Liu Guanghui, Jiang Yanli, Zhou Chunpeng, Wang Xiangxiang, Dai Min, Zhang Jinping, Yu Jing, Zhang Gangzhong
Department of Neurosurgery, Zhengzhou Seventh People's Hospital, Zhengzhou, China.
Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Nutr. 2025 Jun 18;12:1615978. doi: 10.3389/fnut.2025.1615978. eCollection 2025.
Major depressive disorder (MDD) is generally categorized into first-episode MDD (fMDD) and recurrent MDD (rMDD). This study aimed to investigate the changes of brain network, as well as the relationships between relapses, brain regions, nutritional and metabolic indicators by resting-state functional magnetic resonance imaging (rs-fMRI) and graph theoretical analysis.
Thirty-two fMDD patients, 32 rMDD patients, and 32 healthy controls (HCs) underwent rs-fMRI scanning. Graph theoretical analysis was applied to examine the nodal strength and nodal global efficiency of brain networks. In addition, the nutritional and metabolic indicators were acquired from all patients. The differences of demographic, clinical data and topological parameters between groups were compared. Moreover, the relationships between number of relapses, topological parameters of brain regions, nutritional and metabolic indicators were evaluated.
Patients with rMDD showed decreased level of brain-derived neurotrophic factor (BDNF) when compared with those with fMDD. Both fMDD and rMDD patients showed decreased nodal strength and global efficiency in the left amygdala compared to HCs. Additionally, rMDD patients exhibited more extensive network disruptions, including decreased nodal strength in the right middle frontal gyrus, left middle cingulate gyrus, left posterior cingulate gyrus, left hippocampus, and right amygdala, as well as decreased nodal global efficiency in multiple regions involved in emotional processing and cognitive control. Moreover, the number of episodes were negatively associated with the level of BDNF, nodal strength of right amygdala and nodal global efficiency of right amygdala of rMDD patients. The level of BDNF were positively related to nodal strength of right amygdala and nodal global efficiency of right amygdala of rMDD patients.
Our findings revealed distinct patterns of brain network topology between fMDD and rMDD patients, with rMDD patients showing more widespread disruptions, which might be associated with greater number of relapses and worse level of neurological nutrition. These results suggested that recurrent depressive episodes might related to progressive disruptions in brain, particularly in regions involved in emotional processing and regulation.
重度抑郁症（MDD）通常分为首发重度抑郁症（fMDD）和复发性重度抑郁症（rMDD）。本研究旨在通过静息态功能磁共振成像（rs-fMRI）和图论分析，研究脑网络的变化以及复发、脑区、营养和代谢指标之间的关系。
32例fMDD患者、32例rMDD患者和32名健康对照者（HCs）接受了rs-fMRI扫描。应用图论分析来检查脑网络的节点强度和节点全局效率。此外，获取了所有患者的营养和代谢指标。比较了各组之间人口统计学、临床数据和拓扑参数的差异。此外，还评估了复发次数、脑区拓扑参数、营养和代谢指标之间的关系。
与fMDD患者相比，rMDD患者的脑源性神经营养因子（BDNF）水平降低。与HCs相比，fMDD和rMDD患者的左侧杏仁核节点强度和全局效率均降低。此外，rMDD患者表现出更广泛的网络破坏，包括右侧额中回、左侧扣带前回、左侧扣带后回、左侧海马和右侧杏仁核的节点强度降低，以及参与情绪处理和认知控制的多个区域的节点全局效率降低。此外，发作次数与rMDD患者的BDNF水平、右侧杏仁核的节点强度和右侧杏仁核的节点全局效率呈负相关。BDNF水平与rMDD患者右侧杏仁核的节点强度和右侧杏仁核的节点全局效率呈正相关。
我们的研究结果揭示了fMDD和rMDD患者之间脑网络拓扑结构的不同模式，rMDD患者表现出更广泛的破坏，这可能与更多的复发次数和更差的神经营养水平有关。这些结果表明，复发性抑郁发作可能与大脑的渐进性破坏有关，特别是在参与情绪处理和调节的区域。
