Hemispheric asymmetries and network dysfunctions in adolescent depression:A neuroimaging study using resting-state functional magnetic resonance imaging

BACKGROUND Currently,adolescent depression is one of the most significant public health concerns,markedly influencing emotional,cognitive,and social maturation.Despite advancements in distinguish the neurobiological substrates underlying depression,the intricate patterns of disrupted brain network connectivity in adolescents warrant further exploration.AIM To elucidate the neural correlates of adolescent depression by examining brain network connectivity using resting-state functional magnetic resonance imaging(rs-fMRI).METHODS The study cohort comprised 74 depressed adolescents and 59 healthy controls aged 12 to 17 years.Participants underwent rs-fMRI to evaluate functional connectivity within and across critical brain networks,including the visual,default mode network(DMN),dorsal attention,salience,somatomotor,and frontoparietal control networks.RESULTS Analyses revealed pronounced functional disparities within key neural circuits among adolescents with depression.The results demonstrated existence of hemispheric asymmetries characterized by enhanced activity in the left visual network,which contrasted the diminished activity in the right hemisphere.The DMN facilitated increased activity within the left prefrontal cortex and reduced engagement in the right hemisphere,implicating disrupted self-referential and emotional processing mechanisms.Additionally,an overactive right dorsal attention network and a hypoactive salience network were identified,underscoring significant abnormalities in attentional and emotional regulation in adolescent depression.CONCLUSION The findings from this study underscore distinct neural connectivity disruptions in adolescent depression,underscoring the critical role of specific neurobiological markers for precise early diagnosis of adolescent depression.The observed functional asymmetries and network-specific deviations elucidate the complex neurobiological architecture of adolescent depression,supporting the development of targeted therapeutic strategies.

Resting-state functional magnetic resonance imaging and support vector machines for the diagnosis of major depressive disorder in adolescents

BACKGROUND Research has found that the amygdala plays a significant role in underlying pathology of major depressive disorder(MDD).However,few studies have explored machine learning-assisted diagnostic biomarkers based on amygdala functional connectivity(FC).AIM To investigate the analysis of neuroimaging biomarkers as a streamlined approach for the diagnosis of MDD in adolescents.METHODS Forty-four adolescents diagnosed with MDD and 43 healthy controls were enrolled in the study.Using resting-state functional magnetic resonance imaging,the FC was compared between the adolescents with MDD and the healthy controls,with the bilateral amygdala serving as the seed point,followed by statistical analysis of the results.The support vector machine(SVM)method was then applied to classify functional connections in various brain regions and to evaluate the neurophysiological characteristics associated with MDD.RESULTS Compared to the controls and using the bilateral amygdala as the region of interest,patients with MDD showed significantly lower FC values in the left inferior temporal gyrus,bilateral calcarine,right lingual gyrus,and left superior occipital gyrus.However,there was an increase in the FC value in Vermis-10.The SVM analysis revealed that the reduction in the FC value in the right lingual gyrus could effectively differentiate patients with MDD from healthy controls,achieving a diagnostic accuracy of 83.91%,sensitivity of 79.55%,specificity of 88.37%,and an area under the curve of 67.65%.CONCLUSION The results showed that an abnormal FC value in the right lingual gyrus was effective as a neuroimaging biomarker to distinguish patients with MDD from healthy controls.

Vulnerable brain regions in adolescent major depressive disorder:A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

BACKGROUND Adolescent major depressive disorder(MDD)is a significant mental health concern that often leads to recurrent depression in adulthood.Resting-state functional magnetic resonance imaging(rs-fMRI)offers unique insights into the neural mechanisms underlying this condition.However,despite previous research,the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.AIM To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We performed a comprehensive literature search through July 12,2023,for studies investigating brain functional changes in adolescent MDD patients.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls(HCs)using ALE.RESULTS Ten studies(369 adolescent MDD patients and 313 HCs)were included.Combining the ReHo and ALFF/fALFF data,the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs(voxel size:648 mm3,P<0.05),and no brain region exhibited increased activity.Based on the ALFF data,we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients(voxel size:736 mm3,P<0.05),with no regions exhibiting increased activity.CONCLUSION Through ALE meta-analysis,we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients,increasing our understanding of the neuropathology of affected adolescents.

