Fu Shishun, Liang Sipei, Lin Chulan, Wu Yunfan, Xie Shuangcong, Li Meng, Lei Qiang, Li Jianneng, Yu Kanghui, Yin Yi, Hua Kelei, Li Wuming, Wu Caojun, Ma Xiaofen, Jiang Guihua
The Department of Medical Imaging Guangdong Second Provincial General Hospital, Guangzhou, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Front Psychiatry. 2023 Jun 2;14:1143780. doi: 10.3389/fpsyt.2023.1143780. eCollection 2023.
Previously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy.
Thirty three patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample -test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales.
Compared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD.
The results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.
此前，关于创伤后应激障碍合并重度抑郁症（PTSD-MDD）共病的神经影像学研究发现，患者多个脑区存在异常。近期的神经影像学研究揭示了静息状态下人类大脑活动的动态特性，而熵作为动态规律性的指标，可能为研究PTSD-MDD患者的脑功能异常提供新视角。在新冠疫情期间，PTSD-MDD患者数量显著增加。我们决定利用熵对在此期间患上PTSD-MDD的患者的静息态脑功能活动进行研究。
招募了33例PTSD-MDD患者和36例匹配的健康对照者（TC）。使用多种临床量表评估PTSD和抑郁症状。所有受试者均接受功能磁共振成像（fMRI）扫描。并使用脑熵（BEN）映射工具箱计算脑熵图。采用双样本t检验比较PTSD-MDD共病组与TC组之间的脑熵差异。此外，对PTSD-MDD患者的BEN变化与临床量表进行相关性分析。
与TC组相比，PTSD-MDD患者右侧额中眶回（R_MFOG）、左侧壳核和右侧额下回岛盖部（R_IFOG）的BEN降低。此外，PTSD-MDD患者R_MFOG中较高的BEN与较高的CAPS和HAMD-24评分相关。
结果表明，R_MFOG是显示PTSD-MDD共病症状严重程度的潜在标志物。因此，PTSD-MDD可能在与情绪调节障碍和认知缺陷相关的额叶和基底神经节区域存在BEN降低的情况。
