重症抑郁障碍的结构性磁共振影像学研究进展

重症抑郁障碍（MDD）是一种以持续情感低落、思维迟缓、意志减退为主要临床特征的精神障碍,通常伴有认知功能障碍和躯体症状。     

卒中后抑郁的磁共振影像学研究进展

卒中后抑郁（post-stroke depression,PSD）是卒中的常见并发症。加强对PSD的识别,提高对PSD机制和诊断手段的理解,有助于提高对PSD的诊断和治疗水平。现就PSD磁共振影像学,包括磁共振波谱成像、磁共振扩散张量成像及静息态脑功能磁共振成像的研究进展予以综述。     

艾司西酞普兰治疗后抑郁症患者功能磁共振影像学改变的研究进展

本文目的是探讨抑郁症患者接受艾司西酞普兰治疗前后大脑功能磁共振激活改变.功能磁共振研究显示,治疗前,抑郁症患者前额叶、扣带回和纹状体等脑区的活动存在异常,前扣带回、背外侧前额叶、丘脑异常激活可预测艾司西酞普兰的疗效.经艾司西酞普兰治疗后,患者部分脑区恢复正常,且脑区激活的改变与症状的改善具有相关性.本文对抑郁症患者治疗...     

多发性硬化的磁共振成像诊断及研究进展

多发性硬化（MS）从首例病例报告至今已有近160年历史。然而其病因、病理学机制依然不明。目前,全世界有大批学者从事多发性硬化各方面的研究,仅多发性硬化年会就有4个（美国、欧洲、南美洲和亚洲-大洋洲年会）。     

多发性硬化的磁共振成像诊断及研究进展

多发性硬化(MS)从首例病例报告至今已有近160年历史。然而其病因、病理学机制依然不明。目前,全世界有大批学者从事多发性硬化各方面的研究,仅多发性硬化年会就有4个(美国、欧洲、南美洲和亚洲-大洋洲年会)。1981年,MRI首次应用于多发性硬化的检查,从此极大地帮助了对多发性硬化的理解,在诊断、病理学机制的探索、疗效判断、推测预后等方面发挥了巨大作用。目前公认,多发性硬化是中枢神经系统的一种炎性脱髓鞘     

脑神经相关疾病的磁共振成像研究进展

与脑神经有关的临床疾病所能采取的诊断方法十分有限,即使是电生理学检测,也很难作出形态学改变与组织学异常的明确诊断。因此,医学影像学在脑神经解剖和相关疾病的研究中始终占有重要位置。自MRI检查技术问世以来,有关脑神经解剖与相关疾病的研究不断见诸文献报道,但是由于大多数脑神经十分纤细,与邻近正常组织间的信号差异较小,使得MRI空间分辨力较低,因此其进展始终不能令人满意。     

脑神经相关疾病的磁共振成像研究进展

与脑神经有关的临床疾病所能采取的诊断方法十分有限,即使是电生理学检测,也很难作出形态学改变与组织学异常的明确诊断。因此,医学影像学在脑神经解剖和相关疾病的研究中始终占有重要位置。自MRI检查技术问世以来,有关脑神经解剖与相关疾病的研究不断见诸文献报道,但是由于大多数脑神经十分纤细,与邻近正常组织间的信号差异较小,使得MRI空间分辨力较低,因此其进     

青壮年重症抑郁障碍的磁化传递成像研究

目的探讨青壮年重症抑郁障碍患者磁化传递率(MTR)值的改变及其与病程的相关性。方法根据美国精神障碍诊断与统计手册,选择临床晤谈诊断明确并且17项汉密尔顿抑郁量表评分≥18分的30例重症抑郁障碍患者,以及按照年龄、性别、利手性、受教育程度相匹配原则征集的30例正常对照者。采用3.0T MRI扫描仪采集磁化传递成像数据,统计参数图软件对所得MTR参数图进行标准化和平滑等预处理,再行基于体素的分析。MTR值的组间比较行双样本t检验,与病程的相关性分析采用Pearson相关分析。结果在统计参数图中,以团簇水平P<0.05作为统计显著性阈值。与正常对照组相比,重症抑郁障碍组患者未发现MTR值差异有统计学意义的脑区;相关分析显示,其在左侧前额叶、顶叶、颞叶部分区域,以及双侧前扣带回等脑区与病程呈显著负相关。进一步亚组分析显示,长病程(>60周)重症抑郁障碍患者MTR值在左侧额中回、双侧中扣带回、右侧小脑前叶低于与之相匹配的正常对照者;而短病程(≤60周)患者,MTR值则在左侧额中回、颞枕交界区、双侧前扣带回及邻近白质较正常对照者升高。结论不同病程重症抑郁障碍患者脑MTR值呈现不同改变模式,提示对重症抑郁障碍患者长期纵向随访的必要性,尤其是长期抗抑郁治疗对脑结构及功能的影响应作为重点研究课题。     

