Department of Psychiatry & Neuroscience Institute, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa.
South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa; Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa.
Psychiatry Res Neuroimaging. 2023 Jun;331:111630. doi: 10.1016/j.pscychresns.2023.111630. Epub 2023 Mar 17.
There is growing evidence of abnormalities in intrinsic functional connectivity (FC) in posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). However, there has been less work on the commonly occurring co-presentation of PTSD and MDD. Characterising intrinsic FC abnormalities in this clinical population is important for understanding how they may contribute towards impairments underpinned by different networks. Participants were mothers enroled in the Drakenstein Child Health Study from Western Cape, South Africa. Mothers between 18 and 50 years of age were recruited and divided into 4 groups: PTSD, MDD, PTSD with MDD, and healthy controls. Participants underwent resting-state fMRI at the 18-month postpartum time point. Functional connectivity within and between higher order cognitive control networks, including the salience, dorsal attention, frontoparietal, and default mode networks were compared across the 4 groups. PTSD with comorbid MDD was associated with greater intrinsic FC within the R FPAR, relative to controls and the mono-diagnostic groups. Intrinsic FC differences were observed within the default mode network for the MDD group. No group differences in connectivity between networks were observed. Differential intrinsic connectivity in participants with comorbidity are consistent with evidence that such individuals have more severe illness and require more robust intervention.
越来越多的证据表明，创伤后应激障碍（PTSD）和重度抑郁症（MDD）患者的内在功能连接（FC）存在异常。然而，对于 PTSD 和 MDD 同时发生的情况，研究较少。在这种临床人群中描述内在 FC 异常对于理解它们如何影响不同网络下的功能障碍很重要。参与者是来自南非西开普省德雷肯斯坦儿童健康研究的母亲。招募了年龄在 18 至 50 岁之间的母亲，并将她们分为 4 组：PTSD、MDD、PTSD 合并 MDD 和健康对照组。参与者在产后 18 个月进行静息态 fMRI 检查。比较了 4 组之间高级认知控制网络（包括突显网络、背侧注意网络、额顶叶网络和默认模式网络）内和之间的功能连接。与对照组和单诊断组相比，合并 MDD 的 PTSD 患者的 RFPAR 内内在 FC 更高。MDD 组的默认模式网络内观察到内在 FC 差异。网络间的连接没有组间差异。合并症患者的内在连接差异与以下证据一致，即此类患者的病情更严重，需要更有效的干预。
