忧郁型抑郁障碍患者脑区静息态局部一致性的改变

Research on altered regional homogeneity in the resting state of brain regions in melancholic depression

目的探讨忧郁型抑郁障碍(MD)患者脑区静息态局部一致性(ReHo)的改变特征。方法纳入2019年2月至2021年12月就诊于山西医科大学第一医院的26例忧郁型MD患者及同期招募的20名健康对照者为研究对象,行静息态功能磁共振扫描,比较两组ReHo差异。采用自制情感障碍观察表收集受试者一般资料,采用17项汉密尔顿抑郁量表(HAMD-17)评估MD组的抑郁情况。采用Pearson相关分析MD患者差异脑区ReHo值与HAMD-17评分的相关性。结果MD组左侧梭状回、壳核及枕中回/枕下回ReHo值低于对照组,差异有统计学意义(t=-6.392、-4.540、-5.786;P<0.05)。MD组右侧额上回及楔前叶、左侧额中回/中央前回ReHo值高于对照组,差异有统计学意义(t=4.796、5.185、5.111;P<0.05)。MD组左侧梭状回ReHo值与阻滞因子得分呈正相关(r=0.397,P<0.05),右侧楔前叶ReHo值与HAMD-17总分、阻滞因子得分及睡眠障碍因子得分呈负相关(r=-0.452、-0.446、-0.411;P<0.05)。进一步控制混杂因素行偏相关分析,MD患者左侧梭状回ReHo值与阻滞因子得分呈正相关(r=0.437,P<0.05),右侧楔前叶ReHo值与HAMD-17总分及睡眠障碍因子得分呈负相关(r=-0.568、-0.500;P<0.05)。结论MD患者多个脑区存在自发脑活动异常,涉及默认网络及奖赏环路,且与其抑郁严重程度、阻滞症状及睡眠障碍相关。

Objective To investigate the characteristics of regional homogeneity(ReHo)changes in the resting state of brain regions in melancholic depression.Methods A total of 26 patients with melancholic depression attending the First Hospital of Shanxi Medical University from February 2019 to December 2021,and 20 healthy controls were included.All the subjects underwent resting functional magnetic resonance imaging,and the ReHo differences between the two groups were compared.The general data of subjects were collected by self-made affective disorder observation form,and the depression status of MD group was evaluated by 17 item Hamilton Depression Scale(HAMD-17).Pearson correlation was used to analyze the correlation between ReHo value and HAMD-17 score in different brain regions of MD patients.Results The ReHo values of left fusiform gyrus,putamen and middle occipital gyrus/inferior occipital gyrus in MD group were significantly lower than those in the control group,and the differences were statistically significant(t=-6.392,-4.540,-5.786;P<0.05).The ReHo values of the right superior frontal gyrus,precuneus and left middle frontal gyrus/anterior central gyrus in MD group were significantly higher than those in the control group,and the differences were statistically significant(t=4.796,5.185,5.111;P<0.05).The decrease of ReHo value in left fusiform gyrus in MD group was positively correlated with block symptoms(r=0.397,P<0.05).The increase of ReHo value in the right precuneus was negatively correlated with HAMD-17 score,block symptoms and sleep disorders(r=-0.452,-0.446,-0.411;P<0.05).After further controlling the confounding factors,partial correlation analysis showed that the ReHo value of left fusiform gyrus was positively correlated with blocking symptoms(r=0.437,P<0.05),and the ReHo value of right precuneus was negatively correlated with HAMD-17 score and sleep disorder(r=-0.568,-0.500;P<0.05).Conclusions There are spontaneous brain activity abnormalities in multiple brain regions of MD patients,involving default network and reward circuit,which are related to the severity of depression,blocking symptoms and sleep disorders.