抑郁症患者发作期与临床治愈期缰核静息态功能连接的比较研究  

Comparisons of the resting-state fMRI functional connectivity of the habenula in the first-episode current depression and remitted depression

作　　者：滕昌军 张宁[1] 王纯[2] 马辉[1] 谭雅容 高帅[1] 肖朝勇[3] Teng Changjun;Zhang Ning;Wang Chun;Ma Hui;Tan Yarong;Gao Shuai;Xiao Chaoyong(Medical Psychology Department,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Mood Disorder Department,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Cardiology Department,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院医学心理科,210029 [2]南京医科大学附属脑科医院心境障碍科,210029 [3]南京医科大学附属脑科医院放射科,210029

出　　处：《中华行为医学与脑科学杂志》2020年第9期813-819,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目(81571344);江苏省自然科学基金项目(BK20161109);江苏省科技计划(重点病种)项目(BE2015609);南京医科大学科技发展基金项目(NMUB2018197)。

摘　　要：目的探讨并比较发作期和临床治愈期的抑郁症(major depressive disorder,MDD)患者静息态下缰核的功能连接(functional connectivity,FC)特征。方法对35例发作期抑郁症患者(first-episode current MDD,fMDD)、35例经住院治疗达到临床治愈期抑郁症患者(remitted MDD,rMDD)和性别、年龄、教育年限相匹配的30例健康对照被试(healthy controls,HC)进行静息态fMRI扫描。使用汉密尔顿抑郁量表(HAMD17)评估患者的严重程度。以缰核为感兴趣区进行FC分析,比较组间差异,并对差异脑区FC值与病程、HAMD17评分之间进行Pearson相关分析。结果(1)与HC组相比,fMDD组缰核与左侧枕中回(x,y,z=-48,-84,3,t=-4.335,P<0.05)FC减低,缰核与左侧缘上回(x,y,z=-66,-30,36,t=4.876,P<0.05)、左侧额上回(x,y,z=-6,-33,51,t=4.402,P<0.05)、双侧顶下小叶(左侧:t=3.300,P<0.05,右侧:t=3.557,P<0.05)FC增强;与HC组相比,rMDD组缰核与左侧枕中回(x,y,z=-48,-84,3,t=-4.321,P<0.05)、左侧丘脑(x,y,z=-9,3,3,t=-3.971,P<0.05)FC减低,缰核与左侧颞中回(x,y,z=-48,-39,9,t=4.062,P<0.05)、左侧缘上回(x,y,z=-51,-15,45,t=2.906,P<0.05)、左侧额上回(x,y,z=-24,-21,39,t=3.044,P<0.05)、双侧顶下小叶(左侧:t=2.880,P<0.05,右侧:t=3.512,P<0.05)FC增强;(2)fMDD组缰核与右侧眶额皮层(t=-3.899,P<0.05)、左侧颞中回(t=-4.023,P<0.05)功能连接低于rMDD组,缰核与左侧缘上回(t=4.157,P<0.05)、左侧额上回(t=3.327,P<0.05)、左侧丘脑(t=3.316,P<0.05)、左侧顶下小叶(t=3.909,P<0.05)FC高于rMDD组;(3)Pearson相关分析显示,以上差异脑区FC值与HAMD17总分均无相关性,缰核与左侧枕中回FC值与病程具有边缘相关性(r=0.328,P=0.063)。结论发作期与临床治愈期MDD患者缰核与默认网络、视觉网络、奖赏网络功能连接异常,可能参与抑郁症的发病机制。rMDD患者缰核功能连接未恢复正常。Objective To investigate the difference of functional connectivity(FC)between the habenula and other brain regions in the patients with first-episode current depression(fMDD)and remitted depression(rMDD).Methods Thirty-five patients with first-episode current depression(fMDD),35 patients with remitted depression(rMDD)and 30 healthy controls(HC)matched with gender,age and education years were scanned by resting-state fMRI.Hamilton Depression Scale(HAMD17)was used to assess the severity of the patients.After preprocessing,seed-based FC analysis was performed on the habenula.Pearson correlation analysis was performed between the FC values and HAMD17 and duration of disease.Results(1)Compared with the HC group,FC decreased between the habenula and left middle occipital gyrus(l-MOG)in fMDD group(x,y,z=-48,-84,3,t=-4.335,P<0.05),while FC increased between the habenula and left supramarginal gyrus(x,y,z=-66,-30,36,t=4.876,P<0.05),left superior frontal gyrus(l-SFG)(x,y,z=-6,-33,51,t=4.402,P<0.05),left inferior parietal lobe(l-IPL)(t=3.300,P<0.05)and right inferior parietal lobe(r-IPL)(t=3.557,P<0.05)in fMDD group.Compared with the HC,FC decreased between the habenula and l-MOG(x,y,z=-48,-84,3,t=-4.321,P<0.05)and left thalamus(x,y,z=-9,3,3,t=-3.971,P<0.05)in rMDD group,while FC increased between the habenula and left middle temporal gyrus(l-MTG)(x,y,z=-48,-39,9,t=4.062,P<0.05),left supramarginal gyrus(x,y,z=-51,-15,45,t=2.906,P<0.05),l-SFG(x,y,z=-24,-21,39,t=3.044,P<0.05),l-IPL(t=2.880,P<0.05)and r-IPL(t=3.512,P<0.05)in rMDD group.(2)FC decreased in fMDD group between the habenula and right orbitofrontal cortex(r-OFC)(t=-3.899,P<0.05)and l-MTG(t=-4.023,P<0.05)than rMDD group,while FC increased between the habenula and left supramarginal gyrus(t=4.157,P<0.05),l-SFG(t=3.327,P<0.05),left thalamus(t=3.316,P<0.05)and l-IPL(t=3.909,P<0.05)than rMDD group.(3)There was no significantly correlation between the HAMD17 and the FC value changes among the different regions,and was marginal significantly correlation between duration of

关 键 词：抑郁症 发作期 临床治愈期 缰核 功能连接 

分 类 号：R749.4[医药卫生—神经病学与精神病学]