盲人焦虑抑郁状态与脑结构重塑的相关性研究

The correlation between anxiety and depression states and brain structural plasticity in blind people

目的探究盲人群体焦虑抑郁状态与大脑结构重塑模式之间的关系,揭示盲人焦虑抑郁的潜在神经生物学机制。方法前瞻性招募46例全盲被试(盲人组)以及41例视力正常的健康志愿者(HC组)。采用贝克抑郁量表和状态-特质焦虑量表评估被试的抑郁和焦虑状态。所有被试均行扩散张量成像(DTI)和三维T1加权结构MRI检查,计算脑白质各向异性分数(FA)及全脑灰质体积(GMV)。采用Mann-WhitneyU检验比较2组间焦虑/抑郁量表评分的差异,采用体素水平的独立样本t检验比较2组间FA值和GMV,差异有统计学意义的脑区为重塑脑区。使用Spearman相关评估盲人焦虑/抑郁评分与重塑脑区FA值和GMV的相关性。结果盲人组抑郁评分高于HC组,特质焦虑评分低于HC组(均P<0.05,FDR校正)。2组状态焦虑评分差异无统计学意义(P>0.05)。与HC组相比,盲人组的胼胝体大钳、双侧额枕下束、双侧下纵束的FA值均减低,双侧距状裂周围皮质的GMV显著减低(均P<0.05,团块水平FDR校正)。Spearman相关分析显示,胼胝体大钳、双侧额枕下束和右侧下纵束的FA值均与特质焦虑评分呈正相关(均P<0.05);双侧距状裂周围皮质GMV与特质焦虑评分呈正相关(均P<0.05),与抑郁评分呈负相关(P<0.05)。结论与健康人群相比,盲人群体更易罹患抑郁且特质焦虑评分更低。盲人群体的抑郁焦虑特征与枕叶灰白质的结构重塑密切相关。

Objective To investigate the association between anxiety and depressive states and brain structural plasticity in blind people,and to reveal the potential neurobiological mechanisms of anxiety and depression in blind individuals.Methods Forty-six completely blind subjects(blind group)and 41 healthy volunteers(HC group)with normal vision were prospectively recruited.Subjects’depressive and anxiety states were assessed using the Beck Depression Inventory and the State-Trait Anxiety Inventory,respectively.Diffusion tensor imaging was used to calculate the fractional anisotropy(FA)of the white matter.Gray matter volume(GMV)was calculated using 3D T1-weighted structural magnetic resonance imaging.The Mann-Whitney U test was used to compare the differences in anxiety and depression scores,and the independent samples t test based on voxel level was performed to compare the FA and GMV values between the two groups,as well as the brain regions with statistically significant differences were considered the remodeling regions.Correlations between anxiety and depressive states and FA/GMV were assessed using Spearman’s correlation.Results Compared to the HC group,the blind group had significantly higher depression and lower trait anxiety scores(all P<0.05,FDR correction).There were no significant differences in state anxiety scores between the two groups(P>0.05).Compared to the HC group,the blind group had significantly lower FA in corpus callosum forceps major,bilateral inferior fronto-occipital fasciculus,inferior longitudinal fasciculus,as well as GMV in the bilateral calcarine fissure and surrounding cortex(all P<0.05,cluster-wise FDR correction).Spearman’s correlation proved that trait anxiety score was positively correlated with the forceps major,bilateral inferior fronto-occipital fasciculus,and right inferior longitudinal fasciculus(all P<0.05).The GMV of bilateral calcarine fissure and surrounding cortex was positively correlated with trait anxiety score(all P<0.05),and negatively correlated with depression score(P<0.05).Conclusion Blind people are more likely to suffer from depression and have lower trait anxiety score.Their depressive and anxious traits are strongly associated with the structural plasticity of the occipital lobe.