首发抑郁障碍患者及其一级亲属扣带回-楔前叶功能连接的研究

Functional connectivity between the cingulate and precuneus in first-episode depressive disorders and their first-degree relatives

目的 探讨首发抑郁障碍患者及其一级亲属扣带回-楔前叶功能连接的异常.方法 收集2016年6月—2018年2月就诊于山西医科大学第一医院的人口学资料相匹配的23例首发未用药抑郁障碍患者,17名未患病抑郁障碍一级亲属及28名无家族史的健康人群,进行静息态功能磁共振扫描;使用HAMD-24评估患者病情严重程度.结果 3组受试者扣带回与左右楔前叶均存在功能连接差异;与健康对照相比,一级亲属在左侧楔前叶功能连接增加,患者组左右侧楔前叶功能连接均增加;与一级亲属组相比,患者组在右侧楔前叶功能连接显著增加.偏相关分析发现患者扣带回-楔前叶功能连接与病情严重程度呈正相关（r=0.493,P=0.027）.结论 抑郁障碍的发病与扣带回-楔前叶功能连接增加有关,与疾病的严重程度相关,其中扣带回-左侧楔前叶功能连接异常是可能的遗传病理机制.

Objective To investigate the abnormality of the cingulate-precuneus functional connection in the first-episode depressive disorder patients and their first-degree relatives. Methods From June 2016 to February 2018, 23 patients with first-episode untreated depressive disorder, 17 first-degree relatives without depressive disorder and 28 healthy people without family history were examined by resting-state functional magnetic resonance imaging （fMRI）. HAMD-24 was used to assess the severity of the illness. Results There were differences in functional connectivity between the cingulate gyrus and the left and fight preeuneus among the three groups of subjects. Compared with healthy controls, the functional connectivity of the left anterior euneal lobe was increased in the first-degree relatives, and the functional connectivity of the left and right anterior cuneal lobe was increased in the patient group. Compared with the first-degree relatives group, the functional connectivity increased significantly in the right precuneus in the patient group. Partial correlation analysis revealed that the cingulate-precuneus functional connection was positively related to the severity of the depressive disorder （r=0.493, P=0.027）. Conclusions The onset of the depressive disorder is related to the increase of functional connectivity between the cingulum and the precuneus, which is related to the severity of the disease. The cingulate-left precuneus functional connectivity may be a possible genetic pathological mechanism.