5年随访未转相的抑郁症患者基线脑低频振幅及功能连接特征研究

Baseline characteristics of amplitude of low-frequency fluctuation and functional connectivity in major depressive disorder patients without converting to bipolar disorder during 5-year follow-up

目的:探讨5年随访未转相的抑郁症患者基线脑低频振幅及功能连接特征。方法:35例抑郁症患者(抑郁组)和27名性别、年龄和受教育年限相匹配的健康对照者(对照组)进行3.0 T静息态功能磁共振扫描,比较两组脑区低频振幅(ALFF)值,将有统计学差异的脑区对全脑进行功能连接(FC)分析。结果:与对照组相比,抑郁组左后扣带回和左丘脑ALFF值降低,左后扣带回和左额中回、左丘脑和左额眶回间FC增强,左后扣带回和左舌回、左丘脑和左小脑脚间FC减弱(P<0.05,Alphasim矫正)。左后扣带回和左额中回FC值与17项汉密尔顿抑郁量表(HAMD-17)总分正相关(r=0.351,P=0.038)。结论:5年随访未转相的抑郁症患者基线期存在边缘局部脑区异常,同时与全脑FC存在异常,可能是抑郁症发病的重要因素之一。

Objective: To investigate baseline characteristics of amplitude of low-frequency fluctuation(ALFF) and functional connectivity(FC) in major depressive disorder(MDD) patients without converting to bipolar disorder during 5-year follow-up. Method:35 MDD patients(MDD group) and 27 sex-, age-, and education-matched healthy controls(HC group) were scanned with 3.0 T resting-state functional magnetic resonance imaging(rs-fMRI).The ALFF values of brain areas were compared between the two groups.The FC between statistical ALFF aberrant brain areas and whole brain was analyzed. Results:Compared to HC group,the MDD group showed lower ALFF values in the left posterior cingulate gyrus(PCC) and the left thalamus.Seed-based FC increased between left PCC and left middle frontal gyrus(MFC),left thalamus and left orbital frontal gyrus,and decreased between left PCC and left lingual gyrus,left thalamus and left cerebellar peduncle(P<0.05,Alphasim corrected).FC value between the left PCC and the left MFC was positively correlated with the total score of Hamilton Depression Scale(HAMD-17)(r=0.351,P=0.038). Conclusion:MDD patients without converting to bipolar disorder during 5-year follow-up have dysfunction in limbic area and abnormal FC with whole brain,which may be one of the important factors in the pathogenesis of MDD.