重性抑郁障碍患者药物治疗反应相关自发性神经活动改变的Meta分析

Spontaneous neural activity differences associated with antidepressant response in patients with major depressive disorder:a Meta-analysis

目的探索重性抑郁障碍(MDD)患者与药物治疗反应相关的自发性神经活动改变,寻找与治疗反应相关的影像学指标。方法计算机检索中国知网数据库、万方数据库、维普数据库、PubMed、Embase和Web of Science数据库,收集与MDD患者治疗反应相关的静息态脑功能影像研究,使用AES-SDM进行Meta分析。结果共8篇文章纳入Meta分析,包括288例患者和304例健康对照组。Meta分析结果显示,与健康对照组相比,治疗有效的MDD患者左侧小脑(峰值坐标:X=-22,Y=-78,Z=-18,SDM-Z=1.458)、左侧颞叶(峰值坐标:X=-50,Y=-30,Z=-8,SDM-Z=1.539)及右侧角回(峰值坐标:X=48,Y=-66,Z=36,SDM-Z=1.536)的脑功能活动增加,左侧辅助运动区(峰值坐标:X=-10,Y=-2,Z=72,SDM-Z=-1.107)脑功能活动降低;治疗无效的MDD患者双侧额上回、前扣带回(峰值坐标:X=12,Y=42,Z=-4,SDM-Z=1.526)脑功能活动增加,左侧额下回(峰值坐标:X=-48,Y=16,Z=6,SDM-Z=-1.912)脑功能活动降低。结论小脑半球自发性神经活动的改变可能成为预测MDD患者治疗反应的影像学指标。

Objective To explore the spontaneous neural activity differences associated with antidepressant response in patients with major depressive disorder(MDD),and to search for imaging indicators related to the treatment response of MDD.Methods Researches related to the resting-state fMRI of MDD published in Chinese databases(CNKI,Wanfang,VIP)and English databases(PubMed,Embase and Web of Science)were retrieved,and Meta-analysis was performed using AES-SDM.Results A total of 288 patients and 304 healthy controls in 8 literatures were enrolled in this study.Meta-analysis showed that functional activity in the left cerebellum(peak coordinates:X=-22,Y=-78,Z=-18,SDM-Z=1.458),left temporal lobe(peak coordinates:X=-50,Y=-30,Z=-8,SDM-Z=1.539)and right angular gyrus(peak coordinates:X=48,Y=-66,Z=36,SDM-Z=1.536)of MDD patients with effective treatment was increased,while functional activity in the left auxiliary motor area(peak coordinates:X=-10,Y=-2,Z=72,SDM-Z=-1.107)was decreased.In MDD patients with no response to treatment,bilateral superior frontal gyrus and anterior cingulate gyrus(peak coordinates:X=12,Y=42,Z=-4,SDM-Z=1.526)showed increased brain functional activity,while the left inferior frontal gyrus(peak coordinates:X=-48,Y=16,Z=6,SDM-Z=-1.912)showed decreased brain functional activity.Conclusion The change of spontaneous neural activity in cerebellum can be used to predict the treatment response of MDD patients.