Abnormal brain activity in adolescents with Internet addiction who attempt suicide: an assessment using functional magnetic resonance imaging

Internet addiction is associated with an increased risk of suicidal behavior and can lead to brain dysfunction among adolescents.However,whether brain dysfunction occurs in adolescents with Internet addiction who attempt suicide remains unknown.This observational cross-sectional study enrolled 41 young Internet addicts,aged from 15 to 20 years,from the Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,China from January to May 2018.The participants included 21 individuals who attempted suicide and 20 individuals with Internet addiction without a suicidal attempt history.Brain images in the resting state were obtained by a 3.0 T magnetic resonance imaging scanner.The results showed that activity in the gyrus frontalis inferior of the right pars triangularis and the right pars opercularis was significantly increased in the suicidal attempt group compared with the non-suicidal attempt group.In the resting state,the prefrontal lobe of adolescents who had attempted suicide because of Internet addiction exhibited functional abnormalities,which may provide a new basis for studying suicide pathogenesis in Internet addicts.The study was authorized by the Ethics Committee of Chongqing Medical University,China(approval No.2017 Scientific Research Ethics(2017-157))on December 11,2017.

Functional magnetic resonance imaging of internet addiction in young adults

AIM: To report the results of functional magnetic resonance imaging(f MRI) studies pertaining internet addiction disorder(IAD) in young adults.METHODS: We conducted a systematic review on Pub Med, focusing our attention on f MRI studies involving adult IAD patients, free from any comorbid psychiatric condition. The following search words were used, both alone and in combination: f MRI, internet addiction, internet dependence, functional neuroimaging. The search was conducted on April 20^(th), 2015 and yielded 58 records. Inclusion criteria were the following: Articles written in English, patients' age ≥ 18 years, patients affected by IAD, studies providing f MRI results during resting state or cognitive/emotional paradigms. Structural MRI studies, functional imaging techniques other than f MRI, studies involving adolescents, patients with comorbid psychiatric, neurological or medical conditions were excluded. By reading titles and abstracts, we excluded 30 records. By reading the full texts of the 28 remaining articles, we identified 18 papers meeting our inclusion criteria and therefore included in the qualitative synthesis.RESULTS: We found 18 studies fulfilling our inclusion criteria, 17 of them conducted in Asia, and including a total number of 666 tested subjects. The included studies reported data acquired during resting state or different paradigms, such as cue-reactivity, guessing or cognitive control tasks. The enrolled patients were usually males(95.4%) and very young(21-25 years). The most represented IAD subtype, reported in more than 85% of patients, was the internet gaming disorder, or videogame addiction. In the resting state studies, the more relevant abnormalities were localized in the superior temporal gyrus, limbic, medial frontal and parietal regions. When analyzing the task related fmri studies, we found that less than half of the papers reported behavioral differences between patients and normal controls, but all of them found significant differences in cortical and subcortical brain regions involved in cognitive control and reward processing: Orbitofrontal cortex, insula, anterior and posterior cingulate cortex, temporal and parietal regions, brain stem and caudate nucleus.CONCLUSION: IAD may seriously affect young adults' brain functions. It needs to be studied more in depth to provide a clear diagnosis and an adequate treatment.

Brain functional changes in facial expression recognition in patients with major depressive disorder before and after antidepressant treatment A functional magnetic resonance imaging study

Functional magnetic resonance imaging was used during emotion recognition to identify changes in functional brain activation in 21 first-episode, treatment-naive major depressive disorder patients before and after antidepressant treatment. Following escitalopram oxalate treatment, patients exhibited decreased activation in bilateral precentral gyrus, bilateral middle frontal gyrus, left middle temporal gyrus, bilateral postcentral gyrus, left cingulate and right parahippocampal gyrus, and increased activation in right superior frontal gyrus, bilateral superior parietal Iobule and left occipital gyrus during sad facial expression recognition. After antidepressant treatment, patients also exhibited decreased activation in the bilateral middle frontal gyrus, bilateral cingulate and right parahippocampal gyrus, and increased activation in the right inferior frontal gyrus, left fusiform gyrus and right precuneus during happy facial expression recognition. Our experimental findings indicate that the limbic-cortical network might be a key target region for antidepressant treatment in major depressive disorder.

