Department of Psychology, The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, 221004, China.
Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
BMC Psychiatry. 2024 Jul 25;24(1):533. doi: 10.1186/s12888-024-05970-2.
Anxious depression (AD) is a common subtype of major depressive disorder (MDD). Neuroimaging studies of AD have revealed inconsistent and heterogeneous brain alterations with the use of single-model methods. Therefore, it is necessary to explore the pathogenesis of AD using multi-model imaging analyses to obtain more homogeneous and robust results.
One hundred and eighty-two patients with MDD and 64 matched healthy controls (HCs) were recruited. Voxel-based morphometry (VBM) was used to estimate the gray matter volume (GMV) of all subjects. The GMV differences between the AD and non-anxious depression (NAD) participants were used as regions of interest (ROIs) for subsequent resting state functional connectivity (rs-FC) analyses. Correlation analysis was used to evaluate the associations between clinical symptoms and abnormal function in specific brain areas.
Decreased GMV in the medial frontal gyrus (MFG) and the superior frontal gyrus (SFG) was observed in the AD group compared to the NAD group. Taking the MFG and SFG as ROIs, the rs-FC analysis revealed decreased FC between the left SFG and left temporal pole and between the left SFG and right MFG in the AD group compared to the NAD group. Finally, the FC between the left SFG and left temporal pole was negatively correlated with HAMD-17 scores in the AD group.
By combining the GMV and rs-FC models, this study revealed that structural and functional disruption of the affective network may be an important pathophysiology underlying AD. The structural impairment may serve as the foundation of the functional impairment.
焦虑型抑郁症(AD)是一种常见的重性抑郁障碍(MDD)亚型。使用单模型方法的 AD 神经影像学研究显示出不一致和异质的大脑改变。因此,有必要使用多模型成像分析来探索 AD 的发病机制,以获得更同质和更稳健的结果。
共招募了 182 名 MDD 患者和 64 名匹配的健康对照者(HCs)。基于体素的形态测量学(VBM)用于估计所有受试者的灰质体积(GMV)。将 AD 和非焦虑型抑郁症(NAD)参与者之间的 GMV 差异作为随后静息态功能连接(rs-FC)分析的感兴趣区(ROI)。相关性分析用于评估特定脑区异常功能与临床症状之间的关系。
与 NAD 组相比,AD 组内侧额回(MFG)和额上回(SFG)的 GMV 减少。以 MFG 和 SFG 为 ROI,rs-FC 分析显示 AD 组左侧 SFG 与左侧颞极之间以及左侧 SFG 与右侧 MFG 之间的 FC 降低。最后,AD 组左侧 SFG 与左侧颞极之间的 FC 与 HAMD-17 评分呈负相关。
通过结合 GMV 和 rs-FC 模型,本研究揭示了情感网络的结构和功能中断可能是 AD 的一个重要病理生理学基础。结构损伤可能是功能损伤的基础。