青壮年重症抑郁障碍的磁化传递成像研究

目的探讨青壮年重症抑郁障碍患者磁化传递率（MTR）值的改变及其与病程的相关性。方法根据美国精神障碍诊断与统计手册,选择临床晤谈诊断明确并且17项汉密尔顿抑郁量表评分≥18分的30例重症抑郁障碍患者,以及按照年龄、性别、利手性、受教育程度相匹配原则征集的30例正常对照者。采用3．0TMRI扫描仪采集磁化传递成像数据,统计参数图软件对所得MTR参数图进行标准化和平滑等预处理,再行基于体素的分析。MTR值的组间比较行双样本t检验,与病程的相关性分析采用Pearson相关分析。结果在统计参数图中,以团簇水平P〈0．05作为统计显著性阈值。与正常对照组相比,重症抑郁障碍组患者未发现MTR值差异有统计学意义的脑区;相关分析显示,其在左侧前额叶、顶叶、颞叶部分区域,以及双侧前扣带回等脑区与病程呈显著负相关。进一步亚组分析显示,长病程（〉60周）重症抑郁障碍患者MTR值在左侧额中回、双侧中扣带回、右侧小脑前叶低于与之相匹配的正常对照者;而短病程（≤60周）患者,MTR值则在左侧额中回、颞枕交界区、双侧前扣带回及邻近白质较正常对照者升高。结论不同病程重症抑郁障碍患者脑MTR值呈现不同改变模式,提示对重症抑郁障碍患者长期纵向随访的必要性,尤其是长期抗抑郁治疗对脑结构及功能的影响应作为重点研究课题。     

成人注意缺陷多动障碍脑功能磁共振的研究进展

注意缺陷多动障碍（ADHD）是指一种以注意缺陷、多动、冲动的行为表现为主要特征的精神病理障碍。目前儿童 ADHD 有着广泛研究,但对成人 ADHD 患者的研究相对较少。现从成人ADHD的脑功能磁共振方面对国外有关文献进行研究分析,以更好地揭示成人ADHD患者的脑功能磁共振的改变,从而为以后的研究设计提供思路。     

Anatomical MRI study of basal ganglia in major depressive disorder

The basal ganglia form a part of the brain neuroanatomic circuits that may be involved in mood regulation. Decreases in basal ganglia volumes have been previously reported in major depressive disorder patients in comparison to healthy controls. In this study, we measured caudate, putamen, and globus pallidus volumes in 25 patients with major depressive disorder (4 M; age+/-S.D.=41+/-11 years) and 48 healthy controls (29 M; age+/-S.D.=35+/-10 years), using high-resolution magnetic resonance imaging (MRI), in an attempt to replicate prior findings. Unlike most previous studies, we did not find significant differences between patient and control groups in basal ganglia volumetric measures. Nonetheless, there was a significant interaction between diagnosis and cerebral hemisphere, with MDD patients showing decreased asymmetry in globus pallidus volumes in comparison with healthy controls. Furthermore, in the patient group, left putamen volumes correlated inversely with length of illness, and left globus pallidus volume correlated directly with number of prior depressive episodes. These findings suggest that abnormalities in lateralization and possibly neurodegenerative changes in basal ganglia structures participate in the pathophysiology of major depressive disorder.     

部分多模态MRI在重度抑郁症中的研究进展

重度抑郁症是最常见的高致残性的精神疾病之一,其发病机制尚不清楚。MRI技术作为非侵入性的神经影像技术,可揭示重度抑郁症患者大脑功能状态。与健康对照者相比,重度抑郁症患者额叶、颞叶、海马、扣带回、基底节、小脑等脑区功能改变,可能提示重度抑郁症的病理生理异常。现就多模态MRI,包括弥散张量成像(DTI)、弥散峰度成像(DKI)、磁共振波谱成像(MRS)、功能MRI(fMRI)、神经突方向分散度和密度成像(NODDI)在重度抑郁症中的最新研究成果进行综述,以期对其神经生物学机制有更充分的理解。     

Abnormalities in the structural covariance of emotion regulation networks in major depressive disorder

