Jiang Yu, Zhang Ting, Zhang Mengdan, Xie Xiaohui, Tian Yanghua, Wang Kai, Bai Tongjian
Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Behav Brain Res. 2023 Apr 27;444:114379. doi: 10.1016/j.bbr.2023.114379. Epub 2023 Mar 2.
Major depressive disorder is a heterogeneous syndrome, of which the most common subtype is melancholic depression (MEL). Previous studies have indicated that anhedonia is frequently a cardinal feature in MEL. As a common syndrome of motivational deficit, anhedonia is closely associated with dysfunction in reward-related networks. However, little is currently known about apathy, another syndrome of motivational deficits, and the underlying neural mechanisms in MEL and non-melancholic depression (NMEL). Herein, the Apathy Evaluation Scale (AES) was used to compare apathy between MEL and NMEL. On the basis of resting-state functional magnetic resonance imaging, functional connectivity strength (FCS) and seed-based functional connectivity (FC) were calculated within reward-related networks and compared among 43 patients with MEL, 30 patients with NMEL, and 35 healthy controls. Patients with MEL had higher AES scores than those with NMEL (t = -2.20, P = 0.03). Relative to NMEL, MEL was associated with greater FCS (t = 4.27, P < 0.001) in the left ventral striatum (VS), and greater FC of the VS with the ventral medial prefrontal cortex (t = 5.03, P < 0.001) and dorsolateral prefrontal cortex (t = 3.18, P = 0.005). Taken together the results indicate that reward-related networks may play diverse pathophysiological roles in MEL and NMEL, thus providing potential directions for future interventions in the treatment of various depression subtypes.
重度抑郁症是一种异质性综合征，其中最常见的亚型是 melancholic depression (MEL)。先前的研究表明，快感缺失经常是 MEL 的主要特征。作为动机缺乏的常见综合征，快感缺失与奖赏相关网络功能障碍密切相关。然而，目前对于冷漠（另一种动机缺乏综合征）以及 MEL 和非 melancholic depression (NMEL) 的潜在神经机制知之甚少。在此，使用冷漠评估量表 (AES) 来比较 MEL 和 NMEL 之间的冷漠程度。基于静息态功能磁共振成像，计算奖赏相关网络内的功能连接强度 (FCS) 和基于种子点的功能连接 (FC)，并在 43 例 MEL 患者、30 例 NMEL 患者和 35 名健康对照者之间进行比较。MEL 患者的 AES 评分高于 NMEL 患者（t = -2.20，P = 0.03）。相对于 NMEL，MEL 与左侧腹侧纹状体 (VS) 中更大的 FCS（t = 4.27，P < 0.001）以及 VS 与腹内侧前额叶皮层（t = 5.03，P < 0.001）和背外侧前额叶皮层（t = 3.18，P = 0.005）之间更大的 FC 相关联。综合这些结果表明，奖赏相关网络可能在 MEL 和 NMEL 中发挥不同的病理生理作用，从而为未来治疗各种抑郁症亚型的干预措施提供潜在方向。
