静息态功能MRI观察首发轻-中度抑郁症患者默认网络功能连接北大核心CSCD

目的采用静息态功能MRI(rs-fMRI)观察首发轻-中度抑郁症患者默认网络(DMN)功能特点,探讨功能连接异常脑区与临床表现等的相关性。方法采集24例首发轻-中度抑郁症患者(抑郁症组)和22名健康人(对照组)的颅脑rs-fMRI数据。以内侧前额叶皮质(mPFC)及后扣带回皮质(PCC)为种子点,行全脑功能连接分析。采用Pearson相关性分析评价抑郁症组差异脑区功能连接与17项汉密尔顿抑郁量表(HAMD-17)总评分及病程的相关性。结果相比对照组,抑郁症组mPFC与双侧小脑后叶、右侧前扣带回、右侧额下回眶部及左侧楔前叶功能连接减弱(K均>54,P均<0.05),与右侧额下回岛盖部功能连接增强(K>54,P<0.05);抑郁症组PCC与双侧额中回眶部、双侧壳核及左侧额上回背外侧功能连接减弱(K均>54,P均<0.05),与左侧颞中回、双侧角回及右侧楔前叶功能连接增强(K均>54,P均<0.05)。抑郁症患者mPFC与左侧楔前叶间功能连接减弱、PCC与左侧额中回眶部功能连接减弱均与病程呈负相关(r=-0.42、-0.46,P均<0.05);mPFC与右侧前扣带回功能连接减弱与病程呈正相关(r=0.49,P<0.05);功能连接异常脑区均与HAMD-17评分无显著相关(P均>0.05)。结论首发轻-中度抑郁症患者存在DMN内、外脑区功能连接异常,其中部分与病程相关。

Observation on default mode network functional connectivity in first-episode mild to moderate depression patients with resting-state functional MRI

Objective To observe the functional connectivity characteristics of default mode network (DMN) in first-episode mild to moderate depression patients with resting state functional MRI (rs-fMRI), and to explore the relationships of abnormal functional connectivity and clinical manifestations.Methods Cranial rs-fMRI data of 24 patients with first episode mild to moderate depression (depression group) and 22 healthy subjects (control group) were collected. Taken medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) as seed points, the whole brain functional connectivity analysis was performed. Pearson correlation analysis was used to evaluate the correlations of functional connectivity of different brain areas in depression group, the total score of the Hamilton depression scale 17 (HAMD-17) and the course of disease.Results Compared with control group, in depression group, functional connectivity of mPFC and bilateral posterior cerebellar lobes, right anterior cingulate gyrus, right orbital part of inferior frontal gyrus and left precuneus decreased (all K > 54, all P < 0.05), while the functional connectivity with right opercular part of inferior frontal gyrus increased (K > 54, P < 0.05).The functional connectivity of PCC and bilateral orbital part of middle frontal gyrus, bilateral putamen and left dorsolateral superior frontal gyrus reduced in depression group (all K > 54, all P < 0.05), and functional connectivity with the left middle temporal gyrus, bilateral angular gyrus and right precuneus increased (all K > 54, all P < 0.05). Decreased functional connectivity of mPFC and left precuneus, and decreased functional connectivity of PCC and left middle frontal gyrus were all negatively correlated with disease course (r=-0.42, -0.46, all P < 0.05). Decreased functional connectivity between mPFC and right anterior cingulate gyrus was positive correlated with disease course (r=0.49, P < 0.05). There was no significant correlation of the abnormal functional connectivity brain areas of the depression group and the HAMD-17 score (all P > 0.05).Conclusion Patients with first-episode mild to moderate depression had abnormal functional connectivity in the DMN and outside the DMN, some related to the course of this disease.