抑郁症患者心理社会应激下脑网络激活特点及性别差异分析  

Analysis of brain network activations patterns and gender differences in depressed patients under psychosocial stress

作　　者：董戴凤 张小崔[1] 李楚婷 程长 孙小强[1] 熊戈[1] 姚树桥[1] Dong Daifeng;Zhang Xiaocui;Li Chuting;Cheng Chang;Sun Xiaoqiang;Xiong Ge;Yao Shuqiao(Medical Psychological Center,Second Xiangya Hospital,Central South University/Medical Psychological Institute,Central South University/National Clinical Research Center for Mental Disorders,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院医学心理中心、中南大学医学心理研究所、国家精神心理疾病临床医学研究中心,长沙410011

出　　处：《中华精神科杂志》2024年第5期282-289,共8页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(82071532);长沙市自然科学基金(kq2007044);中南大学湘雅二医院科研启航计划(QH20230254)。

摘　　要：目的探究抑郁症患者心理社会应激下默认网络、执行网络、突显网络和边缘网络的激活特点及性别差异。方法前瞻性收集2017年7月至2019年9月在中南大学湘雅二医院门诊就诊的首次发作未服药抑郁症患者(抑郁症组,124例)的临床资料及心理社会应激任务下的功能磁共振成像数据,其中男48例,年龄[M(Q_(1),Q_(3))]25(21,28)岁,女76例,年龄26(19,31)岁。同期采集长沙市高校和社区的健康被试(健康对照组,243名)的行为学资料及心理社会应激任务下的功能磁共振成像数据,其中男106名,年龄21(19,21)岁,女137名,年龄21(20,21)岁。采用独立成分分析方法,检测各组被试在心理社会应激任务下默认网络、执行网络、突显网络及边缘网络的激活值;采用重复测量方差分析检测心理社会应激任务下感兴趣网络激活值的组间差异。结果与健康对照组相比,抑郁症组受试者表现出应激任务下突显网络激活明显减弱(激活值:0.01±0.01比0.03±0.01,F=6.50,P=0.011)。边缘网络的脑激活特征表现出明显的诊断和性别交互效应(F=4.30,P=0.039);简单效应分析显示,与相应性别的健康对照组相比,仅女性抑郁症组表现出明显的应激任务下边缘网络负激活减弱(激活值:-0.42±0.06比-0.62±0.05;P_(Bonferroni)校正=0.015,95%CI:0.038~0.352)。结论抑郁症患者在应激加工过程中存在性别一致和性别特异的脑网络活动特征。ObjectiveTo investigate the activation patterns of the default mode network(DMN),executive central network(ECN),salience network(SN),and frontoparietal network(FPN)in depressed patients under psychosocial stress processing,and the gender differences.MethodsA prospective study was conducted to collect clinical data,behavior data,and functional magnetic resonance imaging(fMRI)data under psychosocial stress tasks from first-episode,unmedicated depressed patients(depression group,124 cases)who visited the outpatient department of the Second Xiangya Hospital of Central South University from July 2017 to September 2019,including 48 males,aged(M(Q_(1),Q_(3)))25(21,28)years,and 76 females,aged 26(19,31)years.At the same period,behavioral data and fMRI data under psychosocial stress tasks were prospectively collected from healthy controls(control group,243 cases)from universities and communities in Changsha,including 106 males,aged 21(19,21)years,and 137 females,aged 21(20,21)years.Independent component analysis was used to detect the DMN,ECN,SN,and FPN activation values in each group under psychosocial stress tasks.Repeated measures ANOVA was used to detect the between-group differences in the activation values of the networks of interest.ResultsCompared with the healthy control group,the depression group exhibited significantly reduced activation of the SN under stress tasks(activation value:0.01±0.01vs 0.03±0.01;F=6.50,P=0.011).The brain activation pattern of the FPN showed a significant diagnostic and gender interaction effect(F=4.30,P=0.039).Simple effect analysis revealed that only the female depression group exhibited significantly reduced negative activation of the FPN under stress tasks compared with the corresponding gender healthy control group(activation value:-0.42±0.06 vs-0.62±0.05;P _(Bonferroni-corrected)=0.015,95%CI=0.038-0.352).Conclusion Depressed patients exhibit gender-consistent and gender-specific brain network activity patterns during stress processing.

关 键 词：抑郁症 成人 应激 性别 脑网络 

分 类 号：R749.4[医药卫生—神经病学与精神病学]