Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Mental Health, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
Department of Psychosomatic, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China.
J Affect Disord. 2023 Feb 15;323:71-84. doi: 10.1016/j.jad.2022.11.023. Epub 2022 Nov 14.
Somatic symptoms are common comorbidities of major depressive disorder (MDD), and negatively impact the course and severity of the disease. In order to enrich the understanding of the pathological mechanism and clarify the neurobiological basis of somatic symptoms in depression, we attempted to explore the changes of brain structure and function in a large sample between depression with and without somatic symptoms.
Structure magnetic resonance imaging (MRI) data were collected from 342 patients with somatic symptoms (SD), 208 patients without somatic symptoms (NSD), and 510 healthy controls (HCs) based on the REST-meta-MDD project. We analyzed the whole brain VBM maps of the three groups, and combined with weight degree centrality (DC) index, we investigated whether the brain regions with gray matter volume (GMV) and gray matter density (GMD) abnormalities in MDD patients with somatic symptoms had corresponding brain functional abnormalities.
Between depression with and without somatic symptoms, we found that there are extensive GMV and GMD differences involving cortical regions such as the temporal lobe, occipital lobe, and insula, as well as subcortical brain regions such as thalamus and striatum. The comparison results of weight DC signals of GMV and GMD abnormal clusters between the SD and NSD groups were basically consistent with the GMV and GMD abnormal clusters.
The results indicate that the structure and function of cortical-striatal-thalamic-cortical (CSTC) circuit centered on the thalamus were abnormal in MDD patients with somatic symptoms. This may be the neurobiological basis of somatic symptoms in MDD.
躯体症状是重性抑郁障碍(MDD)的常见共病,对疾病的病程和严重程度有负面影响。为了丰富对病理机制的理解,阐明抑郁障碍中躯体症状的神经生物学基础,我们尝试在大样本中探索伴躯体症状和不伴躯体症状的抑郁障碍患者之间的脑结构和功能变化。
基于 REST-meta-MDD 项目,我们从 342 例躯体症状(SD)患者、208 例无躯体症状(NSD)患者和 510 例健康对照者(HCs)中收集结构磁共振成像(MRI)数据。我们分析了三组的全脑 VBM 图谱,并结合权重度中心度(DC)指数,研究了 MDD 伴躯体症状患者灰质体积(GMV)和灰质密度(GMD)异常的脑区是否存在相应的脑功能异常。
在伴躯体症状和不伴躯体症状的抑郁障碍之间,我们发现涉及颞叶、枕叶和岛叶等皮质区域以及丘脑和纹状体等皮质下脑区的广泛 GMV 和 GMD 差异。GMV 和 GMD 异常簇的 SD 和 NSD 组之间的权重 DC 信号比较结果与 GMV 和 GMD 异常簇基本一致。
结果表明,以丘脑为中心的皮质-纹状体-丘脑-皮质(CSTC)回路的结构和功能在伴躯体症状的 MDD 患者中异常。这可能是 MDD 中躯体症状的神经生物学基础。