Long Jing-Yi, Qin Kun, Pan Nanfang, Fan Wen-Liang, Li Yi
Wuhan Mental Health Center, Wuhan, China; Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China; and Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China.
Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Br J Psychiatry. 2024 May;224(5):170-178. doi: 10.1192/bjp.2024.41.
Major depressive disorder (MDD) has been increasingly understood as a disruption of brain connectome. Investigating grey matter structural networks with a large sample size can provide valuable insights into the structural basis of network-level neuropathological underpinnings of MDD.
Using a multisite MRI data-set including nearly 2000 individuals, this study aimed to identify robust topology and connectivity abnormalities of grey matter structural network linked to MDD and relevant clinical phenotypes.
A total of 955 MDD patients and 1009 healthy controls were included from 23 sites. Individualised structural covariance networks (SCN) were established based on grey matter volume maps. Following data harmonisation, network topological metrics and focal connectivity were examined for group-level comparisons, individual-level classification performance and association with clinical ratings. Various validation strategies were applied to confirm the reliability of findings.
Compared with healthy controls, MDD individuals exhibited increased global efficiency, abnormal regional centralities (i.e. thalamus, precentral gyrus, middle cingulate cortex and default mode network) and altered circuit connectivity (i.e. ventral attention network and frontoparietal network). First-episode drug-naive and recurrent patients exhibited different patterns of deficits in network topology and connectivity. In addition, the individual-level classification of topological metrics outperforms that of structural connectivity. The thalamus-insula connectivity was positively associated with the severity of depressive symptoms.
Based on this high-powered data-set, we identified reliable patterns of impaired topology and connectivity of individualised SCN in MDD and relevant subtypes, which adds to the current understanding of neuropathology of MDD and might guide future development of diagnostic and therapeutic markers.
重度抑郁症(MDD)越来越被理解为一种大脑连接组的破坏。对大样本的灰质结构网络进行研究可以为MDD网络水平神经病理学基础的结构基础提供有价值的见解。
本研究使用包含近2000名个体的多中心MRI数据集,旨在识别与MDD及相关临床表型相关的灰质结构网络的稳健拓扑和连接异常。
从23个地点纳入了955名MDD患者和1009名健康对照。基于灰质体积图建立个体化结构协方差网络(SCN)。在数据协调之后,检查网络拓扑指标和焦点连接性以进行组水平比较、个体水平分类性能以及与临床评分的关联。应用了各种验证策略以确认研究结果的可靠性。
与健康对照相比,MDD个体表现出全局效率增加、区域中心性异常(即丘脑、中央前回、扣带中部皮质和默认模式网络)以及回路连接改变(即腹侧注意网络和额顶网络)。首发未用药患者和复发患者在网络拓扑和连接性方面表现出不同的缺陷模式。此外,拓扑指标的个体水平分类优于结构连接性的分类。丘脑-岛叶连接与抑郁症状的严重程度呈正相关。
基于这个高能量数据集,我们在MDD及相关亚型中识别出个体化SCN拓扑和连接受损的可靠模式,这增加了当前对MDD神经病理学的理解,并可能指导未来诊断和治疗标志物的开发。