Differential aberrant connectivity of precuneus and anterior insula may underpin the diagnosis of schizophrenia and mood disorders

BACKGROUND Over the past decade,resting-state functional magnetic resonance imaging(rsfMRI)has concentrated on brain networks such as the default mode network(DMN),the salience network(SN),and the central executive network(CEN),allowing for a better understanding of cognitive deficits observed in mental disorders,as well as other characteristic psychopathological phenomena such as thought and behavior disorganization.AIM To investigate differential patterns of effective connectivity across distributed brain networks involved in schizophrenia(SCH)and mood disorders.METHODS The sample comprised 58 patients with either paranoid syndrome in the context of SCH(n=26)or depressive syndrome(Ds)(n=32),in the context of major depressive disorder or bipolar disorder.The methods used include rs-fMRI and subsequent dynamic causal modeling to determine the direction and strength of connections to and from various nodes in the DMN,SN and CEN.RESULTS A significant excitatory connection from the dorsal anterior cingulate cortex to the anterior insula(aI)was observed in the SCH patient group,whereas inhibitory connections from the precuneus to the ventrolateral prefrontal cortex and from the aI to the precuneus were observed in the Ds group.CONCLUSION The results delineate specific patterns associated with SCH and Ds and offer a better explanation of the underlying mechanisms of these disorders,and inform differential diagnosis and precise treatment targeting.

失眠障碍神经影像学特征及重复经颅磁刺激治疗效果

目的基于静息态功能MRI(rs-fMRI)观察失眠障碍(ID)患者脑功能改变,以及重复经颅磁刺激(rTMS)治疗效果。方法前瞻性纳入37例ID患者(ID组)及20名健康受试者(对照组),比较组间及ID组内rTMS治疗前后睡眠状况及心理状态量表评分;基于颅脑rs-fMRI观察组间低频振幅(ALFF)、局部一致性(ReHo)存在差异脑区,并对其与预设脑区进行体素水平静息态功能连接(FC)分析。结果治疗前ID组匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)、爱普沃斯嗜睡量表(ESS)评分、贝克忧郁量表(BDI)评分及贝克焦虑量表(BAI)评分均高于对照组(P均<0.05);ID组右侧正中扣带回和扣带旁回(Cingulum_Mid_R)ALFF值及ReHo均低于对照组(FWE校正P均<0.05),Cingulum_Mid_R与左侧前扣带回和扣带旁回(Cingulum_Ant_L)、左侧海马(Hippocampus_L)与右侧额中回(Frontal_Mid_R)间FC降低(FWE校正P均<0.05)。rTMS治疗后ID患者PSQI、ISI及ESS评分均较治疗前减低(P均<0.05),但上述神经影像学指标均无显著改变(FWE校正P均>0.05)。结论ID导致Cingulum_Mid_R ALFF值和ReHo同步减低,额叶-扣带回、额叶和边缘系统之间FC减弱。rTMS可改善ID患者睡眠及精神状态,但其对神经影像学的影响尚需进一步观察。

Increased regional homogeneity in internet addiction disorder： a resting state functional magnetic resonance imaging study

