多次感染新冠病毒后出现严重抑郁症患者的长期白质变化：一项为期3至6个月的研究

Long-term white matter changes in patients who develop severe depression after multiple COVID-19 infections: a 3-6-month study.

作者信息

Cui Yuanyuan, Wang Yihao, Lu Li, Zhang Youhan, Yu Qingyang, Dong Shuwen, Wang Yajing, Liu Yongying, Dong Guoxing, Dai Jiankun, Bai Yonghai, Xiao Yi, Liu Shiyuan

机构信息

Department of Radiology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.

Department of Psychology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.

出版信息

Quant Imaging Med Surg. 2025 May 1;15(5):4364-4374. doi: 10.21037/qims-24-2168. Epub 2025 Apr 28.

DOI:10.21037/qims-24-2168

PMID:40384680

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12084683/

Abstract

BACKGROUND

The white matter (WM) of patients who suffer from depression after long-term coronavirus disease 2019 (COVID-19) showed a dynamic change. However, to date, no research on the dynamic change in the WM of patients who develop severe depression after multiple COVID-19 infections has been conducted. This study aimed to evaluate long-term WM changes in patients who experience mild or moderate depression after their first COVID-19 infection followed by severe depression after their second infection.

METHODS

In total, 27 outpatients who developed severe depression after two COVID-19 infections (the patient group) and 28 outpatients who developed mild or moderate depression after one COVID-19 infection (the control group) were included in this prospective study. Psychological assessments for depression, anxiety, and insomnia were conducted 3-6 months after infection. Diffusion tensor imaging was performed. The fractional anisotropy (FA), mean diffusivity, axial diffusivity, and radial diffusivity were calculated and compared between the groups. The correlations between the psychological scores and image parameters were analyzed.

RESULTS

There was no difference between the two groups in terms of age (51.857±2.770 48.148±2.0678 years, P=0.222), gender (female: 75.0% 55.6%, P=0.130), and education (P=0.317). The psychological scores were higher in the patient group than the control group (Patient Health Questionnaire-9: 17.290±2.600 8.640±2.599, Generalized Anxiety Disorder-7:15.440±3.490 7.640±2.376, Athens Insomnia Scale: 15.852±3.219 10.179±2.763; all P<0.001). The patient group showed decreased FA values in the bilateral corticospinal tracts, anterior thalamic radiations, and right superior longitudinal fasciculus (P <0.05). All the psychological scores were negatively mildly to moderately correlated with the FA values of the above-mentioned WM tracts (r=-0.491, r=-0.570, and r=-0.355, P<0.001, P<0.001, and P=0.008).

CONCLUSIONS

The present study revealed impairments in the WM integrity of patients who developed severe depression within 3-6 months of repeated COVID-19 infections. The findings revealed the mechanism of COVID-19-related depression and underscored the importance of psychological intervention after COVID-19 infection.

摘要

背景

长期感染2019冠状病毒病（COVID-19）后出现抑郁的患者，其白质（WM）呈现动态变化。然而，迄今为止，尚未对多次感染COVID-19后出现重度抑郁的患者白质的动态变化进行研究。本研究旨在评估首次感染COVID-19后出现轻度或中度抑郁，随后第二次感染后出现重度抑郁的患者的长期白质变化。

方法

本前瞻性研究共纳入27例两次感染COVID-19后出现重度抑郁的门诊患者（患者组）和28例首次感染COVID-19后出现轻度或中度抑郁的门诊患者（对照组）。在感染后3 - 6个月进行抑郁、焦虑和失眠的心理评估。进行扩散张量成像。计算并比较两组的分数各向异性（FA）、平均扩散率、轴向扩散率和径向扩散率。分析心理评分与图像参数之间的相关性。

结果

两组在年龄（51.857±2.770对48.148±2.0678岁，P = 0.22）、性别（女性：75.0%对55.6%，P = 0.13）和教育程度（P = 0.317）方面无差异。患者组的心理评分高于对照组（患者健康问卷 - 9：17.290±2.600对8.640±2.599，广泛性焦虑障碍 - 7：15.440±3.490对7.640±2.376，雅典失眠量表：15.852±3.219对10.179±2.763；所有P < 0.001）。患者组双侧皮质脊髓束、丘脑前辐射和右侧上纵束的FA值降低（P < 0.05）。所有心理评分与上述白质束的FA值呈轻度至中度负相关（r = -0.491，r = -0.570，r = -0.355，P < 0.001，P < 0.001，P = 0.008）。