首发未治疗成年重性抑郁障碍患者大尺度静息态脑网络研究

Study on large-scale resting-state functional networks in first-episode untreated adult patients with major depressive disorder

目的探讨基于独立成分分析(independent component analysis,ICA)法的大尺度脑网络研究对首发未治疗成人重性抑郁障碍(major depressive disorder,MDD)患者静息态脑网络(resting state networks,RSNs)内及网络间功能连接变化的价值。方法 2019年1月至2021年6月选取MDD患者23例(MDD组)及性别、年龄及受教育年限相匹配的健康志愿者(healthy control,HC)30例(HC组),两组均进行静息态脑功能成像(resting state functional magnetic resonance imaging,rs-fMRI)检查,MDD组进行17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)评估。采用ICA法对rs-fMRI数据进行分析,获得有意义的RSNs。采用SPM-12、Gift软件比较MDD组与HC组RSNs内及网络间内在功能连接强度的差异,采用IBM SPSS statistic 25.0进行Pearson相关分析评价MDD组RSNs内及网络间功能连接强度与HAMD-17评分的相关性。结果与HC组相比,MDD组内侧前额叶皮质(medial prefrontal cortex,mPFC)(MNI:x,y,z=-6,54,25)内在功能连接强度显著增强;左侧角回(angular gyrus,AG)(MNI:x,y,z=-48,-66,21)、左侧楔前叶(precuneus,PCu)(MNI:x,y,z=-6,-63,33)、左侧背外侧前额叶皮质(dorsolateral prefrontal cortex,dlPFC)(MNI:x,y,z=-36,12,51)及右侧前脑岛(anterior insula,AI)(MNI:x,y,z=36,21,0)内在功能连接强度均显著减弱;MDD组后默认网络(posterior default mode network,pDMN)与前默认网络(anterior default mode network,aDMN)间功能连接强度较HC组显著减弱(t=-2.206,P=0.032),pDMN与左额顶网络(left frontal parietal network,lFPN)间功能连接强度较HC组显著增强(t=2.318,P=0.025)。MDD组mPFC内在功能连接强度、pDMN-lFPN间功能连接强度与HAMD-17评分均呈正相关(r=0.524,P=0.010;r=0.441,P=0.035)。结论基于ICA法的大尺度脑网络研究能够发现首发未治疗成人MDD患者RSNs内及网络间功能连接异常,有望为临床MDD的诊治提供客观的影像学标记。

Objective To investigate the value of large-scale brain network research based on independent component analysis(ICA)in discovering the changes of intrinsic functional connections within and between resting-state networks(RSNs)in first-episode untreated adult patients with major depressive disorder(MDD).Methods From January 2019 to June 2021,twenty-three patients with MDD(MDD group)and 30 healthy volunteers(HC group)matched with gender,age and years of education were selected.All participants underwent resting-state brain function imaging(rs-fMRI),and the MDD group completed the 17-item Hamilton depression scale(HAMD-17).The independent component analysis(ICA)method was used to analyze rs-fMRI data,and meaningful RSNs were obtained.SPM12 and Gift softwares were used to compare the strength of intrinsic functional connection within and between the RSNs of the MDD group and HC group,and the Pearson correlation analysis was conducted by IBM SPSS statistics 25.0 to evaluate the correlation between the functional connection strength and HAMD-17 scores in MDD group.Results Compared with the HC group,intrinsic functional connection strength of medial prefrontal cortex(mPFC)(MNI:x,y,z=-6,54,25)in MDD group was significantly enhanced,while the intrinsic functional connection strength of the left angular gyrus(AG)(MNI:x,y,z=-48,-66,21),the left precuneus(PCu)(MNI:x,y,z=-6,-63,33),the left dorsolateral prefrontal cortex(dlPFC)(MNI:x,y,z=-36,12,51)and the right anterior insula(AI)(MNI:x,y,z=36,21,0)were significantly weakened.Compared with the HC group,functional connection strength between posterior default mode net work(pDMN)and anterior default mode network(aDMN)in MDD group was significantly weakened(t=-2.206,P=0.032),and function connection strength between pDMN and left frontal parietal network(lFPN)was significantly strengthened(t=2.318,P=0.025).In MDD group,intrinsic functional connection strength of mPFC and the functional connection strength of pDMN-lFPN were positively correlated with the HAMD-17 score(r=0.524,P=0.010;r=0.441,P=0.035).Conclusion Large-scale brain network study based on the ICA can find abnormal functional connections within and between RSNs in first-episode untreated adult patients with MDD,and provide objective imaging markers for the clinical diagnosis and treatment of MDD.