Zhang Huifeng, Ding Lei, He Lanxiang, Zhou Rubai, Lu Wenxian, Xu Tenghuan, Wu Ye, Peng Daihui
Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
School of Computer Science and Technology, Nanjing University of Science and Technology, Nanjing, Jiangsu 210094, China.
Neuroimage Clin. 2025 Apr 13;46:103786. doi: 10.1016/j.nicl.2025.103786.
Major depressive disorder (MDD) encompasses a broad spectrum of heterogeneous symptoms arising from distinct etiological mechanisms. Phenotypic markers of psychopathology are most likely influenced by exposure to childhood maltreatment, yielding distinct subtypes within conventional diagnostic boundaries. However, the biological interactions between MDD subtypes and types of childhood trauma remain unclear.
50 atypical depression (AD) patients, 97 non-AD patients and 50 healthy controls were included to complete multi-shell diffusion MRI scans and clinical assessments. Differential tractography was performed to clarify the axonal injury between the AD and non-AD groups. Moreover, correlational tractography was employed to individually assess the relationship between quantitative anisotropy (QA) and all types of childhood trauma in each depressed subgroup.
Our study found that AD and non-AD patients had differential axonal loss primarily involving the bilateral superior longitudinal fasciculus, arcuate fasciculus, inferior longitudinal fasciculus, parietal aslant tract, and corpus callosum. Furthermore, AD patients showed significantly negative associations between QA values, childhood trauma total scores, and threat-related adversity, while significantly positive associations were observed in non-AD patients. However, similar phenomena were not observed for deprivation-related adversities.
Our findings indicate differential spatial patterns of axonal alterations associated with threat-related adversity in atypical depression and non-atypical depression. Efforts to attenuate the consequences of childhood maltreatment for MDD should consider the associations between specific patterns of adversity and specific clinical manifestations.
重度抑郁症（MDD）包含由不同病因机制引起的广泛异质症状。精神病理学的表型标志物很可能受到童年期虐待经历的影响，在传统诊断范围内产生不同的亚型。然而，MDD亚型与童年创伤类型之间的生物学相互作用仍不清楚。
纳入50例非典型抑郁症（AD）患者、97例非AD患者和50名健康对照者，完成多壳层扩散磁共振成像扫描和临床评估。进行差异纤维束成像以阐明AD组和非AD组之间的轴突损伤。此外，采用相关纤维束成像分别评估每个抑郁亚组中各向异性定量（QA）与所有类型童年创伤之间的关系。
我们的研究发现，AD患者和非AD患者存在不同的轴突损失，主要累及双侧上纵束、弓状束、下纵束、顶叶斜束和胼胝体。此外，AD患者的QA值、童年创伤总分与威胁相关逆境之间呈显著负相关，而非AD患者则呈显著正相关。然而，在与剥夺相关的逆境中未观察到类似现象。
我们的研究结果表明，非典型抑郁症和非非典型抑郁症中与威胁相关逆境相关的轴突改变存在不同的空间模式。减轻童年虐待对MDD影响的努力应考虑特定逆境模式与特定临床表现之间的关联。
