抑郁障碍核心脑网络能量与抗抑郁药物早期疗效相关性的脑磁图研究  

A magnetoencephalographic study on the relationship between core brain network power in depression and early efficacy of antidepressants

作　　者：王强[1] 田水 汤浩[3] 阎锐[3] 赵鹏[1] 曹秋云[1] 姚志剑[3] WANG Qiang;TIAN Shui;TANG Hao;YAN Rui;ZHAO Peng;CAO Qiu-yun;YAO Zhi-jian(Medical School of Nanjing University,Nanjing Drum Tower Hospital,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院心理科,210008 [2]南京医科大学第一附属医院放射科 [3]南京医科大学附属脑科医院精神科(江苏省抑郁症诊疗中心)

出　　处：《临床精神医学杂志》2022年第6期425-428,共4页Journal of Clinical Psychiatry

基　　金：国家自然科学基金(81871066);国家重点研发计划(2018YFC1314601);江苏省重点研发计划专项(BE2018609,BE2019675);江苏省科教强卫工程省市共建医学创新团队(CXTDC2016004);江苏省医学科研重点项目(K2019011);南京市医学科技发展重点项目(ZKX21035)。

摘　　要：目的:探讨抑郁障碍3个核心脑网络基线时alpha和beta波能量与抗抑郁治疗早期疗效的关系。方法:筛选63例抑郁障碍患者和22名健康被试入组,采集基线时脑磁源性静息态数据,计算默认网络(DMN)、中央执行网络(CEN)和警醒网络(SN)的alpha和beta波能量。在基线和治疗2周时进行汉密尔顿抑郁量表(HAMD-17)评估,以2周6项HAMD减分率≥50%为有效组,否则为无效组。比较有效和无效组的能量差异,并将能量与疗效作相关性和ROC曲线分析。结果:有效组、无效组和健康对照3组间DMN、CEN网络的beta波能量存在差异,事后检验经Bonfferoni校正发现有效组DMN(P=0.035)、CEN(P=0.025)能量高于无效组;3个网络beta波能量DMN(r=0.37,P=0.008)、CEN(r=0.34,P=0.017)、SN(r=0.33,P=0.019)均与疗效相关,且有助于识别早期疗效(AUC=0.684,P=0.021,敏感度60.9%,特异度71%)。结论:抑郁障碍3个核心网络基线时beta波能量有助于预测药物抗抑郁治疗的早期疗效。Objective:To explore the relationship between alpha and beta power at baseline in the default mode network(DMN),central executive network(CEN) and salience network(SN) core brain networks in depression and the early efficacy of antidepressant therapy.Method:63 patients with major depressive disorder and 22 healthy controls were enrolled for resting-state magnetoencephalography.The Hamilton Rating Scale for Depression(HAMD-17) was assessed at baseline and after 2 weeks of antidepressant treatment.A 2-week reduction rate≥50% of HAMD(6 items) score was regarded as the response group,otherwise it was considered as the non-response group.The power difference between the two groups was compared,and the correlation between the power,antidepressant efficacy and ROC curve were analyzed.Results:There were differences in the beta power of DMN and CEN networks among the response grouop,non-response group and the healthy control group.After the Bonfferoni correction,it was found that the power of DMN(P=0.035) and CEN(P=0.025) in the response group was higher compared to the non-response group.The beta power of each network DMN(r=0.37,P=0.008),CEN(r=0.34,P=0.017),SN(r=0.33,P=0.019) was correlated with the antidepressant efficacy;and assessed the early efficacy of antidepressant treatment(AUC=0.684,P=0.021,sensitivity 60.9%,specificity 71%).Conclusion:The baseline beta bandpower in the three core networks of depression is helpful to predict the early efficacy of pharmacological antidepressant therapy.

关 键 词：抑郁障碍 早期疗效 默认网络 中央执行网络 警醒网络 

分 类 号：R749.4[医药卫生—神经病学与精神病学]