Zhang Xiaoliu, Cao Jun, Huang Qian, Hong Su, Dai Linqi, Chen Xiaorong, Chen Jianmei, Ai Ming, Gan Yao, He Jinglan, Kuang Li
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2023 Apr 5;14:1157587. doi: 10.3389/fpsyt.2023.1157587. eCollection 2023.
Major depressive disorder (MDD) is a disabling and severe psychiatric disorder with a high rate of prevalence, and adolescence is one of the most probable periods for the first onset. The neurobiological mechanism underlying the adolescent MDD remains unexplored.
In this study, we examined the cortical and subcortical alterations of neuroanatomical structures and spontaneous functional activation in 50 unmedicated adolescents with MDD vs. 39 healthy controls through the combined structural and resting-state functional magnetic resonance imaging.
Significantly altered regional gray matter volume was found at broader frontal-temporal-parietal and subcortical brain areas involved with various forms of information processing in adolescent MDD. Specifically, the increased GM volume at the left paracentral lobule and right supplementary motor cortex was significantly correlated with depression severity in adolescent MDD. Furthermore, lower cortical thickness at brain areas responsible for visual and auditory processing as well as motor movements was found in adolescent MDD. The lower cortical thickness at the superior premotor subdivision was positively correlated with the course of the disease. Moreover, higher spontaneous neuronal activity was found at the anterior cingulum and medial prefrontal cortex, and this hyperactivity was also negatively correlated with the course of the disease. It potentially reflected the rumination, impaired concentration, and physiological arousal in adolescent MDD.
The abnormal structural and functional findings at cortico-subcortical areas implied the dysfunctional cognitive control and emotional regulations in adolescent depression. The findings might help elaborate the underlying neural mechanisms of MDD in adolescents.
重度抑郁症(MDD)是一种致残性的严重精神疾病,患病率很高,而青少年是最有可能首次发病的时期之一。青少年MDD的神经生物学机制仍未得到探索。
在本研究中,我们通过联合结构和静息态功能磁共振成像,检查了50名未接受药物治疗的青少年MDD患者与39名健康对照者的神经解剖结构的皮质和皮质下改变以及自发功能激活情况。
在青少年MDD患者中,发现与各种形式信息处理相关的更广泛的额颞顶叶和皮质下脑区的区域灰质体积有显著改变。具体而言,青少年MDD患者左侧中央旁小叶和右侧辅助运动皮层的灰质体积增加与抑郁严重程度显著相关。此外,在青少年MDD患者中,负责视觉、听觉处理以及运动的脑区皮质厚度较低。前运动区上部分支的皮质厚度较低与疾病病程呈正相关。此外,在前扣带回和内侧前额叶皮层发现了较高的自发神经元活动,这种活动亢进也与疾病病程呈负相关。这可能反映了青少年MDD患者的沉思、注意力受损和生理觉醒。
皮质-皮质下区域的结构和功能异常发现暗示了青少年抑郁症中认知控制和情绪调节功能失调。这些发现可能有助于阐明青少年MDD的潜在神经机制。