首次发病未服药成年抑郁症患者大脑皮质厚度变化的Meta分析

Cortical thickness abnormalities in drug-naive first-episode adult depression:a Meta-analysis

目的通过Meta分析探讨首次发病未服药抑郁症患者大脑灰质皮质厚度的变化特征。方法以"depression"或"depressive disorder"或"unipolar depression"以及"cortical thickness"或"thickness"为关键词,检索PubMed、Web of Science数据库自建库开始截至2023年7月23日发表的与抑郁症大脑皮质厚度变化有关的基于全脑皮质顶点分析的研究。采用标记差异映射分析(signed differential mapping,SDM)软件进行基于全脑体素的数据分析,通过Meta回归分析探讨疾病严重程度对抑郁症皮质厚度的影响,并检验异质性及评估发表偏倚。结果共纳入8项研究,包括417例首次发病未服药抑郁症患者和409名健康对照者。与健康对照者相比,首次发病未服药抑郁症患者在辅助运动区(Z=-2.471)和中央沟盖区(Z=-2.190)等多个脑区呈现皮质厚度降低(均P<0.0005)。进一步回归分析发现首次发病未服药抑郁症患者的疾病严重程度与辅助运动区(Z=2.265,P<0.0005)和右侧中央沟盖区(Z=1.560,P<0.0005)的皮质厚度变化呈正相关,平均疾病持续时间与右侧额下回岛盖部皮质厚度变化呈正相关(Z=1.922,P<0.0005),与右侧中扣带回的皮质厚度变化呈负相关(Z=-3.035,P<0.0005)。结论首次发病未服药抑郁症患者在疾病早期即出现辅助运动区以及岛盖区的皮质厚度降低,并且这种皮质变化与疾病严重程度和病程均有关。

ObjectiveThis meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder(DF-MDD).MethodsSystematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23,2023,by using the keywords("depression"OR"depressive disorder"OR"unipolar depression")AND("cortical thickness"OR"thickness").The SDM(signed differential mapping)software was used to perform whole-brain voxel-wise meta-analysis,heterogeneity test,and assess publication bias.Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression,and heterogeneity was tested,along with an assessment of publication bias.ResultsEight studies were ultimately included,encompassing 417 DF-MDD patients and 409 healthy controls.Compared to the healthy control group,DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions,including the supplementary motor area(Z=-2.471,P<0.0005)and the rolandic operculum(Z=-2.190,P<0.0005).Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area(Z=2.265,P<0.0005)and the rolandic operculum(Z=1.56,P<0.0005).Additionally,the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus(Z=1.922,P<0.0005),and negatively correlated with changes in the right midcingulate cortex(Z=-3.035,P<0.0005)in DF-MDD.ConclusionDF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease.And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.