Liu Chaomeng, Li Li, Pan Weigang, Zhu Dandi, Lian Siyuan, Liu Yi, Ren Li, Mao Peixian, Ren Yanping, Ma Xin
Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Front Aging Neurosci. 2023 Mar 6;15:1107320. doi: 10.3389/fnagi.2023.1107320. eCollection 2023.
To preliminarily explore the functional activity and information integration of the brains under resting state based on graph theory in patients with first-episode, late-life depression (LLD) before and after antidepressant treatment.
A total of 50 patients with first-episode LLD and 40 non-depressed controls (NCs) were recruited for the present research. Participants underwent the RBANS test, the 17-item Hamilton depression rating scale (HAMD-17) test, and resting-state functional MRI scans (rs-fMRI). The RBANS test consists of 12 sub-tests that contribute to a total score and index scores across the five domains: immediate memory, visuospatial/constructional, language, attention, and delayed memory. Escitalopram or sertraline was adopted for treating depression, and the dosage of the drug was adjusted by the experienced psychiatrists. Of the 50 LLD patients, 27 cases who completed 6-month follow-ups and 27 NCs matched with age, sex, and education level were included for the final statistical analysis.
There were significant differences in RBANS total score, immediate memory, visuospatial/constructional, language, attention, and delayed memory between LLD baseline group and NCs group ( < 0.05). Considering the global attribute indicators, the clustering coefficient of global indicators was lower in the LLD baseline group than in the NCs group, and the small-world attribute of functional brain networks existed in all three groups. The degree centrality and node efficiency of some brains were lower in the LLD baseline group than in the NCs group. After 6 months of antidepressant therapy, the scores of HAMD-17, immediate memory, language, and delayed memory in the LLD follow-up group were higher than those in the LLD baseline group. Compared with the LLD baseline group, the degree centrality and node efficiency of some brains in the cognitive control network were decreased in the LLD follow-up group.
The ability to integrate and divide labor of functional brain networks declines in LLD patients and linked with the depression severity. After the relief of depressive symptoms, the small-world attribute of functional brain networks in LLD patients persists. However, the information transmission efficiency and centrality of some brain regions continue to decline over time, perhaps related to their progressive cognitive impairment.
基于图论初步探讨首发晚发性抑郁症（LLD）患者抗抑郁治疗前后静息状态下大脑的功能活动及信息整合情况。
本研究共招募了50例首发LLD患者和40例非抑郁对照者（NCs）。参与者接受了RBANS测试、17项汉密尔顿抑郁评定量表（HAMD - 17）测试以及静息态功能磁共振成像扫描（rs - fMRI）。RBANS测试由12个子测试组成，这些子测试有助于得出五个领域的总分和指标分数：即刻记忆、视觉空间/构建、语言、注意力和延迟记忆。采用艾司西酞普兰或舍曲林治疗抑郁症，药物剂量由经验丰富的精神科医生调整。在50例LLD患者中，27例完成6个月随访的患者以及27例年龄、性别和教育水平相匹配的NCs纳入最终统计分析。
LLD基线组与NCs组在RBANS总分、即刻记忆、视觉空间/构建、语言、注意力和延迟记忆方面存在显著差异（<0.05）。考虑全局属性指标，LLD基线组全局指标的聚类系数低于NCs组，且三组均存在功能性脑网络的小世界属性。LLD基线组部分脑区的度中心性和节点效率低于NCs组。抗抑郁治疗6个月后，LLD随访组的HAMD - 17、即刻记忆、语言和延迟记忆得分高于LLD基线组。与LLD基线组相比，LLD随访组认知控制网络中部分脑区的度中心性和节点效率降低。
LLD患者功能性脑网络的整合与分工能力下降，且与抑郁严重程度相关。抑郁症状缓解后，LLD患者功能性脑网络的小世界属性依然存在。然而，随着时间推移，部分脑区的信息传递效率和中心性持续下降，这可能与其进行性认知障碍有关。