Major depressive disorder (MDD) is a common psychiatric disorder that is characterized by cognitive deficits and affective symptoms. To date, an increasing number of neuroimaging studies have focused on emotion regulation and have consistently shown that emotion dysregulation is one of the central features and underlying mechanisms of MDD. Although gray matter morphological abnormalities in regions within emotion regulation networks have been identified in MDD, the interactions and relationships between these gray matter structures remain largely unknown. Thus, in this study, we adopted a structural covariance method based on gray matter volume to investigate the brain morphological abnormalities within the emotion regulation networks in a large cohort of 65 MDD patients and 65 age- and gender-matched healthy controls. A permutation test with p < 0.05 was used to identify the significant changes in covariance connectivity strengths between MDD patients and healthy controls. The structural covariance analysis revealed an increased correlation strength of gray matter volume between the left angular gyrus and the left amygdala and between the right angular gyrus and the right amygdala, as well as a decreased correlation strength of the gray matter volume between the right angular gyrus and the posterior cingulate cortex in MDD. Our findings support the notion that emotion dysregulation is an underlying mechanism of MDD by revealing disrupted structural covariance patterns in the emotion regulation network.     

Diffusion tensor imaging brain structural clustering patterns in major depressive disorder

Using magnetic resonance diffusion tensor imaging data from 45 patients with major depressive disorder (MDD) and 41 healthy controls (HCs), network indices based on a 246‐region Brainnetcome Atlas were investigated in the two groups, and in the MDD subgroups that were subgrouped based on their duration of the disease. Correlation between the network indices and the duration of illness was also examined. Differences were observed between the MDD_S subgroup (short disease duration) and the HC group, but not between the MDD and HC groups. Compared with the HCs, the clustering coefficient (CC) values of MDD_S were higher in precentral gyrus, and caudal lingual gyrus; the CC of MDD_L subgroup (long disease duration) was higher in postcentral gyrus and dorsal granular insula in the right hemisphere. Network resilience analyses showed that the MDD_S group was higher than the HC group, representing relatively more randomized networks in the diseased brains. The correlation analyses showed that the caudal lingual gyrus in the right hemisphere and the rostral lingual gyrus in the left hemisphere were particularly correlated with disease duration. The analyses showed that duration of the illness appears to have an impact on the networking patterns. Networking abnormalities in MDD patients could be blurred or hidden by the heterogeneity of the MDD clinical subgroups. Brain plasticity may introduce a recovery effect to the abnormal network patterns seen in patients with a relative short term of the illness, as the abnormalities may disappear in MDD_L.     

Longitudinal MRI study of cortical thickness, perfusion, and metabolite levels in major depressive disorder

Järnum H, Eskildsen SF, Steffensen EG, Lundbye‐Christensen S, Simonsen CW, Thomsen IS, Fründ E‐T, Théberge J, Larsson E‐M. Longitudinal MRI study of cortical thickness, perfusion, and metabolite levels in major depressive disorder. Objective: To determine whether patients with major depressive disorder (MDD) display morphologic, functional, and metabolic brain abnormalities in limbic‐cortical regions at a baseline magnetic resonance (MR) scan and whether these changes are normalized in MDD patients in remission at a follow‐up scan. Method: A longitudinal 3.0‐Tesla (T) magnetic resonance imaging (MRI) study was carried out with cortical thickness measurements with a surface‐based approach, perfusion measurements with three‐dimensional (3D) pseudo‐continuous arterial spin labeling (pCASL), and spectroscopy (1H‐MRS) measurements in the anterior cingulate cortex (ACC) with water as an internal reference adjusted for cerebrospinal fluid content. We examined 23 MDD patients and 26 healthy controls. MDD patients underwent a baseline MRI at inclusion and were invited to a follow‐up scan when they were in remission or after a 6‐month follow‐up period. Results: Major findings were a significantly thinner posterior cingulate cortex in non‐remitters than in remitters, a significant decrease in perfusion in the frontal lobes and the ACC in non‐remitters compared with healthy controls at baseline and significantly reduced N‐acetylaspartate, myo‐inositol, and glutamate levels in MDD patients compared with healthy controls at baseline. Conclusion: Using novel MRI techniques, we have found abnormalities in cerebral regions related to cortical‐limbic pathways in MDD patients.     

Situational major depressive disorder

Fifty-seven patients with situational major depression diagnosed by the Research Diagnostic Criteria were compared with 72 subjects with nonsituational major depression on demographic, clinical, and psychosocial variables. The situational patients tended to be younger and had fewer prior episodes of depression and fewer hospitalizations. No differences were found in categories of life events, in overall clinical picture, in social supports, or in family history.     

