Li Kangning, Lu Xiaowen, Xiao Chuman, Zheng Kangning, Sun Jinrong, Dong Qiangli, Wang Mi, Zhang Liang, Liu Bangshan, Liu Jin, Zhang Yan, Guo Hua, Zhao Futao, Ju Yumeng, Li Lingjiang
Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
Zhumadian Psychiatric Hospital, Zhumadian 463000, China.
Brain Sci. 2023 Apr 23;13(5):705. doi: 10.3390/brainsci13050705.
The mechanism by which antidepressants normalizing aberrant resting-state functional connectivity (rsFC) in patients with major depressive disorder (MDD) is still a matter of debate. The current study aimed to investigate aberrant rsFC and whether antidepressants would restore the aberrant rsFC in patients with MDD.
A total of 196 patients with MDD and 143 healthy controls (HCs) received the resting-state functional magnetic resonance imaging and clinical assessments at baseline. Patients with MDD received antidepressant treatment after baseline assessment and were re-scanned at the 6-month follow-up. Network-based statistics were employed to identify aberrant rsFC and rsFC changes in patients with MDD and to compare the rsFC differences between remitters and non-remitters.
We identified a significantly decreased sub-network and a significantly increased sub-network in MDD at baseline. Approximately half of the aberrant rsFC remained significantly different from HCs after 6-month treatment. Significant overlaps were found between baseline reduced sub-network and follow-up increased sub-network, and between baseline increased sub-network and follow-up decreased sub-network. Besides, rsFC at baseline and rsFC changes between baseline and follow-up in remitters were not different from non-remitters.
Most aberrant rsFC in patients with MDD showed state-independence. Although antidepressants may modulate aberrant rsFC, they may not specifically target these aberrations to achieve therapeutic effects, with only a few having been directly linked to treatment efficacy.
抗抑郁药使重度抑郁症（MDD）患者异常静息态功能连接（rsFC）恢复正常的机制仍存在争议。本研究旨在调查MDD患者的异常rsFC以及抗抑郁药是否能恢复其异常rsFC。
共196例MDD患者和143名健康对照者（HCs）在基线时接受了静息态功能磁共振成像和临床评估。MDD患者在基线评估后接受抗抑郁药治疗，并在6个月随访时再次进行扫描。采用基于网络的统计学方法来识别MDD患者的异常rsFC和rsFC变化，并比较缓解者与未缓解者之间的rsFC差异。
我们在基线时发现MDD患者存在一个显著减少的子网和一个显著增加的子网。经过6个月治疗后，约一半的异常rsFC与HCs相比仍存在显著差异。在基线时减少的子网与随访时增加的子网之间，以及基线时增加的子网与随访时减少的子网之间，发现了显著重叠。此外，缓解者的基线rsFC以及基线与随访之间的rsFC变化与未缓解者并无差异。
MDD患者中大多数异常rsFC表现出状态独立性。尽管抗抑郁药可能会调节异常rsFC，但它们可能并非特异性地针对这些异常来实现治疗效果，只有少数异常与治疗疗效直接相关。
