Research Institute of Neuromuscular and Neurodegenerative Disease, Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, West Wenhua Street No. 107, Jinan, 250012, China.
Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
Brain Imaging Behav. 2024 Oct;18(5):1034-1043. doi: 10.1007/s11682-024-00896-5. Epub 2024 May 30.
Since depression is common in amyotrophic lateral sclerosis (ALS) patients, we aimed to explore the specific brain functional network dynamics in ALS patients with depression (ALS-D) compared with healthy controls (HCs) and ALS patients without depressive symptoms (ALS-ND). According to the DSM-V, 32 ALS-D patients were selected from a large and newly diagnosed ALS cohort. Then, 32 demographic- and cognitive-matched ALS-ND patients were also selected, and 64 HCs were recruited. These participants underwent resting-state fMRI scans, and functional connectivity state analysis and dynamic graph theory were applied to evaluate brain functional network dynamics. Moreover, the Hamilton Depression Rating Scale (HDRS) was used to quantify depressive symptoms in the ALS-D patients. Four distinct states were identified in the ALS-D patients and controls. Compared with that in HCs, the fraction rate (FR) in state 2 was significantly decreased in ALS-D patients, and the FR in state 4 was significantly increased in ALS-D patients. Compared with that of HCs, the dwell time in state 4 was significantly increased in the ALS-D patients. Moreover, compared with that in the ALS-D patients, the FR in state 3 was significantly decreased in the ALS-ND patients. Among the ALS-D patients, there was the suggestion of a positive association between HDRS scores and dwell time of state 4, but this association did not reach statistical significance (r = 0.354; p = 0.055). Depression is an important feature of ALS patients, and we found a special pattern of brain functional network dynamics in ALS-D patients. Our findings may play an important role in understanding the mechanism underlying depression in ALS patients and help develop therapeutic interventions for depressed ALS patients.
由于抑郁症在肌萎缩侧索硬化症（ALS）患者中很常见，我们旨在探索抑郁型 ALS 患者（ALS-D）与健康对照组（HCs）和无抑郁症状的 ALS 患者（ALS-ND）相比大脑特定功能网络动态的变化。根据 DSM-V，我们从一个大型的新诊断 ALS 队列中选择了 32 名 ALS-D 患者。然后，我们还选择了 32 名在人口统计学和认知方面与 ALS-D 患者相匹配的 ALS-ND 患者，以及 64 名 HCs。这些参与者接受了静息状态 fMRI 扫描，并应用功能连接状态分析和动态图论来评估大脑功能网络动态。此外，我们使用汉密尔顿抑郁量表（HDRS）来量化 ALS-D 患者的抑郁症状。在 ALS-D 患者和对照组中，共识别出四种不同的状态。与 HCs 相比，ALS-D 患者的状态 2 分数率（FR）显著降低，而 ALS-D 患者的状态 4 FR 显著增加。与 HCs 相比，ALS-D 患者的状态 4 停留时间显著增加。此外，与 ALS-D 患者相比，ALS-ND 患者的状态 3 FR 显著降低。在 ALS-D 患者中，HDRS 评分与状态 4 停留时间之间存在正相关的趋势，但这种相关性没有达到统计学意义（r=0.354；p=0.055）。抑郁症是 ALS 患者的一个重要特征，我们发现 ALS-D 患者大脑功能网络动态存在一种特殊模式。我们的研究结果可能对理解 ALS 患者抑郁的机制有重要作用，并有助于为抑郁的 ALS 患者开发治疗干预措施。