Structural MRI correlates for vulnerability and resilience to major depressive disorder

Background

In major depressive disorder (MDD), it is unclear to what extent structural brain changes are associated with depressive episodes or represent part of the mechanism by which the risk for illness is mediated. The aim of this study was to investigate whether structural abnormalities are related to risk for the development of MDD.

Methods

We compared healthy controls with a positive family history for MDD (HC-FHP), healthy controls with no family history of any psychiatric disease (HC-FHN) and patients with MDD. Groups were age- and sex-matched. We analyzed data from high-resolution magnetic resonance imaging using voxel-based morphometry. We performed small volume corrections for our regions of interest (hippocampus, dorsolateral [DLPFC] and dorsomedial prefrontal cortex [DMPFC], anterior cingulate cortex [ACC] and basal ganglia) using a family-wise error correction (p < 0.05) to control for multiple comparisons.

Results

There were 30 participants in the HC-FHP group, 64 in the HC-FHN group and 33 patients with MDD. The HC-FHP group had smaller right hippocampal and DLPFC grey matter volumes compared with the HC-FHN group, and even smaller right hippocampal volumes compared with patients with MDD. In addition, the HC-FHP group exhibited smaller white matter volumes in the DLPFC and left putamen but also greater volumes in 2 areas of the DMPFC compared with the HC-FHN group. Patients with MDD exhibited smaller volumes in the ACC, DMPFC, DLPFC and the basal ganglia compared with healthy controls.

Limitations

The retrospective identification of family history might result in a bias toward unidentified participants in the control group at risk for MDD, diminishing the effect size.

Conclusion

Volume reductions in the hippocampus and DLPFC might be associated with a greater risk for MDD. The HC-FHP group had smaller hippocampal volumes compared with patients with MDD, which is suggestive for neuroplastic effects of treatment. The HC-FHP group had not yet experienced a depressive episode and therefore might have been resilient and might have had some protective strategies. Whether resilience is associated with the larger white matter volumes in the DMPFC (e.g., owing to compensatory, neuroplastic remodelling mechanisms) needs to be confirmed in future studies.     

A preliminary study of sleep-disordered breathing in major depressive disorder

BACKGROUND AND PURPOSE: Individuals with obstructive sleep-disordered breathing (OSDB) commonly report symptoms of depression; however, the percentage of individuals with major depressive disorder (MDD) who experience OSDB is less clear. This study aimed to examine OSDB in a sample of individuals with MDD, unselected for sleep-related complaints, along a continuum of ventilatory and hypoxic abnormalities. PATIENTS AND METHODS: The overnight sleep-related breathing of 19 individuals with MDD and 15 non-depressed controls was recorded using an unattended nasal pressure-based home sleep monitoring device. The device recorded nasal airflow, breathing effort, heart rate, oxygen saturation, and body position. RESULTS: The two groups varied significantly on three sleep-related breathing variables: major flow-limitation events, major flow-limitation events accompanied by a desaturation, and average saturation throughout the evening; and these groups approached significance on minor flow-limitation events accompanied by a desaturation and average number of desaturations throughout the evening. Sleep-related breathing variables predicted accurate grouping in 81.3% of those with MDD and 80.6% of the non-depressed participants. CONCLUSIONS: These results suggest that OSDB may play a more important role in MDD than previously recognized. OSDB may contribute to or exacerbate the condition of someone predisposed to MDD, and the treatment of OSDB may ameliorate or possibly prevent depressive symptoms.     

The relationship between depressive personality disorder and major depressive disorder: a population-based twin study

OBJECTIVE: One of the most important controversies regarding depressive personality disorder is the overlap with mood disorders. The aim of this study was to estimate the genetic and environmental sources of covariance between depressive personality disorder and major depressive disorder and to what extent genetic, shared, and unique environmental factors are specific to each disorder. METHOD: A total of 2,801 young adult twins from the Norwegian Institute of Public Health Twin Panel were assessed at personal interview for depressive personality disorder and major depressive disorder with the Structured Interview for DSM-IV Personality and the Composite International Diagnostic Interview. Bivariate Cholesky models were fitted to the data by using the Mx statistical program. RESULTS: In the best-fitting model, the covariation between depressive personality disorder and major depressive disorder were accounted for by genetic and unique environmental factors only. A model that did not include genetic factors specific to major depressive disorder was rejected. The authors found no clear evidence for gender differences in sources of comorbidity of depressive personality disorder and major depressive disorder. CONCLUSIONS: Although depressive personality disorder and major depressive disorder share a substantial proportion of genetic and environmental risk factors, the results from this study support the hypothesis that the two disorders are distinct entities with overlapping, but not identical, etiologies.