Yan Haohao, Han Yiding, Shan Xiaoxiao, Li Huabing, Liu Feng, Xie Guojun, Li Ping, Guo Wenbin
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
Neuropharmacology. 2023 Dec 1;240:109692. doi: 10.1016/j.neuropharm.2023.109692. Epub 2023 Aug 29.
The study aimed to investigate the functional connectivity (FC) between the cerebellum and intrinsic cerebral networks in patients with panic disorder (PD), and to observe changes in the cerebellar-cerebral FC following pharmacotherapy. Fifty-four patients with PD and 54 healthy controls (HCs) underwent clinical assessments and functional magnetic resonance imaging scans before and after a 5-week paroxetine treatment. Seed-based cerebellar-cerebral FC was compared between the PD and HC groups, as well as between patients with PD before and after treatment. Additionally, the correlations between FC and clinical features of PD were analyzed. Compared to HCs, patients with PD had altered cerebellar-cerebral FC in the default mode, affective-limbic, and sensorimotor networks. Moreover, a negative correlation between cerebellar-insula disconnection and the severity of depressive symptoms in patients with PD (Pearson correlation, r = -0.424, p = 0.001, Bonferroni corrected) was found. After treatment, most of the enhanced FCs observed in patients with PD at baseline returned to levels similar to those observed in HCs. However, the reduced FC at baseline did not significantly change after treatment. The findings suggest that patients with PD have specific deficits in resting-state cerebellar-cerebral FC and that paroxetine may improve PD by restoring the balance of cerebellar-cerebral FC. These findings emphasize the crucial involvement of cerebellar-cerebral FC in the neuropsychological mechanisms underlying PD and in the potential pharmacological mechanisms of paroxetine for treating PD.
该研究旨在调查惊恐障碍（PD）患者小脑与大脑固有网络之间的功能连接（FC），并观察药物治疗后小脑-大脑FC的变化。54例PD患者和54名健康对照者（HCs）在进行为期5周的帕罗西汀治疗前后接受了临床评估和功能磁共振成像扫描。比较了PD组和HC组之间以及PD患者治疗前后的基于种子点的小脑-大脑FC。此外，还分析了FC与PD临床特征之间的相关性。与HCs相比，PD患者在默认模式、情感边缘和感觉运动网络中的小脑-大脑FC发生了改变。此外，还发现PD患者小脑-岛叶断开与抑郁症状严重程度之间存在负相关（Pearson相关性，r = -0.424，p = 0.001，经Bonferroni校正）。治疗后，PD患者基线时观察到的大多数增强的FC恢复到与HCs中观察到的水平相似。然而，基线时降低的FC在治疗后没有显著变化。这些发现表明，PD患者在静息状态下小脑-大脑FC存在特定缺陷，帕罗西汀可能通过恢复小脑-大脑FC的平衡来改善PD。这些发现强调了小脑-大脑FC在PD潜在神经心理机制以及帕罗西汀治疗PD潜在药理机制中的关键作用。
