Department of Psychiatry, First Clinical College, Xuzhou Medical University, Xuzhou, 221000, China.
Department of Psychiatry, the Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, 221000, China.
BMC Psychiatry. 2023 Apr 21;23(1):282. doi: 10.1186/s12888-023-04693-0.
The nucleus accumbens (Nac) is a crucial brain region in the pathophysiology of major depressive disorder (MDD) patients with anhedonia. However, the relationship between the functional imaging characteristics of Nac subregions and anhedonia remains unclear. Thus, this study aimed to investigate the role of resting-state functional connectivity (rsFC) of the Nac subregions between MDD and anhedonia.
We performed resting-state functional magnetic resonance imaging (fMRI) to measure the rsFC of Nac subregions in 55 MDD patients and 30 healthy controls (HCs). A two-sample t test was performed to determine the brain regions with varying rsFC among Nac subregions between groups. Then, correlation analyses were carried out to investigate the relationships between the aberrant rsFC of Nac subregions and the severity of anhedonia. Furthermore, we constructed a mediation model to explain the role of the aberrant rsFC of Nac subregions between MDD and the severity of anhedonia.
Compared with the HC group, decreased rsFC of Nac subregions with regions of the prefrontal cortex, insula, lingual gyrus, and visual association cortex was observed in MDD patients. In the MDD group, the rsFC of the right Nac shell-like subregions with the middle frontal gyrus (MFG)/superior frontal gyrus (SFG) was correlated with consummatory anhedonia, and the rsFC of the Nac core-like subdivisions with the inferior frontal gyrus (IFG)/insula and lingual gyrus/visual association cortex was correlated with anticipatory anhedonia. More importantly, the functional alterations in the Nac subregions mediated the association between anhedonia and depression.
The present findings suggest that the functional alteration of the Nac subregions mediates the association between MDD and anhedonia, which provides evidence for the hypothesis that MDD patients have neurobiological underpinnings of reward systems that differ from those of HCs.
伏隔核(Nac)是伴有快感缺失的重度抑郁症(MDD)患者病理生理学的关键脑区。然而,Nac 亚区的功能成像特征与快感缺失之间的关系尚不清楚。因此,本研究旨在探讨 MDD 伴快感缺失患者 Nac 亚区静息态功能连接(rsFC)的作用。
我们对 55 例 MDD 患者和 30 例健康对照(HC)进行静息态功能磁共振成像(fMRI)测量 Nac 亚区的 rsFC。采用两样本 t 检验确定组间 Nac 亚区之间 rsFC 变化的脑区。然后进行相关性分析,以探讨 Nac 亚区异常 rsFC 与快感缺失严重程度的关系。此外,我们构建了一个中介模型来解释 Nac 亚区异常 rsFC 在 MDD 与快感缺失严重程度之间的作用。
与 HC 组相比,MDD 患者 Nac 亚区与前额叶皮质、岛叶、舌回和视觉联合皮质的 rsFC 降低。在 MDD 组中,右侧 Nac 壳状亚区与额中回(MFG)/额上回(SFG)的 rsFC 与消费性快感缺失相关,而 Nac 核心样亚区与额下回(IFG)/岛叶和舌回/视觉联合皮质的 rsFC 与预期性快感缺失相关。更重要的是,Nac 亚区的功能改变介导了快感缺失与抑郁之间的关联。
本研究结果表明,Nac 亚区的功能改变介导了 MDD 与快感缺失之间的关联,为 MDD 患者的奖赏系统存在与 HC 不同的神经生物学基础假说提供了证据。