRD, 41 in nTRD) and 40 healthy controls (HCs) were enrolled for the functional magnetic resonance imaging (fMRI) scans. A seed-based functional connectivity (FC) method was used to investigate the brain network abnormalities of default mode network (DMN), affective network (AN), salience network (SN) and cognitive control network (CCN) for the MDD. Finally, the correlation was analyzed between the abnormal FCs and 17-item Hamilton Rating Scale for Depression scale (HAMD-17) scores.
Compared with the HC group, the FCs in DMN, AN, SN, CCN were altered in both the TRD and nTRD groups. Compared with the nTRD group, FC alterations in the AN and CCN were more abnormal in the TRD group, and the FC alterations were generally decreased at the SN in the TRD group. In addition, the FC values of right dorsolateral prefrontal cortices and left caudate nucleus in the TRD group and the FC values of right subgenual anterior cingulate cortex and left middle temporal gyrus in the nTRD group were positively correlated with HAMD-17 scale scores.
Abnormal FCs are present in four brain networks (DMN, AN, SN, CCN) in both the TRD and nTRD groups. Except of DMN, FCs in AN, SN and CCN maybe underlay the neurobiological mechanism in differentiating TRD from nTRD.
先前的神经影像学研究对治疗抵抗性抑郁症(TRD)和非治疗抵抗性抑郁症(nTRD)患者之间大脑网络整合的差异关注较少,且其受损的大脑网络整合与临床症状之间的关系尚未阐明。
共纳入 81 例重性抑郁障碍(MDD)患者(TRD 组 40 例,nTRD 组 41 例)和 40 名健康对照者(HCs)进行功能磁共振成像(fMRI)扫描。采用基于种子点的功能连接(FC)方法,对 MDD 的默认模式网络(DMN)、情感网络(AN)、突显网络(SN)和认知控制网络(CCN)的脑网络异常进行研究。最后,分析异常 FC 与汉密尔顿抑郁量表(HAMD-17)评分之间的相关性。
与 HCs 组相比,TRD 组和 nTRD 组的 DMN、AN、SN、CCN 的 FC 均发生改变。与 nTRD 组相比,TRD 组的 AN 和 CCN 的 FC 改变更为异常,且 TRD 组的 SN 中 FC 改变普遍减少。此外,TRD 组右侧背外侧前额叶皮质和左侧尾状核的 FC 值与 HAMD-17 量表评分呈正相关,nTRD 组右侧前扣带回皮质下亚区和左侧颞中回的 FC 值与 HAMD-17 量表评分呈正相关。
TRD 组和 nTRD 组均存在 4 个脑网络(DMN、AN、SN、CCN)的异常 FC。除 DMN 外,AN、SN 和 CCN 的 FC 可能是区分 TRD 和 nTRD 的神经生物学机制。