Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China; Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China.
School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
Psychiatry Res Neuroimaging. 2023 Dec;336:111729. doi: 10.1016/j.pscychresns.2023.111729. Epub 2023 Oct 18.
This study investigated the mediating factors between childhood emotional neglect (EN) and major depressive disorder (MDD) and whether combining multi-indicator could help diagnose MDD. Regional homogeneity (ReHo) and clinical features were compared between 33 MDD patients and 36 healthy controls (HC). Mediation analysis was employed to explore whether social support or ReHo mediates the association between EN and MDD. The linear discriminant analysis model was constructed with EN, social support, and ReHo, and applied to distinguish MDD from HC in both primary and replication cohorts. We found that MDD patients experienced severer EN and poorer social support, and exhibited lower ReHo in the left middle occipital gyrus and bilateral postcentral gyrus, and higher ReHo in the right cerebellum crus1. EN could affect MDD directly and indirectly through ReHo in these discrepant brain regions and social support. Combining ReHo values of these four distinct brain regions, EN, and objective support could classify MDD patients from HC, and the 10-fold cross-validation accuracy within-study replication and in the independent cohort was 83.78 % ± 1.49 % and 82.72 % ± 2.22 %, respectively. These findings suggested that childhood EN, social support, and emotional-related regions' ReHo were associated with risks of MDD, providing new insights into the pathological mechanisms underlying MDD.
本研究旨在探讨儿童期情感忽视（EN）与重度抑郁症（MDD）之间的中介因素，以及多指标结合是否有助于 MDD 的诊断。对 33 名 MDD 患者和 36 名健康对照（HC）的局部一致性（ReHo）和临床特征进行了比较。采用中介分析探讨社会支持或 ReHo 是否在 EN 和 MDD 之间的关联中起中介作用。构建了包含 EN、社会支持和 ReHo 的线性判别分析模型，并应用于初级和复制队列中区分 MDD 和 HC。结果发现，MDD 患者经历了更严重的 EN 和较差的社会支持，并且在左侧中枕叶和双侧后中央回的 ReHo 降低，在右侧小脑 crus1 的 ReHo 升高。EN 可以直接和间接地通过这些不同脑区和社会支持的 ReHo 来影响 MDD。结合这四个不同脑区、EN 和客观支持的 ReHo 值，可以对 MDD 患者和 HC 进行分类，在内部研究复制和独立队列中的 10 倍交叉验证准确性分别为 83.78%±1.49%和 82.72%±2.22%。这些发现表明，儿童期 EN、社会支持和情感相关区域的 ReHo 与 MDD 的发病风险有关，为 MDD 的病理机制提供了新的见解。
