青年抑郁症患者脑功能网络连接与自杀未遂行为的相关性研究  

Association between functional network connectivity and suicidal behavior in young patients with depression disorder

作　　者：操军[1] 陈小容 况利[1] 陈建梅[1] 艾明[1] 甘窈[1] 王我 吕臻 何静澜 Cao Jun;Chen Xiaorong;Kuang Li;Chen Jianmei;Ai Ming;Gan Yao;Wang Wo;Lyu Zhen;He Jinglan(Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Mental Health Center,the University-Town Hospital of Chongqing Medical University,Chongqing 401331,China)

机构地区：[1]重庆医科大学附属第一医院精神科,400016 [2]重庆医科大学附属大学城医院心理卫生中心,401331

出　　处：《中华精神科杂志》2020年第4期300-306,共7页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(81671360);重庆市自然科学基金(cstc2018jcyjAX0164);重庆市科卫联合医学科研项目(2018QNXM014);重庆市社会事业与民生保障科技创新专项重点研发项目(cstc2017shms-zdyfX0038)。

摘　　要：目的探讨自杀未遂青年抑郁症患者静息态脑网络内和脑网络间功能连接的差异及其与自杀未遂之间的相关性,进而分析大脑网络之间的相互关系在青年抑郁症自杀行为发生中的作用机制。方法采用17项汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD17)、Beck抑郁自评量表(Beck Depression Inventory,BDI)、自杀态度问卷(Suicide Attitude Questionnaire,SAQ)、Barratt冲动性量表(Barratt Impulsiveness Scale,BIS)、Beck绝望量表(Beck Hopelessness Scale,BHS)和自杀意念量表(Scale for Suicide Ideation,SSI)对纳入的35例自杀未遂青年抑郁症患者(自杀未遂组)、18例非自杀未遂青年抑郁症患者(非自杀未遂组)以及47名性别、年龄和受教育年限相匹配的健康对照者(健康对照组)进行抑郁严重程度和自杀特质相关临床心理量表评定。采用静息态功能磁共振成像和独立成分分析方法比较3组静息态脑网络间功能连接的差异,采用Pearson相关分析对自杀未遂组的脑功能网络连接值与临床行为量表之间进行相关分析。结果(1)自杀未遂组较非自杀未遂组前默认网络与突显网络和右侧额-顶网络的功能网络连接降低(t=-2.63,P=0.036;t=-3.42,P=0.048),突显网络与右侧额-顶网络的功能网络连接增强(t=3.07,P=0.038)。(2)Pearson相关性分析显示,自杀未遂组前默认网络和右侧额-顶网络的功能网络连接与BHS评分呈负相关(r=-0.353;P=0.037),突显网络-右侧额顶网络功能网络连接和前-后默认网络的功能网络连接与HAMD17评分呈负相关(r=-0.369,P=0.029;r=-0.372,P=0.028)。结论青年抑郁症自杀未遂行为与大脑默认网络、突显网络和额-顶网络三大核心神经认知网络功能连接异常有关,并且广泛涉及网络的多个节点。Objective To investigate the functional connectivity of resting-state networks in young depressed patients with suicide attempts and its association with suicide attempt as well as to better understand the underlying neural mechanism of suicide.Methods Hamilton Depression Scale-17 items(HAMD17),Beck Depression Inventory(BDI),Suicide Attitude Questionnaire(SAQ),Barratt Impulsiveness Scale(BIS),Beck Hopelessness Scale(BHS)and Scale for Suicide Ideation(SSI)were used to assess the severity of depressive symptoms and suicidal characteristics in 35 young depressed patients with suicide attempts(SU group),18 patients with non-suicide attempt(NSU group)and 47 gender,age,and education matched healthy controls(HC group).The alterations of intra-and internetwork connectivity among SU,NSU and HC group were analyzed with functional magnetic resonance imaging and independent component analysis(ICA).Pearson correlation was adopted to analyze the association between functional network connectivity and clinical psychological scales.Results(1)There were significant differences in functional network connectivity within the default mode network(DMN),salience network(SN)and bilateral frontal-parietal network(FPN)among three groups.Compared with NSU group,SU showed significantly decreased internetwork connectivity between anterior default mode network(aDMN),salience network(SN)(t=-2.63,P=0.036),and right frontal-parietal network(rFPN)(t=-3.42,P=0.048).However,enhanced internetwork connectivity between the SN and the right fronto-parietal network(rFPN)was found in SU group(t=3.07,P=0.038).In addition,decreased aDMN-rFPN connectivity was negatively correlated with BHS scores(r=-0.353;P=0.037),and the differences in SN-rFPN and aDMN-pDMN connectivity were negatively associated with the HAMD score in the SU group(r=-0.369,P=0.029;r=-0.372,P=0.028).Conclusions These findings suggest that SU experience reorganization at the level of large-scale brain networks.Suicide attempt is correlated with abnormal functional network connectivity withi

关 键 词：抑郁症 自杀未遂 磁共振成像 神经网络(计算机) 

分 类 号：R749.4[医药卫生—神经病学与精神病学]