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一种独特的皮质下功能连接模式将负性情绪与重度抑郁症的治疗结果联系起来。

A distinctive subcortical functional connectivity pattern linking negative affect and treatment outcome in major depressive disorder.

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.

CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.

出版信息

Transl Psychiatry. 2024 Mar 5;14(1):136. doi: 10.1038/s41398-024-02838-7.

Abstract

Major depressive disorder (MDD) is associated with functional disturbances in subcortical regions. In this naturalistic prospective study (NCT03294525), we aimed to investigate relationships among subcortical functional connectivity (FC), mood symptom profiles and treatment outcome in MDD using multivariate methods. Medication-free participants with MDD (n = 135) underwent a functional magnetic resonance imaging scan at baseline and completed posttreatment clinical assessment after 8 weeks of antidepressant monotherapy. We used partial least squares (PLS) correlation analysis to explore the association between subcortical FC and mood symptom profiles. FC score, reflecting the weighted representation of each individual in this association, was computed. Replication analysis was undertaken in an independent sample (n = 74). We also investigated the relationship between FC score and treatment outcome in the main sample. A distinctive subcortical connectivity pattern was found to be associated with negative affect. In general, higher FC between the caudate, putamen and thalamus was associated with greater negative affect. This association was partly replicated in the independent sample (similarity between the two samples: r = 0.66 for subcortical connectivity, r = 0.75 for mood symptom profile). Lower FC score predicted both remission and response to treatment after 8 weeks of antidepressant monotherapy. The emphasis here on the role of dorsal striatum and thalamus consolidates prior work of subcortical connectivity in MDD. The findings provide insight into the pathogenesis of MDD, linking subcortical FC with negative affect. However, while the FC score significantly predicted treatment outcome, the low odds ratio suggests that finding predictive biomarkers for depression remains an aspiration.

摘要

重度抑郁症(MDD)与皮质下区域的功能障碍有关。在这项自然前瞻性研究(NCT03294525)中,我们旨在使用多元方法研究 MDD 患者皮质下功能连接(FC)、情绪症状特征与治疗结果之间的关系。无药物治疗的 MDD 参与者(n=135)在基线时进行了功能磁共振成像扫描,并在 8 周抗抑郁药单药治疗后完成了治疗后临床评估。我们使用偏最小二乘法(PLS)相关分析来探讨皮质下 FC 与情绪症状特征之间的关系。计算了反映该关联中每个个体的加权表示的 FC 得分。在独立样本(n=74)中进行了复制分析。我们还在主要样本中研究了 FC 得分与治疗结果之间的关系。发现一种独特的皮质下连接模式与负性情绪有关。一般来说,尾状核、壳核和丘脑之间的 FC 越高,负性情绪越大。这一关联在独立样本中得到部分复制(两个样本之间的相似性:皮质下连接 r=0.66,情绪症状特征 r=0.75)。较低的 FC 得分预测了 8 周抗抑郁药单药治疗后的缓解和反应。这里强调背侧纹状体和丘脑的作用,巩固了先前关于 MDD 皮质下连接的工作。研究结果为 MDD 的发病机制提供了深入了解,将皮质下 FC 与负性情绪联系起来。然而,尽管 FC 得分显著预测了治疗结果,但低比值比表明,寻找抑郁症的预测生物标志物仍然是一个愿望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47b3/10915152/d18f245a77b2/41398_2024_2838_Fig1_HTML.jpg

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