Background Internet addition disorder （lAD） is currently becoming a serious mental health problem among Chinese adolescents. The pathogenesis of lAD, however, remains unclear. The purpose of this study applied regional homogeneity （ReHo） method to analyze encephalic functional characteristic of lAD college students under resting state. Methods Functional magnetic resonanc image （fMRI） was performed in 19 lAD college students and 19 controls under resting state. ReHo method was used to analyze the differences between the average ReHo in two groups. Results The following increased ReHo brain regions were found in lAD group compared with control group： cerebellum, brainstem, right cingulate gyrus, bilateral parahippocampus, right frontal lobe （rectal gyrus, inferior frontal gyrus and middle frontal gyrus）, left superior frontal gyrus, left precuneus, right postcentral gyrus, right middle occipital gyrus, right inferior temporal gyrus, left superior temporal gyrus and middle temporal gyrus. The decreased ReHo brain regions were not found in the lAD group compared with the control group. Conclusions There are abnormalities in regional homogeneity in lAD college students compared with the controls and enhancement of synchronization in most encephalic regions can be found. The results reflect the functional change of brain in lAD college students. The connections between the enhancement of synchronization among cerebellum, brainstem, limbic lobe, frontal lobe and apical lobe may be relative to reward pathways.

Altered regional homogeneity in post-traumatic stress disorder: a resting-state functional magnetic resonance imaging study

Objective Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder （PTSD）. Comparison of the resting-state patterns of intrinsic functional synchronization, as measured by functional magnetic resonance imaging （fMRI）, between groups with and without PTSD following a traumatic event can help identify the neural mechanisms of the disorder and targets for intervention. Methods Fifty-four PTSD patients and 72 matched traumatized subjects who experienced the 2008 Sichuan earthquake were imaged with blood oxygen level-dependent （BOLD） fMRI and analyzed using the measure of regional homogeneity （ReHo） during the resting state. Results PTSD patients presented enhanced ReHo in the left inferior parietal lobule and right superior frontal gyrus, and reduced ReHo in the right middle temporal gyrus and lingual gyrus, relative to traumatized individuals without PTSD. Conclusion Our findings showed that abnormal brain activity exists under resting conditions in PTSD patients who had been exposed to a major earthquake. Alterations in the local functional connectivity of cortical regions are likely to contribute to the neural mechanisms underlying PTSD.

Task-related functional magnetic resonance imaging-based neuronavigation for the treatment of depression by individualized repetitive transcranial magnetic stimulation of the visual cortex

To determine whether repetitive transcranial magnetic stimulation(rTMS)of the visual cortex(VC)provides effective and welltolerated treatment and whether magnetic resonance imaging(MRI)measures functional change of the VC as a biomarker of therapeutic effect in major depressive disorder(MDD),we performed a sham-controlled,double-blind,randomized,three-arm VC rTMS treatment study in 74 MDD patients.Neuronavigated rTMS(10 Hz,90%of resting motor threshold,1,600 pulses over20 min twice per day)was performed over the VC for five days.Clinical outcome was measured by Hamilton Depression Rating Scale(HAMD-24)at days 0,1,3,5 and after terminating rTMS,with follow-up at four weeks.MRI was measured at days 0 and5.The individualized group exhibited the greatest change in HAMD-24 scores after VC rTMS for 5 days(F=5.53,P=0.005),which were maintained during follow-up period(F=4.22,P=0.016).All patients reported good tolerance.Changes in VC taskrelated functional MRI correlated with symptomatic reduction in the individualized group.Treatment reduced the initially abnormal increase in resting state functional connectivity from the VC to the pre/subgenual anterior cingulate cortex at day 5,especially in the individualized group.We demonstrated therapeutic potential and good tolerance of VC rTMS in MDD patients,indicated by biomarkers of f MRI measurement.

