Liang Qunjun, Xu Ziyun, Chen Shengli, Lin Shiwei, Lin Xiaoshan, Li Ying, Zhang Yingli, Peng Bo, Hou Gangqiang, Qiu Yingwei
Department of Radiology, Shenzhen Nanshan People's Hospital, Shenzhen University, Shenzhen 518000, People's Republic of China.
Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen 518060, People's Republic of China.
Brain Commun. 2024 Nov 26;6(6):fcae425. doi: 10.1093/braincomms/fcae425. eCollection 2024.
Agitated depression (A-MDD) is a severe subtype of major depressive disorder, with an increased risk of suicidality and the potential to evolve into bipolar disorder. Despite its clinical significance, the neural basis remains unclear. We hypothesize that psychomotor agitation, marked by pressured speech and racing thoughts, is linked to disruptions in brain dynamics. To test this hypothesis, we examined brain dynamics using time delay estimation and edge-centre time series, as well as dynamic connections between the somatomotor network (SMN) and the default mode network in 44 patients with A-MDD, 75 with non-agitated MDD (NA-MDD), and 94 healthy controls. Our results revealed that the neural co-activity duration was shorter in the A-MDD group compared with both the NA-MDD and controls (A-MDD versus NA-MDD: = 2.295; A-MDD versus controls: = 2.192, all < 0.05). In addition, the dynamic of neural fluctuation in SMN altered in the A-MDD group than in the NA-MDD group ( = -2.616, = 0.011) and was correlated with agitation severity ( = -0.228, = 0.011). The inter-network connection was reduced in the A-MDD group compared with the control group ( = 2.102, = 0.037), especially at low-amplitude time points ( = 2.139, = 0.034). These findings indicate rapid neural fluctuations and disrupted dynamic coupling between the SMN and default mode network in A-MDD, potentially underlying the psychomotor agitation characteristic of this subtype. These insights contribute to a more nuanced understanding of the heterogeneity of depression and have implications for differential diagnosis and treatment strategies.
激越性抑郁症（A-MDD）是重度抑郁症的一种严重亚型，具有更高的自杀风险，且有可能发展为双相情感障碍。尽管其具有临床重要性，但其神经基础仍不清楚。我们假设，以言语逼迫和思维奔逸为特征的精神运动性激越与脑动力学紊乱有关。为了验证这一假设，我们使用时间延迟估计和边缘-中心时间序列，以及44例A-MDD患者、75例非激越性抑郁症（NA-MDD）患者和94名健康对照者的躯体运动网络（SMN）与默认模式网络之间的动态连接，来研究脑动力学。我们的结果显示，与NA-MDD组和对照组相比，A-MDD组的神经共同活动持续时间更短（A-MDD与NA-MDD相比：t = 2.295；A-MDD与对照组相比：t = 2.192，均p < 0.05）。此外，A-MDD组SMN中神经波动的动态变化比NA-MDD组更大（t = -2.616，p = 0.011），且与激越严重程度相关（r = -0.228，p = 0.011）。与对照组相比，A-MDD组的网络间连接减少（t = 2.102，p = 0.037），尤其是在低振幅时间点（t = 2.139，p = 0.034）。这些发现表明，A-MDD中存在快速的神经波动以及SMN与默认模式网络之间的动态耦合破坏，这可能是该亚型精神运动性激越特征的潜在基础。这些见解有助于更细致地理解抑郁症的异质性，并对鉴别诊断和治疗策略具有启示意义。
