Hu Liyu, Chen Jianxiang, Li Xinbei, Zhang Haoran, Zhang Jinhuan, Lu Yingqi, Lian Jie, Yu Haibo, Yang Nan, Wang Jianjun, Lyu Hanqing, Xu Jinping
Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China.
Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
Front Aging Neurosci. 2024 Sep 17;16:1338179. doi: 10.3389/fnagi.2024.1338179. eCollection 2024.
Although depression symptoms are commonly reported in patients with subcortical vascular mild cognitive impairment (svMCI), their impact on brain functions remains largely unknown, with diagnoses mainly dependent on behavioral assessments.
In this study, we analyzed resting-state fMRI data from a cohort of 34 svMCI patients, comprising 18 patients with depression symptoms (svMCI+D) and 16 patients without (svMCI-D), along with 34 normal controls (NC). The study used the fraction of the amplitude of low-frequency fluctuations (fALFF), resting-state functional connectivity, correlation analyses, and support vector machine (SVM) techniques.
The fALFF of the right cerebellum (CERE.R) differed among the svMCI+D, svMCI-D, and NC groups. Specifically, the regional mean fALFF of CERE. R was lower in svMCI-D patients compared to NC but higher in svMCI+D patients compared to svMCI-D patients. Moreover, the adjusted fALFF of CERE. R showed a significant correlation with Montreal Cognitive Assessment (MOCA) scores in svMCI-D patients. The fALFF of the right orbital part of the superior frontal gyrus was significantly correlated with Hamilton Depression Scale scores in svMCI+D patients, whereas the fALFF of the right postcingulate cortex (PCC.R) showed a significant correlation with MOCA scores in svMCI-D patients. Furthermore, RSFC between PCC. R and right precuneus, as well as between CERE. R and the right lingual gyrus (LING.R), was significantly reduced in svMCI-D patients compared to NC. In regional analyses, the adjusted RSFC between PCC. R and PreCUN. R, as well as between CERE. R and LING. R, was decreased in svMCI-D patients compared to NC but increased in svMCI+D patients compared to svMCI-D. Further SVM analyses achieved good performances, with an area under the curve (AUC) of 0.82 for classifying svMCI+D, svMCI-D, and NC; 0.96 for classifying svMCI+D and svMCI-D; 0.82 for classifying svMCI+D and NC; and 0.92 for classifying svMCI-D and NC.
The study revealed disruptive effects of cognitive impairment, along with both disruptive and complementary effects of depression symptoms on spontaneous brain activity in svMCI. Moreover, these findings suggest that the identified features might serve as potential biomarkers for distinguishing between svMCI+D, svMCI-D, and NC, thereby guiding clinical treatments such as transcranial magnetic stimulation for svMCI.
尽管在皮质下血管性轻度认知障碍（svMCI）患者中普遍报告有抑郁症状，但其对脑功能的影响在很大程度上仍不清楚，诊断主要依赖于行为评估。
在本研究中，我们分析了34例svMCI患者的静息态功能磁共振成像（fMRI）数据，其中包括18例有抑郁症状的患者（svMCI+D）和16例无抑郁症状的患者（svMCI-D），以及34名正常对照（NC）。该研究使用了低频振幅分数（fALFF）、静息态功能连接、相关性分析和支持向量机（SVM）技术。
右侧小脑（CERE.R）的fALFF在svMCI+D、svMCI-D和NC组之间存在差异。具体而言，与NC相比，svMCI-D患者CERE.R的区域平均fALFF较低，但与svMCI-D患者相比，svMCI+D患者的则较高。此外，CERE.R的校正fALFF在svMCI-D患者中与蒙特利尔认知评估（MOCA）评分显著相关。在svMCI+D患者中，额上回右侧眶部的fALFF与汉密尔顿抑郁量表评分显著相关，而在svMCI-D患者中，右侧后扣带回皮质（PCC.R）的fALFF与MOCA评分显著相关。此外，与NC相比，svMCI-D患者中PCC.R与右侧楔前叶之间以及CERE.R与右侧舌回（LING.R）之间的静息态功能连接（RSFC）显著降低。在区域分析中，与NC相比，svMCI-D患者中PCC.R与楔前叶之间以及CERE.R与舌回之间的校正RSFC降低，但与svMCI-D患者相比，svMCI+D患者中的则增加。进一步的SVM分析取得了良好的效果，对svMCI+D、svMCI-D和NC进行分类的曲线下面积（AUC）为０.82；对svMCI+D和svMCI-D进行分类的AUC为0.96；对svMCI+D和NC进行分类的AUC为0.82；对svMCI-D和NC进行分类的AUC为0.92。
该研究揭示了认知障碍的破坏作用，以及抑郁症状对svMCI患者自发脑活动的破坏和互补作用。此外，这些发现表明，所识别的特征可能作为区分svMCI+D、svMCI-D和NC的潜在生物标志物，从而指导针对svMCI的经颅磁刺激等临床治疗。
