Fang Zhe, Mu Qingli, Wu Congchong, Jia Lili, Wang Zheng, Hu Shaohua, Xu Yi, Huang Manli, Lu Shaojia
Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China; Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Clinical Psychology, The Fifth Peoples' Hospital of Lin'an District, Hangzhou, Zhejiang, China.
J Psychiatr Res. 2022 Dec;156:84-90. doi: 10.1016/j.jpsychires.2022.10.028. Epub 2022 Oct 10.
Anhedonia, as one of the core manifestations of major depressive disorder (MDD), has an effect on prognosis of the disease. However, the neuropathology of MDD is complex and the neural basis of anhedonia remains unclear. The aim of the present study was to investigate the impacts of anhedonia on brain functional alterations in patients with MDD.
A total of 62 individuals including MDD patients with anhedonia (n = 22), MDD patients without anhedonia (n = 20), and healthy controls (HCs, n = 20) were recruited. All participants underwent resting-state functional magnetic resonance imaging scanning and intrinsic brain function was explored by using regional homogeneity (ReHo) method. A two-sample t-test was performed to explore ReHo differences between MDD patients and HCs, then analysis of variance (ANOVA) was introduced to obtain brain regions with significant differences among three groups, and finally post hoc tests were calculated for inter-group comparisons. Correlations between ReHo values of each survived area and clinical characteristics in MDD patients were further analyzed.
Compared with HCs, MDD showed increased ReHo in the left superior temporal gyrus (STG) and bilateral inferior frontal gyrus (IFG), as well as decreased ReHo in the left superior frontal gyrus (SFG). Interestingly, this relationship was attenuated and no longer significant after consideration for the effect of anhedonia in MDD patients. MDD patients with anhedonia were more likely to exhibit decreased ReHo in the left SFG and left middle cingulate gyrus (MCG) when comparing to HCs. No significant difference was found between MDD patients without anhedonia and HCs, either the two groups of MDD patients. There was no significant association between ReHo values of each survived area and clinical characteristics in MDD patients.
The present results suggest that the impacts of anhedonia on brain functional alterations in MDD should be emphasized and disturbed intrinsic brain function in the frontal-limbic regions may be associated with anhedonia in MDD patients.
快感缺失作为重度抑郁症(MDD)的核心表现之一,对该疾病的预后有影响。然而,MDD的神经病理学很复杂,快感缺失的神经基础仍不清楚。本研究的目的是调查快感缺失对MDD患者脑功能改变的影响。
共招募了62名个体,包括有快感缺失的MDD患者(n = 22)、无快感缺失的MDD患者(n = 20)和健康对照者(HCs,n = 20)。所有参与者均接受静息态功能磁共振成像扫描,并采用局部一致性(ReHo)方法探索脑内在功能。进行双样本t检验以探索MDD患者与HCs之间的ReHo差异,然后引入方差分析(ANOVA)以获得三组之间有显著差异的脑区,最后计算事后检验进行组间比较。进一步分析MDD患者各存活区域的ReHo值与临床特征之间的相关性。
与HCs相比,MDD患者在左侧颞上回(STG)和双侧额下回(IFG)的ReHo增加,而在左侧额上回(SFG)的ReHo降低。有趣的是,在考虑MDD患者快感缺失的影响后,这种关系减弱且不再显著。与HCs相比,有快感缺失的MDD患者在左侧SFG和左侧扣带中回(MCG)更可能表现出ReHo降低。无快感缺失的MDD患者与HCs之间以及两组MDD患者之间均未发现显著差异。MDD患者各存活区域的ReHo值与临床特征之间无显著关联。
目前的结果表明,应强调快感缺失对MDD患者脑功能改变的影响,额叶-边缘区域内在脑功能紊乱可能与MDD患者的快感缺失有关。