抗抑郁治疗对重度抑郁症患者认知控制网络的影响  

Effects of Antidepressant Treatment on Cognitive Control Network in Patients with Major Depressive Disorder

作　　者：郑凯中[1] 李椋[1] 刘洋[1] 卢虹冰[1] 李宝娟[1] 

机构地区：[1]第四军医大学生物医学工程学院计算机应用教研室,陕西西安710032

出　　处：《华南国防医学杂志》2017年第4期229-235,共7页Military Medical Journal of South China

基　　金：国家自然科学基金项目(81301199)

摘　　要：目的结合静息态脑功能连接分析方法,探讨治疗前、后重度抑郁症(major depressive disorder,MDD)患者认知控制网络(cognitive control network,CCN)功能连接的变化。方法对27名MDD患者治疗前、后和27名相匹配的正常被试进行静息态功能磁共振成像(functional magnetic resonance imaging,fMRI)扫描。使用独立成分分析(independent component analysis,ICA)方法将fMRI图像序列中的每一幅图像分解成一系列相互独立的空间模式。以背外侧前额叶皮层(dorsolateral prefrontal cortex,DLPFC)、背侧前扣带皮层(dorsal anterior cingulate cortex,dACC)和后扣带皮层(posterior cingulate cortex,PCC)等脑区制作CCN模板,从分解出的所有独立成分中选择与该模板最匹配的CCN子网络。最后,使用双样本t检验方法研究抗抑郁治疗后CCN子网络功能连接的变化。结果根据ICA的分解结果,将CCN分为两个空间独立的子网络,且在静息状态下,这两个子网络的时间序列并不同步。治疗前MDD患者相比正常被试在两个子网络的额中回功能连接显著增加(P<0.001)。经过抗抑郁治疗后,抑郁症患者在额中回的功能连接都显著降低(P<0.001)。但恢复情况依然有差异,子网络1功能连接恢复正常,子网络2功能连接还略高于正常被试。结论经有效的抗抑郁治疗后,随着临床症状的改善,MDD患者CCN功能连接趋于正常。Objective To explore changes in functional cormeetivity of cognitive control network（CCN） in major depressive disorder （MDD） patients before and after antidepressant treatment, Methods Twenty-seven MDD patients were tested by resting-state functional magnetic resonance imaging（fMRI） before and after treatment, meanwhile, twenty-seven matehed healthy people were performed the same process. Independent component analysis（ICA） was performed to decompose the fMRI images into spatial independent components. The dorsolateral prefrontal cortex （DLPFC）, dorsal anterior eingulate cortex （dACC） and posterior eingulate cortex （PC.C） in the eneephalie region were created a CCN tem- plate, and the most matched independent components in it were selected as subnetworks of CCN. The changes of CCN subnetworks irffunetional eonneetivities after antidepressant treatment were performed to two-sample t-tests. Results Ac- cording to the decomposition results of ICA,CNN was divided into two spatial independent sub-networks, and the time se- ries in two sub-networks were synchronous in default-mode. Compared with healthy subjects , functional cormectivity of MDD group before treatment was significantly increased in the middle frontal gyrusin both two sub-networks（P〈0. 001）. The functional connectivity in CCN was remarkablly reduced in MDD patients after antidepressant treatment（P〈0. 001）. However, in one of the sub-network, abnormalities in functional connectivity of the CCN persisted in the post-treatment group. Recovery results were different. The functional connectivity in sub-network 1 returned to normal, and functional connectivity in sub-network 2 was higher than control group. Conclusion Altered functional connectivity of the CCN in patients with MDD was partially normalized after antidepressant treatment with the improvement of the symptoms. With the improvement of clinical symptom, CNN eonnectivities in MDD patients tend to be normal after effective antidepression treatment.

关 键 词：重度抑郁症 认知控制网络 独立成分分析 抗抑郁治疗 

分 类 号：R749[医药卫生—神经病学与精神病学]