Functional neuroanatomy in panic disorder:Status quo of the research

AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.METHODS Panic disorder(PD) is a frequent psychiatric disease. Gorman et al(1989; 2000) proposed a comprehensive neuroanatomical model of PD, which suggested that fear-and anxiety-related responses are mediated by a so-called "fear network" which is centered in the amygdala and includes the hippocampus, thalamus, hypothalamus, periaqueductal gray region, locus coeruleus and other brainstem sites. We performed a systematic search by the electronic database PubMed. Thereby, the main focus was laid on recent neurofunctional, neurostructural, and neurochemical studies(from the period between January 2012 and April 2016). Within this frame, special attention was given to the emerging field of imaging genetics. RESULTS We noted that many neuroimaging studies have reinforced the role of the "fear network" regions in the pathophysiology of panic disorder. However, recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem, anterior and midcingulate cortex(ACC and MCC), insula, and lateral as well as medial parts of the prefrontal cortex. Interestingly, differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al(2000). Indeed, amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms, sample heterogeneity and size, as well as on limitations of neuroimaging techniques. Advanced neurochemical studies have substantiated the major role of serotonergic, noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD. However, alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable. A promising new research approach is "imaging genetics". Imaging genetic studies are designed to evaluate the impact of genetic variations(polymorphisms) on cerebral function in regions critical for PD. Most recently, imaging genetic studies have not only confirmed the importance of serotonergic and noradrenergic transmission in the etiology of PD but also indicated the significance of neuropeptide S receptor, CRH receptor, human TransM EMbrane protein(TMEM123D), and amiloride-sensitive cation channel 2(ACCN2) genes. CONCLUSION In light of these findings it is conceivable that in the near future this research will lead to the development of clinically useful tools like predictive biomarkers or novel treatment options.

Cerebral activation during unilateral clenching in patients with temporomandibular joint synovitis and biting pain： an functional magnetic resonance imaging study

Background Functional magnetic resonance is a non-invasive method that can examine brain activity and has been widely used in various fields including jaw movement and pain processing. Temporomandibular disorder （TMD） is one of the most frequent facial pain problems. The objective of this study was to investigate the brain activities using functional magnetic resonance imaging （fMRI） during unilateral maximal voluntary clenching tasks in the TMD synovitis patients with biting pain.Methods Fourteen TMD synovitis patients with unilateral biting pain and 14 controls were included in the study.Contralateral biting pain was defined as right molar clenching causing left temporomandibular joint （TMJ） pain. Ipsilateral biting pain was defined as right molar clenching causing right TMJ pain. Symptom Check List-90 （SCL-90） was administered to the patients and controls. Independent sample t-test was used to compare the SCL-90 subscales between the two groups. Unilateral clenching tasks were performed by the patients and controls. Imaging data were analyzed using SPM99.Results Patients were divided into contralateral TMD biting pain group （n=8） and ipsilateral TMD biting pain group （n=6）. The SCL-90 subscales were significantly different between the two groups for somatization, depression, anxiety,phobic anxiety, and paranoid ideation. Group analysis of the controls demonstrated brain activations in the inferior frontal gyrus, precentral gyrus, middle frontal gyrus, superior temporal gyrus, and insular. The areas of activation were different between right and left clenching task. In TMJ synovitis patients with contralateral or ipsilateral biting pain, the group analysis showed activations in the inferior frontal gyrus, superior temporal gyrus, medium frontal gyrus, precentral gyrus,and anterior cingulate cortex.Conclusions The inferior frontal gyrus and precentral gyrus play essential roles during the unilateral clenching task.Activation of anterior cingulate cortex in the synovitis patients with biting pain was associated with higher levels of psychological distress.

Sustained attention in psychosis:Neuroimaging findings

To provide a systematic review of scientific literatureon functional magnetic resonance imaging(fMRI) stud-ies on sustained attention in psychosis. We searchedPubMed to identify fMRI studies pertaining sustainedattention in both affective and non-affective psycho-sis. Only studies conducted on adult patients using asustained attention task during fMRI scanning wereincluded in the final review. The search was conductedon September 10 th, 2013. 15 fMRI studies met our in-clusion criteria: 12 studies were focused on Schizophre-nia and 3 on Bipolar Disorder Type Ⅰ(BDI). Only halfof the Schizophrenia studies and two of the BDI stud-ies reported behavioral abnormalities, but all of themevidenced significant functional differences in brain re-gions related to the sustained attention system. Alteredfunctioning of the insula was found in both Schizophre-nia and BDI, and therefore proposed as a candidate trait marker for psychosis in general. On the other hand, other brain regions were differently impaired in affective and non-affective psychosis: alterations of cingulate cortex and thalamus seemed to be more common in Schizophrenia and amygdala dysfunctions in BDI. Neural correlates of sustained attention seem to be of great interest in the study of psychosis, highlight-ing differences and similarities between Schizophrenia and BDI.

