首发未治疗青少年抑郁障碍患者静息状态下杏仁核功能连接异常改变及意义  

Dysfunctional resting-state functional connectivitiy of amygdala in medication-navie first-episode adolescent patients with major depressive disorder

作　　者：李飞燕 李淑英[1] 吕培培[1] 王源莉[1] 朱妍[1] 潘红庆 高鑫[1] LI Feiyan;LI Shuying;LYU Peipei;WANG Yuanli;ZHU Yan;PAN Hongqing;GAO Xin(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院,郑州450052

出　　处：《山东医药》2018年第42期20-23,共4页Shandong Medical Journal

基　　金：河南省卫计委重点项目(201502006);河南省科技厅重点攻关项目(152102310046);河南省科技厅医学攻关项目(201403061)

摘　　要：目的观察首发未治疗青少年抑郁障碍(MDD)患者静息状态下杏仁核功能连接的异常改变,并探讨其意义。方法选取首发未治疗青少年MDD患者50例(MMD组)及年龄、性别、受教育年限与之匹配的健康青少年29例(对照组),采用静息状态功能磁共振技术进行头部扫描。以左右侧杏仁核为感兴趣区,分析其与全脑脑区功能连接改变是否存在差异及功能连接改变是否与MDD病程、病情有关。结果 MDD组左侧杏仁核与左侧额叶、右侧颞叶、双侧枕回、左侧顶叶、左侧楔前叶的功能连接较对照组增强(P均<0. 05),和左侧顶叶功能连接增强与病程呈正相关(r=0. 32,P <0. 05),和右侧颞叶功能连接增强与HAMD-17评分呈负相关(r=-0. 29,P <0. 05)。MDD组右侧杏仁核与双侧枕回、左侧额前回、左侧额中回、右侧中央前回及左侧旁叶的功能连接较对照组增强(P均<0. 05),和左侧枕回功能连接增强与HAMD-17评分呈负相关(r=-0. 30,P <0. 05)。结论首发未治疗青少年MDD患者杏仁核功能连接存在异常,且和部分脑区功能连接改变与病程、病情有关;杏仁核功能连接异常可能是MDD的发病机制之一。Objective To investigate resting-state functional connectivity(FC)of amygdala in drug-naive first-episode adolescent patients with major depressive disorder(MDD).Methods We enrolled fifty first-episode and drug-naive adolescent MDD patients(MDD group)and twenty-nine age-,sex-and education-matched adolescent healthy controls(HC group).The resting-state functional magnetic resonance imaging(fMRI)was performed.We selected bilateral amygdala as regions of interests(ROI).The differences of these regions from the whole brain functional connectivity were analyzed,meanwhile,whether the functional connection change was related to the MDD course and condition was also analyzed.Results Compared with the HC group,the patients in the MDD group had enhanced FCs between the left amygdala and left frontal cortices,right temporal cortices,bilateral occipital gyrus,left parietal cortices,and left precuneus cortices(all P<0.05).The MDD patients had enhanced FCs between the right amygdala and bilateral occipital gyrus,left anterior frontal gyrus,left middle frontal gyrus,right precentral gyrus,and left parietal cortices.In addition,the increased FC between left amygdala and left parietal cortices of the MDD group was positively correlated with the duration of depression since onset(r=0.32,P<0.05),the increased FC between left amygdala and right temporal cortices was negatively correlated with Hamihon Rating Scale for Depression(HAMD)-17 scores(r=-0.29,P<0.05).The increased FC between right amygdala and left occipital gyrus was negatively correlated with HAMD-17 scores(r=-0.30,P<0.05).Conclusion The FC of amygdala is abnormal in the adolescent MDD patients,which is related to the duration of disease and the severity of clinical symptoms,and the amygdala dysfunction is one of the pathogenesis of MDD.

关 键 词：青少年抑郁障碍 静息状态功能磁共振 杏仁核 功能连接 病程 HAMD-17评分 

分 类 号：R749.94[医药卫生—神经病学与精神病学]