Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medical, Southeast University, Nanjing 210009, China.
Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing 210096, China.
J Affect Disord. 2023 May 15;329:55-63. doi: 10.1016/j.jad.2023.02.104. Epub 2023 Feb 24.
Major depressive disorder (MDD) is a highly heterogeneous disease, which brings great difficulties to clinical diagnosis and therapy. Its mechanism is still unknown. Prior neuroimaging studies mainly focused on mean differences between patients and healthy controls (HC), largely ignoring individual differences between patients.
This study included 112 MDD patients and 93 HC subjects. Resting-state functional MRI data were obtained to examine the patterns of individual variability of brain functional connectivity (IVFC). The genetic risk of pathways including dopamine, 5-hydroxytryptamine (5-HT), norepinephrine (NE), hypothalamic-pituitary-adrenal (HPA) axis, and synaptic plasticity was assessed by multilocus genetic profile scores (MGPS), respectively.
The IVFC pattern of the MDD group was similar but higher than that in HCs. The inter-network functional connectivity in the default mode network contributed to altered IVFC in MDD. 5-HT, NE, and HPA pathway genes affected IVFC in MDD patients. The age of onset, duration, severity, and treatment response, were correlated with IVFC. IVFC in the left ventromedial prefrontal cortex had a mediating effect between MGPS of the 5-HT pathway and baseline depression severity.
Environmental factors and differences in locations of functional areas across individuals were not taken into account.
This study found MDD patients had significantly different inter-individual functional connectivity variations than healthy people, and genetic risk might affect clinical manifestations through brain function heterogeneity.
重度抑郁症(MDD)是一种高度异质的疾病,这给临床诊断和治疗带来了很大的困难。其发病机制尚不清楚。先前的神经影像学研究主要集中在患者和健康对照(HC)之间的均值差异上,在很大程度上忽略了患者之间的个体差异。
本研究纳入了 112 例 MDD 患者和 93 例 HC 受试者。采集静息态功能磁共振成像数据,以研究脑功能连接(FC)个体差异的模式。通过多基因评分(MGPS)分别评估包括多巴胺、5-羟色胺(5-HT)、去甲肾上腺素(NE)、下丘脑-垂体-肾上腺(HPA)轴和突触可塑性在内的通路的遗传风险。
MDD 组的 IVFC 模式与 HC 相似但较高。默认模式网络中的网络间功能连接导致 MDD 中 IVFC 的改变。5-HT、NE 和 HPA 通路基因影响 MDD 患者的 IVFC。发病年龄、病程、严重程度和治疗反应与 IVFC 相关。左腹内侧前额叶的 IVFC 在 5-HT 通路 MGPS 与基线抑郁严重程度之间具有中介作用。
未考虑环境因素和个体之间功能区位置的差异。
本研究发现 MDD 患者的个体间功能连接变化明显不同于健康人,遗传风险可能通过脑功能异质性影响临床表现。