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个体功能脑系统拓扑结构与重度抑郁症:斑块大小与临床特征及行为的关系。

Individualized Functional Brain System Topologies and Major Depression: Relationships Among Patch Sizes and Clinical Profiles and Behavior.

机构信息

Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

出版信息

Biol Psychiatry Cogn Neurosci Neuroimaging. 2024 Jun;9(6):616-625. doi: 10.1016/j.bpsc.2024.02.011. Epub 2024 Feb 28.

Abstract

BACKGROUND

Neuroimaging studies of major depression have typically been conducted using group-level approaches. However, given interindividual differences in brain systems, there is a need for individualized approaches to brain systems mapping and putative links toward diagnosis, symptoms, and behavior.

METHODS

We used an iterative parcellation approach to map individualized brain systems in 328 participants from a multisite, placebo-controlled clinical trial. We hypothesized that participants with depression would show abnormalities in salience, control, default, and affective systems, which would be associated with higher levels of self-reported anhedonia, anxious arousal, and worse cognitive performance. Within hypothesized brain systems, we compared patch sizes (number of vertices) between depressed and healthy control groups. Within depressed groups, abnormal patches were correlated with hypothesized clinical and behavioral measures.

RESULTS

Significant group differences emerged in hypothesized patches of 1) the lateral salience system (parietal operculum; t = -3.11, p = .002) and 2) the control system (left medial posterior prefrontal cortex region; z = -3.63, p < .001), with significantly smaller patches in these regions in participants with depression than in healthy control participants. Results suggest that participants with depression with significantly smaller patch sizes in the lateral salience system and control system regions experience greater anxious arousal and cognitive deficits.

CONCLUSIONS

The findings imply that neural features mapped at the individual level may relate meaningfully to diagnosis, symptoms, and behavior. There is strong clinical relevance in taking an individualized brain systems approach to mapping neural functional connectivity because these associated region patch sizes may help advance our understanding of neural features linked to psychopathology and foster future patient-specific clinical decision making.

摘要

背景

重度抑郁症的神经影像学研究通常采用组水平方法进行。然而,鉴于大脑系统存在个体间差异,因此需要采用个体化方法来对大脑系统进行映射,并对诊断、症状和行为进行推测。

方法

我们采用迭代分区方法对来自多中心安慰剂对照临床试验的 328 名参与者进行个体化大脑系统映射。我们假设,患有抑郁症的患者的突显、控制、默认和情感系统会出现异常,这与更高水平的自我报告快感缺失、焦虑唤醒和认知表现下降有关。在假设的大脑系统中,我们比较了抑郁组和健康对照组之间的斑块大小(顶点数)。在抑郁组内,异常斑块与假设的临床和行为测量值相关。

结果

在假设的斑块中,1)外侧突显系统(顶叶脑岛;t=-3.11,p=0.002)和 2)控制系统(左侧内侧前额叶皮质区域;z=-3.63,p<.001)出现了显著的组间差异,抑郁患者的这些区域中的斑块明显小于健康对照组参与者。结果表明,在外侧突显系统和控制系统区域中斑块较小的抑郁患者体验到更大的焦虑唤醒和认知缺陷。

结论

这些发现表明,在个体水平上绘制的神经特征可能与诊断、症状和行为有意义地相关。采用个体化大脑系统方法进行神经功能连接映射具有很强的临床相关性,因为这些相关区域斑块大小可能有助于我们进一步理解与精神病理学相关的神经特征,并促进未来针对患者的临床决策。

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本文引用的文献

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The orbitofrontal cortex and emotion in health and disease, including depression.眶额皮质与健康和疾病中的情绪,包括抑郁症。
Neuropsychologia. 2019 May;128:14-43. doi: 10.1016/j.neuropsychologia.2017.09.021. Epub 2017 Sep 24.

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