抑郁症患者岛叶-皮质静息态功能连接的观察  

Insular subdivisions functional connectivity in patients with major depressive disorder: a resting-state functional magnetic resonance imaging study

作　　者：陈盼 陈枫 陈观茂 龚佳英 贾艳滨[2] 钟舒明[2] 齐张璋 赖顺凯 黄力[1] 王颖[1] Chen Pan;Chen Feng;Chen Guanmao;Gong Jiaying;Jia Yanbin;Zhong Shuming;Qi Zhangzhang;Lai Shunkai;Huang Li;Wang Ying(Medical Imaging Center,First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Psychiatry,First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院医学影像中心,广州510630 [2]暨南大学附属第一医院精神心理科,广州510630

出　　处：《中华精神科杂志》2019年第5期347-353,共7页Chinese Journal of Psychiatry

基　　金：国家自然科学基金面上项目(81671670,81501456);广东省社会发展领域科技计划项目(2014B020212022);广州市科技计划项目(20160402007,201604020184).

摘　　要：目的探讨未服药抑郁症患者静息态岛叶功能连接特征。方法选取50例未服药的抑郁症患者(抑郁症组)和51名健康对照者(对照组)进行静息态fMRI(rs-fMRI)扫描,对rs-fMRI数据进行常规预处理并基于岛叶分区为双侧岛叶前部、双侧岛叶中部、双侧岛叶后部6个种子点进行全脑功能连接分析,采用双样本t检验比较2组间脑功能连接值的差异,经过不依赖阈值集群增强(threshold-free cluster enhancement,TFCE)的多重比较校正,并将差异有统计学意义脑区的功能连接值与HAMD24评分等临床变量进行相关分析。结果与对照组相比,抑郁症组左侧岛叶前部与双侧前扣带回之间功能连接减低(t=-4.83,P<0.05,TFCE校正),左侧岛叶前部与左侧额中回、双侧后扣带回/楔前叶之间功能连接增强(t=4.08、4.42,均P<0.05,TFCE校正)。左侧岛叶前部与双侧前扣带回(r=-0.125,P=0.387)、左侧额中回(r=0.149,P=0.302)、双侧后扣带回/楔前叶(r=-0.207,P=0.148)的功能连接值与HMAD24评分无相关性。结论抑郁症患者可能存在左侧岛叶前部与边缘系统、额叶皮质功能连接异常,包括岛叶-前扣带回连接减弱,岛叶-额叶、岛叶-后扣带回/楔前叶连接增高。Objective To provide a basic profile of resting-state functional connectivity (FC) in unmedicated patients with major depressive disorder (MDD). Methods Fifty unmedicated patients with MDD and 51 healthy controls underwent the resting-state functional magnetic resonance imaging (rs-fMRI). After preprocessing of rs-fMRI, the seed-based resting-state FC of the insular subdivisions, including the anterior insula, middle insula, and posterior insula, was evaluated. Two-sample t-test and multiple comparison correction of Threshold-Free Cluster Enhancement (TFCE) were used to compare the FC values of each group to locate the regions with significant change, where its correlation to the Hamilton Depression Scale (HAMD24) scores was also explored. Results In comparison to the healthy controls, the MDD patients decreased FC between the left anterior insula and bilateral anterior cingulate cortices (t=-4.83, P<0.05, TFCE correction), and increased FC between the left anterior insula and the left middle frontal gyrus, as well as the bilateral posterior cingulate cortices/precuneus (t=4.08, 4.42;both P<0.05, TFCE correction). There were no significant correlations between the HAMD24 scores and the FC values from the left anterior insula to the bilateral anterior cingulate cortices (r=-0.125, P=0.387), the left middle frontal gyrus (r=0.149, P=0.302), and the bilateral posterior cingulate cortices/precuneus (r=-0.207, P=0.148). Conclusion Patients with depression have abnormal functional connectivity between the left anterior insula and the other two regions, such as the limbic system and the frontal cortex, which may present with an aweakened insula-anterior cingulate gyrus connectivity, and the enhanced insular-frontal, and insula-posterior cingulate/precuneus connectivity.

关 键 词：抑郁症 磁共振成像 大脑皮质 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]