Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China; Graduate School of China Academy of Chinese Medical Sciences, Beijing, China.
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
J Affect Disord. 2024 Jan 15;345:216-225. doi: 10.1016/j.jad.2023.10.085. Epub 2023 Oct 20.
Anhedonia is a significant predictor of disease progression and treatment outcomes in Major Depressive Disorder (MDD), linked to reward network dysfunctions. However, understanding of its underlying neural mechanisms remains limited. This study aimed to investigate the brain functional mechanisms underlying MDD with anhedonia using resting-state functional magnetic resonance imaging (rs-fMRI).
The Snaith-Hamilton Pleasure Scale (SHAPS) was used to evaluation MDD with anhedonia (anMDD) and non-anhedonia MDD (non-anMDD). Forty-eight patients with anMDD, Forty-four patients with non-anMDD, and Fifty healthy controls (HCs) were enrolled for the fMRI scans. A seed-based functional connectivity (FC) method was employed to explore reward network abnormalities.
anMDD patients exhibited lower FC values in Ventral Striatum (VS), right lateral Ventral Tegmental Area (VTA_R), left Thalamus (THA_L), and higher FC values in Ventromedial Prefrontal Cortex (vmPFC), left Anterior Insula (AI_L), and Presupplementary Motor Area (Pre-SMA) compared to HCs. Comparing anMDD to non-anMDD, significant differences were observed in FC values of VS, vmPFC, Pre-SMA, and THA_L regions. Correlation analysis revealed positive correlations between FC values of VS_R and NAc_R, as well as THA_L and Cerebellum_Crus1_L, with SHAPS scores. Negative correlations were observed between FC values of Pre-SMA and the right caudate, and between vmPFC and Frontal_Mid_Orb_L, and SHAPS scores.
Both anMDD and non-anMDD groups demonstrated abnormal FCs in the reward network. These findings indicate distinct roles of reward-related circuits in the two subtypes, contributing to a refined understanding of depression phenotypes and potential directions for targeted interventions.
快感缺失是重性抑郁障碍（MDD）疾病进展和治疗结果的重要预测因子，与奖励网络功能障碍有关。然而，其潜在的神经机制仍知之甚少。本研究旨在使用静息态功能磁共振成像（rs-fMRI）研究有快感缺失的 MDD 的大脑功能机制。
采用 Snaith-Hamilton 快感量表（SHAPS）评估有快感缺失的 MDD（anMDD）和无快感缺失的 MDD（non-anMDD）。招募了 48 名 anMDD 患者、44 名 non-anMDD 患者和 50 名健康对照者（HCs）进行 fMRI 扫描。采用种子点功能连接（FC）方法探讨奖励网络异常。
与 HCs 相比，anMDD 患者的腹侧纹状体（VS）、右侧腹侧中脑（VTA_R）、左侧丘脑（THA_L）的 FC 值较低，而腹内侧前额叶皮质（vmPFC）、左侧前岛叶（AI_L）和补充运动区（Pre-SMA）的 FC 值较高。与 non-anMDD 相比，anMDD 患者的 VS、vmPFC、Pre-SMA 和 THA_L 区域的 FC 值存在显著差异。相关性分析显示，VS_R 与 NAc_R 以及 THA_L 与小脑 Crus1_L 的 FC 值与 SHAPS 评分呈正相关。Pre-SMA 与右侧尾状核的 FC 值和 vmPFC 与额叶中眶回 L 的 FC 值与 SHAPS 评分呈负相关。
anMDD 和 non-anMDD 组的奖励网络均存在异常 FC。这些发现表明奖励相关回路在这两种亚型中发挥不同作用，有助于深入了解抑郁表型和潜在的靶向干预方向。
