抑郁症患者的脑功能连接改变存在性别差异:基于静息态功能磁共振成像

The changes of brain functional connectivity in patients with major depressive disorder have gender differences:based on resting-state functional MRI

目的利用静息态功能磁共振成像探讨不同性别抑郁症患者脑功能连接的改变。方法总共纳入抑郁症患者106例,另外招募匹配健康对照志愿者106例。采集所有受试者静息态功能磁共振成像的图像后,利用GRETNA软件对数据进行预处理及功能网络构建,然后计算网络属性,采用双样本t检验比较组间差异(Boferroni多重比较校正)。结果与对照组相比,实验组全局属性增加,女性全局属性局部效率(P=0.0003)、小世界(P=0.041)的差异有统计学意义,男性全局属性全局效率(P=0.0098)、局部效率(P=0.0098)的差异有统计学意义。女性抑郁症患者的左后扣带回、左腹侧前额皮层、左顶下回、左顶叶、左颞顶联合区的节点聚类系数低于男性(P<0.05),女性抑郁症患者的右颞下回、右腹内侧前额叶皮层、左背侧额叶皮层、右前岛叶、左腹侧额叶皮层、左/右中岛叶、左后岛叶、左顶叶的节点度值均低于男性(P<0.05),女性抑郁症患者的左后扣带回、右背外侧前额叶皮层、左腹侧前额叶皮层、左顶下回、左丘脑、左顶叶、左颞顶联合区、左枕叶的节点局部效率均低于男性(P<0.05)。结论女性抑郁症患者下降区域主要为情绪控制、视觉控制区域,男性抑郁症患者主要下降区域为压力控制、奖赏控制区域。这有可能成为性别差异的神经机制。

Objective To explore the changes in brain functional connectivity in patients with major depressive disorder of different genders by using resting-state functional magnetic resonance imaging.Methods A total of 106 patients with major depressive disorder were included,while 106 healthy control volunteers were recruited.After collecting resting fMRI images of all subjects,the data were preprocessed and functional network construction was constructed using GRETNA software.The network attributes were calculated,and the differences between groups were compared by two-sample t test(Boferroni multiple comparison correction).Results Compared with the control group,the global attributes of the experimental group increased,and there were statistical differences in the local efficiency of global attributes(P=0.0003)and small world(P=0.041)in women,and the global efficiency(P=0.0098)and local efficiency(P=0.0098)in men.The node clustering coefficients of the left posterior cingulate gyrus,left ventral prefrontal cortex,left parietal inferior gyrus,left parietal lobe,and left temporoparietal junction cortex in female patients with depression were significantly lower than those in men(P<0.05).The nodality values of the right inferior temporal gyrus,right ventral lateral pre frontal cortex,left dorsal frontal cortex,right anterior insulin,left ventral frontal cortex,left/right middle insulin,left posterior insulin,and left parietal lobe were lower than those of men(P<0.05).The local efficiency of the nodes of the left post cingulate,right dorsolateral prefrontal cortex,left ventral prefrontal cortex,left parietal gyrus,left parietal gyrus,left parietal region,left temporoparietal junction cortex,and left occipital lobe were lower in female depression than in men(P<0.05).Conclusion The decline area of female depressed patients is mainly the emotional control and visual control area.The main decline area of male depression patients is the pressure control and reward control area.This has the potential to be a neural mechanism for gender differences.