伴自杀未遂青少年抑郁障碍患者杏仁核静息态功能连接研究

The study on resting-state functional connectivity of the amygdala in adolescents with major depressive disorder accompanied by suicide attempt

目的采用静息态功能磁共振成像技术探讨伴自杀未遂青少年抑郁障碍(MDD)患者双侧杏仁核与全脑功能连接特征。方法对36例自杀未遂青少年MDD(sMDD组)、36例无自杀未遂青少年MDD患者(nsMDD组)及35例健康者(HC组)进行静息态功能磁共振(rs-fMRI)扫描。选取双侧杏仁核为种子点,计算其至全脑体素的时序相关性。分析三组间功能连接特征(rsFC)及其强度与临床量表间的相关性。结果三组间rsFC:左侧杏仁核-右侧颞中回;左侧杏仁核-右侧岛叶;右侧杏仁核-右侧额中回差异有统计学意义(P<0.05)。偏相关分析显示,在sMDD组中,右侧杏仁核-右侧额中回的rsFC强度与DERS评分呈负相关(r=-0.521,P=0.002)。结论青少年MDD患者杏仁核相关情绪调节回路的功能异常可能是青少年自杀行为的潜在神经机制。

Objective To explore the functional connection between bilateral amygdala and whole brain in adolescent depression patients with attempted suicide by resting-state functional magnetic resonance imaging(rs-fMRI).Methods A total of 36 major depressive disorder(MDD)adolescents with suicide attempt history(the sMDD group),36 MDD adolescents without suicide attempt history(the nsMDD group),and 35 healthy subjects(the HC group)were selected for rs-fMRI scan.We selected the bilateral amygdala as the seed point and calculated the temporal correlation between them and all the voxels in the whole brain.Finally,the Resting-state functional connectivity(rsFC)with significant differences among the three groups and the correlation between it and clinical scales were explored.Results The rsFC with statistically significant differences among the three groups:left amygdala-right middle temporal gyrus;left amygdala-right insula;right amygdala-right middle frontal gyrus(P<0.05).Partial correlation analysis showed that,in the sMDD group,the rsFC of the right amygdala-right middle frontal gyrus was significantly negatively correlated with DERS score(r=-0.521,P=0.002).Conclusion The abnormal function of the amygdala-related emotional regulation circuits in adolescent depression patients may be the potential neural mechanism of adolescent suicidal behavior.