首发抑郁症伴自杀意念患者中缝核功能连接的改变

目的 观察首发抑郁症伴自杀意念（SI）患者中缝核功能连接（FC）改变。方法 前瞻性纳入98例首发抑郁症患者，根据伴SI与否将其分为伴SI组（n=56）与不伴SI组（n=42）；另以47名健康志愿者为对照组。以静息态功能MRI观察背侧中缝核（DRN）、中缝中央核（MRN）与全脑间的FC；比较3组及两两组间FC，分析伴SI组差异脑区FC与临床资料的相关性。结果 相比对照组，伴与不伴SI组DRN与左侧小脑及左侧壳核的FC均降低（P均<0.05），MRN与右侧颞下回的FC均升高而与左侧额下回、右侧枕上回、左侧顶下小叶及左侧壳核的FC均降低（P均<0.05）；其中，伴SI组DRN与左侧壳核的FC高于不伴SI组（P<0.05）；相比不伴SI组及对照组，伴SI组MRN与右侧中央后回的FC升高（P均<0.05）。伴SI组MRN与左侧壳核的FC与24项汉密尔顿抑郁量表（HAMD-24）体质量得分呈正相关（r_s=0.297，P=0.026）。结论 首发抑郁症伴SI患者中缝核与皮层和皮层下区的FC存在异常改变，且其MRN与左侧壳核的FC与HAMD-24体质量得分呈正相关。

Changes in functional connectivity of raphe nucleus in patients with first-episode depression complicated with suicidal ideation

Objective To observe the changes in functional connectivity (FC) of raphe nucleus in patients with first-episode depression complicated with suicidal ideation (SI). Methods Ninety-eight first-episode depression patients were prospectively enrolled and assigned into SI group (n=56) or non SI group (n=42) based on complicated with SI or not, while 47 healthy volunteers were recruited as control group. Resting-state functional MRI was performed. FC between dorsal raphe nucleus (DRN), median raphe nucleus (MRN) and the whole brain were analyzed and compared among 3 groups and between each 2 groups, and the correlations of FC of different brain regions with clinical data of SI group were explored. Results Compared with control group, FC between DRN and left cerebellum and left putamen in SI group and non SI group decreased (all P<0.05), between MRN and right inferior temporal gyrus increased but between MRN and left inferior frontal gyrus, right superior occipital gyrus, left inferior parietal lobule, left putamen decreased (all P<0.05). FC between DRN and left putamen in SI group was higher than that in non SI group (P<0.05). FC between MRN and right central posterior gyrus of SI group increased compared with that in the rest 2 groups (both P<0.05). FC between MRN and left putamen in SI group was positively correlated with body mass score of Hamilton depression scale-24 (HAMD-24)(r_s=0.297, P=0.026). Conclusion Abnormal changes of FC between raphe nucleus and cortex, also between raphe nucleus and subcortical area occurred, and FC between MRN and left putamen positively correlated with body mass score of HAMD-24 in patients with first-episode depression complicated with SI.