Meta-analysis of brain activation in depressive patients with emotional perception disorders

OBJECTIVE：To elucidate the distribution of abnormally activated brain regions in depressive patients during emotional perception processing using activation likelihood estimation,a quantitative meta-analytic technique.DATA SOURCES：Computer-based online retrieval was conducted using the PscyINFO,Pubmed and CNKI databases,searching literature from the establishment of each database until June 2010.STUDY SELECTION：Inclusion criteria：（1） studies examined emotion perception tasks using func-tional magnetic resonance imaging; （2） studies indicated regional brain activation abnormalities in depressive patients compared with controls in standard Talairach or MNI coordinates.Any analyzed coordinates based on the MNI system were converted to Talairach space with icbm2tal software.The map of activation likelihood estimation was finally created through the Gaussian smooth （full-width half-maximum=8 mm）,permutation test and corrected for multiple comparisons using the false discovery rate method （q=0.05） with Ginger-ALE 2.0 software.MAIN OUTCOME MEASURES：Activation of brain regions in patients.RESULTS：Seventeen studies were identified,involving a total of 261 patients,273 healthy controls and 201 foci.Meta-analysis revealed a dysfunctional emotion regulation loop in depressive patients,comprised of the prefrontal cortex,the basal ganglia and the limbic lobe,in which the amygdala was a key component.During emotion processing,the left prefrontal cortex and basal ganglia were hy-poactive among depressive patients,whereas the opposite change was found in the limbic lobe.CONCLUSION：Abnormal connections among the prefrontal cortex,basal ganglia and limbic lobe may be involved in the pathophysiology of depressive disorder.

Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.

An association study of protein tyrosine phosphatase receptor type R gene polymorphism and the resting-state functional magnetic resonance imaging in major depressive disorder

Objective To explore the influence of a polymorphism of protein tyrosine phosphatase receptor type R(PTPRR)gene rs1513105 on abnormal brain activities in resting-state patients with major depressive disorder(MDD)using the gene-imaging technology.Methods 54MDD and 43 gender-,age-,and education-matched con-

网络游戏成瘾患者脑功能异常静息态功能磁共振成像研究

目的采用局部一致性(regional homogeneity,ReHo)和功能连接(functional connectivity,FC)相结合的方法探究网络游戏成瘾(Internet gaming disorder,IGD)患者静息状态下的脑局部固有连接的改变。材料与方法对44例IGD患者和49例年龄、性别、受教育年限相匹配的健康对照者进行静息态功能磁共振成像(resting state-functional magnetic resonance imaging,rs-fMRI)检查。计算并比较两组的ReHo值,以检测IGD患者脑内局部连接的改变;以ReHo值异常的脑区进行功能连接,以得到不同脑区间连接性的改变。采用网络成瘾测试(Internet Addiction Test,IAT)评估IGD的严重程度。Pearson相关分析用于评估具有ReHo改变的脑区域与IAT评分之间的关系。结果IGD组双侧内侧额上回、双侧背外侧额上回、左侧辅助运动区、右侧额中回ReHo增加;左侧枕下回、左侧枕中回、左侧舌回、左侧距状裂周围皮层、左侧梭状回、左侧颞上回以及左侧小脑ReHo值减低(体素水平P<0.005,团块水平P<0.05,高斯随机场校正)。IGD组右侧背外侧额上回与右侧额上回、双侧辅助运动区、右侧中央前回的功能连接性增加(体素水平P<0.005,团块水平P<0.05,高斯随机场校正)。此外,左侧距状裂周围皮层ReHo值与IAT评分呈负相关(r=-0.340,P=0.024)。结论在前额叶皮层、颞枕叶皮层局部连接发生改变,可能表明IGD的认知控制和奖励处理以及视觉、听觉网络已受到影响。此外,左侧距状裂周围皮层ReHo值与IAT评分呈负相关,可能为IGD的神经病理机制提供新的认识。

