膝下前扣带回与背外侧前额叶的功能连接提示抗抑郁早期疗效  

Predictability of early antidepressant treatment outcome based on the functional connectivity between subgenual anterior cingulate and the dorsolateral prefrontal cortex

作　　者：王强[1] 田水 汤浩[3] 阎锐[3] 史家波[3] 陈瑜[3] 卢青[2] 姚志剑[1,3] WANG Qiang;TIAN Shui;TANG Hao;YAN Rui;SHI Jia-bo;CHEN Yu;LU Qing;YAO Zhi-jian(Medical School of Nanjing University,Nanjing210093,China)

机构地区：[1]南京大学医学院,210093 [2]东南大学生物科学与医学工程学院 [3]南京医科大学附属脑科医院心境障碍科(江苏省抑郁症诊疗中心)

出　　处：《临床精神医学杂志》2018年第6期361-365,共5页Journal of Clinical Psychiatry

基　　金：国家高技术研究发展计划(863计划)(2015AA020509);国家自然科学基金(81571639,81371522,61372032);江苏省临床医学科技专项(BL2014009);江苏省科教强卫工程江苏省医学创新团队项目(CXTDC2016004);江苏省科教强卫青年医学人才项目(QNRC2016049,QNRC2016050);南京市医学科技发展项目(YKK15106,YKK15110)

摘　　要：目的:探讨抑郁症患者膝下前扣带回(sgACC)与背外侧前额叶(DLPFC)的功能连接以及与抗抑郁药治疗早期疗效的关系。方法:采集38例抑郁症患者(患者组)和28名健康对照者(正常对照组)基线时脑磁源性静息态数据,并对患者在基线和抗抑郁治疗2周后实施汉密尔顿抑郁量表(HAMD-17)评估;计算sgACC与双侧DLPFC的beta波功能连接;将2周后HAMD-17中核心6项(HAMD-6)总分减分率≥50%作为有效组,<50%作为无效组,将功能连接与疗效进行相关性及ROC曲线分析。结果:治疗2周后sgACC与左侧DLPFC(r=-0. 48,P=0. 0064)、右侧DLPFC(r=-0. 54,P=0. 0015)功能连接与HAMD-6减分率负相关; sgACC与双侧DLPFC的功能连接(AUC=0. 868,P=0. 0001,敏感度70. 6%,特异度90. 5%)有助于早期区分治疗是否有效。结论:sgACC与双侧DLPFC基线时beta频段功能连接可提示抗抑郁药治疗的早期疗效。Objective:To explore whether the resting-state functional connectivity of the subgenual cingulate cortex(sgACC)and the dorsolateral prefrontal cortex(DLPFC)at baseline could indicate the outcome of early antidepressant treatment for major depressive(MD)patients.Method:Thirty-eight MDD patients and28healthy controls were enrolled for baseline resting-state magnetoencephalography(MEG)scan and HAMD17was assessed at baseline and week2for MD patients.Correlation analysis and receiver operating characteristic curve(ROC curve)were performed for each functional connectivity in the beta-band and the efficacy of antidepressant.Results:The pretreatment connectivities of the sgACC with the left DLPFC(r=-0.48,P=0.0064)and right DLPFC(r=-0.54,P=0.0015)were negatively correlated with clinical efficacy.ROC analyses showed that the functional connectivities of sgACC with the DLPFC(AUC=0.868,P=0.0001,sensitivity70.6%,specificity90.5%)could help classifying responders from non-responders as early as week2.Conclusion:The resting-state functional connectivity of beta band between the sgACC and the DLPFC could potentially serve as a valuable biomarker to indicate the therapeutic effect after2weeks of antidepressant treatment.

关 键 词：抑郁症 膝下前扣带回 背外侧前额叶 功能连接 

分 类 号：R749.4[医药卫生—神经病学与精神病学]