初发未治伴和不伴童年创伤抑郁患者mALFF信号与大五人格差异及其相互关系

目的 探索伴与不伴童年创伤抑郁症患者脑功能激活和人格特征的差异及其差异指标间关系。方法 采用匹配病例对照研究设计，通过年龄、性别、学历、抑郁严重程度等配对收集重庆医科大学附属第一医院精神科门诊初发未治的伴（观察组）与不伴童年创伤抑郁症患者（对照组）各25例，以两组患者静息态功能磁共振自发低频振幅（mALFF信号）及大五人格问卷为观察指标，比较两组患者各指标的差异及探索差异指标间的相关性。结果 1.两组患者在年龄、性别、学历、HAMD-24评分差异无统计学意义（P>0.05）；2.两组在大五人格分量表的外向性、开放性、宜人性、责任心之间差异无统计学意义（P>0.05），但观察组神经质得分较对照组高，差异有统计学意义（P<0.01）；3.观察组较对照组存在左侧海马/海马旁回脑区及右侧楔前叶脑区的mALFF信号值降低，差异有统计学意义（体素水平P<0.001，团块水平P<0.05的GRF校正）；4.两组患者神经质得分与左侧海马/左侧海马旁回脑区及右侧楔前叶mALFF信号值均存在负相关关系（r=-0.397，P<0.01；r=-0.401，P<0.01）。结论 伴童年创伤抑郁症患者较不伴童年创伤抑郁症患者有更明显的神经质人格特征，且神经质水平越高，左侧海马/海马旁回脑区、右侧楔前叶脑激活越低，提示其更易感知压力，但同时可能存在屏蔽日常过度回忆创伤经历的脑保护神经影像学机制。

Differences and relationship between mALFF signal and Big Five personality in first-episode untreated major depressive disorder patients with and without childhood trauma

Objective To explore the differences in activation of brain function and personality characteristics of major depressive disorder patients with and without childhood trauma and the relationship between the difference indicators. Methods A matched case-control study was designed to collect 25 cases of first-episode untreated major depressive disorder patients with childhood trauma (observation group) and 25 cases of first-episode untreated major depressive disorder patients without childhood trauma (control group) in the psychiatric outpatient department of the First Affiliated Hospital of Chongqing Medical University through age, gender, educational background and severity of depression. The spontaneous low frequency amplitude (mALFF signal) of resting-state fMRI and Big Five Personality Scale were used as observation indexes to compare the differences between the two groups and explore the correlation between the differences. Results 1. There was no significant difference in the scores of age, gender, education background and HAMD between the two groups (P > 0.05). 2. There was no significant difference in extraversion, openness, agreeableness and responsibility of Big Five Personality Scale (P > 0.05). The score of neuroticism in the observation group was higher than that in the control group (P < 0.01). 3. Compared with the control group, the activation of mALFF in the left hippocampus / parahippocampal gyrus, and right precuneus lobe was decreased in the observation group(GRF theory correction of voxel level P < 0.001 and cluster level P < 0.05). 4.There was a negative correlation between neuroticism score and mALFF signal in left hippocampus / left parahippocampal gyrus and right precuneus (r=-0.397, P<0.01; r=-0.401, P<0.01). Conclusion The major depressive disorder patients with childhood trauma had more obvious neuroticism personality than those major depressive disorder patients without childhood trauma. The higher the neuroticism level, the lower the activation of brain function in the left hippocampus / parahippocampal gyrus and the right precuneus. It is suggested that they are more likely to perceive stress, but there may be a neuroprotective neuroimaging mechanism to shield daily excessive memory of traumatic experience.