Li Na, Li Yong, Lu Yueying, Zhang Kun, Wang Shuo, Wang Chaomin
Department of Psychiatry, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Clinical Psychology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Front Psychiatry. 2025 Jul 8;16:1554476. doi: 10.3389/fpsyt.2025.1554476. eCollection 2025.
To investigate the effect of chronic stress on cortical thickness in patients with depression.
We recruited 90 participants (Jan 2023-Oct 2024): 30 treatment-naive depressed patients with chronic stress (CSD group; mean age 39.1 ± 9.8 years, baseline HAMD-17 27.4 ± 4.8), 30 treatment-naive depressed patients without chronic stress (Dep group; 38.9 ± 9.6 years, HAMD 26.1 ± 4.9), and 30 age/sex-matched healthy controls (HC; 41.2 ± 10.0 years). Chronic stress was defined using the Life Events Scale (LES > 100, based on regional norms). All patients received Fluvoxamine Maleate treatment. LES scores, HAMD-17 scores, and cortical thickness (via MRI) were assessed pre-treatment and 2 months post-treatment. Depressive relapse was monitored for 12-14 months (mean 12.9 ± 1.6 months).
Baseline: LES scores were CSD > Dep > HC (all P<0.05); HAMD scores were CSD≈Dep > HC (P<0.05). Compared to HC, both patient groups showed reduced baseline cortical thickness in left pars triangularis, pars opercularis, precuneus, middle temporal, and cingulate gyri, and right superior frontal, precuneus, and inferior frontal gyri (P<0.05). Crucially, the CSD group exhibited significantly greater thinning than the Dep group in these regions (P<0.05). Post-treatment (2 months): LES and HAMD scores decreased significantly in both patient groups but remained higher than HC (P<0.05). Post-treatment LES scores remained CSD > Dep (P<0.05), while HAMD scores were similar between patient groups (P>0.05). Cortical thickness increased in CSD and Dep groups but did not reach HC levels (P<0.05), and the difference between CSD and Dep thickness was no longer significant (P>0.05). The CSD group experienced significantly faster time to relapse (mean 5.4 ± 2.3 months) compared to the Dep group (8.3 ± 2.5 months; t=4.656, P<0.001).
Chronic stress contributes to greater cortical thinning in depressed patients, particularly in specific frontal, temporal, parietal, and cingulate regions. Although treatment facilitates cortical thickness recovery alongside symptom improvement, individuals experiencing chronic stress relapse more quickly.
探讨慢性应激对抑郁症患者皮质厚度的影响。
我们招募了90名参与者（2023年1月至2024年10月）：30名未经治疗的伴有慢性应激的抑郁症患者（慢性应激抑郁症组；平均年龄39.1±9.8岁，基线汉密尔顿抑郁量表-17项评分为27.4±4.8），30名未经治疗的无慢性应激的抑郁症患者（抑郁症组；38.9±9.6岁，汉密尔顿抑郁量表评分为26.1±4.9），以及30名年龄/性别匹配的健康对照者（健康对照组；41.2±10.0岁）。使用生活事件量表（基于区域常模，生活事件量表得分>100）定义慢性应激。所有患者均接受马来酸氟伏沙明治疗。在治疗前和治疗后2个月评估生活事件量表得分、汉密尔顿抑郁量表-17项评分以及皮质厚度（通过磁共振成像）。对抑郁复发情况进行12 - 14个月（平均12.9±1.6个月）的监测。
基线时：生活事件量表得分慢性应激抑郁症组>抑郁症组>健康对照组（均P<0.05）；汉密尔顿抑郁量表得分慢性应激抑郁症组≈抑郁症组>健康对照组（P<0.05）。与健康对照组相比，两个患者组在左侧三角部、岛盖部、楔前叶、颞中回和扣带回，以及右侧额上回、楔前叶和额下回的基线皮质厚度均降低（P<0.05）。至关重要的是，在这些区域，慢性应激抑郁症组的皮质变薄程度显著大于抑郁症组（P<0.05）。治疗后（2个月）：两个患者组的生活事件量表和汉密尔顿抑郁量表得分均显著下降，但仍高于健康对照组（P<0.05）。治疗后生活事件量表得分慢性应激抑郁症组>抑郁症组（P<0.05），而患者组之间的汉密尔顿抑郁量表得分相似（P>0.05）。慢性应激抑郁症组和抑郁症组的皮质厚度均增加，但未达到健康对照组水平（P<0.05），且慢性应激抑郁症组和抑郁症组厚度之间的差异不再显著（P>0.05）。与抑郁症组（8.3±2.5个月；t = 4.656，P<0.001）相比，慢性应激抑郁症组的复发时间显著更快（平均5.4±2.3个月）。
慢性应激导致抑郁症患者的皮质变薄更明显，尤其是在特定的额叶、颞叶、顶叶和扣带回区域。尽管治疗有助于皮质厚度恢复以及症状改善，但经历慢性应激的个体复发更快。