原发性失眠患者奖赏网络关键核团在静息态fMRI功能连接的改变

目的:利用功能性磁共振成像(fMRI)技术观察原发性患者奖赏网络区域中脑腹侧被盖(Ventral ttegmental area,VTA)以及伏隔核(Nucleus accumbens,NAcc)脑功能连接的改变。方法:28例原发性失眠比较26例健康对照组脑功能成像的改变,并分析中脑腹侧被盖以及伏隔核功能连接的改变与失眠的情绪障碍障碍之间的关系。结果:比较原发性失眠患者对比健康对照组,VTA与NAcc全脑的功能连接均降低,与VTA-l功能连接增降低的脑区为双侧前扣带回、左侧眶额回,与VTA-r功能连接增降低的脑区为双侧前扣带回、左侧眶额回、右侧中央前回,与NAcc-l功能连接降低的脑区为双侧丘脑、辅助运动区,与NAcc-r功能连接降低的脑区为双侧丘脑、小脑。结论:睡眠障碍会显著降低奖赏网络中VTA与NAcc的功能连接,说明长期睡眠障碍可能影响在原发性失眠患者奖赏处理能力,导致失眠患者情感功能发生障碍。

伴自杀意念首发抑郁症患者小脑-大脑功能连接的fMRI研究

目的:基于静息态fMRI探讨伴自杀意念的首发抑郁症患者小脑-大脑功能连接(FC)的改变。方法:前瞻性将2018年2月-2022年1月在本院就诊的58例伴自杀意念(SI组)和42例不伴自杀意念的抑郁症患者(NSI组)以及49例相匹配的健康志愿者(HC组)纳入本研究,对所有被试行静息态fMRI扫描。分别在双侧小脑的Crus-Ⅰ、-Ⅱ、-Ⅴ、-Ⅵ和蚓部勾画ROI,采用基于种子点的FC分析方法计算抑郁症患者小脑各ROI与大脑的FC值。对所有抑郁症患者进行抑郁相关的临床量表评估,包括24项汉密尔顿抑郁量表(HAMD24)和Beck自杀意念量表中文版(BSI-CV),HAMD24评分包括HAMD24总分及焦虑/躯体化、体质量、认知障碍、日夜变化、阻滞、睡眠障碍和绝望感共7项因子的评分;BSI-CV评分包括自杀意念因子和自杀危险因子两项评分。采用Pearson或Spearman相关分析对组间差异有统计学意义的小脑-大脑FC值(SI组、NSI组和HC组两两比较)与临床变量(病程、HAMD24评分和BSI-CV评分)进行相关性分析。结果:与HC组相比,SI组和NSI组的小脑与颞上回、中央前回、中央钩盖、中央旁小叶的FC值升高,小脑与额中回、颞叶、角回和后扣带回的FC值降低;与NSI组相比,SI组的小脑与颞中回和颞下回的FC值升高,与右侧角回的FC值降低。右侧小脑Crus-Ⅰ与大脑间的FC值与HAMD24总分及阻滞、体质量、日夜变化和认知障碍四项因子的评分均呈负相关(r=-0.308、-0.315、-0.273、-0.311、-0.263,P均<0.05);左侧小脑Crus-Ⅰ与额中回和后扣带回的FC值与体质量因子评分之间均呈负相关(r=-0.295、-0.289,P均<0.05),左侧小脑Crus-Ⅰ与颞上回的FC值与自杀危险因子评分呈负相关(r=-0.277,P<0.05),左侧小脑Crus-Ⅰ与中央钩盖的FC值与体质量因子评分呈正相关(r=0.278,P<0.05);左侧小脑Crus-Ⅰ与中央旁小叶的FC值与睡眠障碍因子评分呈正相关(r=0.382,P<0.05)。结论:静息态fMRI证实伴自杀意念的抑郁症患者的小脑与大脑之间的功能连接出现了紊乱,主要发生于执行网络和默认模式网络,从而为伴自杀意念抑郁症患者发病机制的研究提供了新思路。