产后抑郁症患者脑结构网络拓扑属性的特征性改变  

Changes of topological attributes of brain structural network in patients with postpartum depression

作　　者：谢恺 李洋 朱小兰 蔡玉姣 罗一烽 曹志宏 李月峰 史佳佳 Xie Kai;Li Yang;Zhu Xiaolan;Cai Yujiao;Luo Yifeng;Cao Zhihong;Li Yuefeng;Shi Jiajia(Department of Medical Imaging,Jiangsu University Affiliated Yixing Hospital,Yixing 214200,China;Center for Reproductive Health,Zhenjiang Fourth People's Hospital,Zhenjiang 212001,China;Department of Surgery,Jiangsu University Affiliated Yixing Hospital,Yixing 214200,China)

机构地区：[1]江苏大学附属宜兴医院医学影像科,宜兴214200 [2]镇江市第四人民医院生殖医学中心,镇江212001 [3]江苏大学附属宜兴医院外科,宜兴214200

出　　处：《中华围产医学杂志》2024年第6期468-476,共9页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金(81871343);江苏省重点研发计划项目(BE2021693)。

摘　　要：目的探讨产后抑郁症(postpartum depression,PPD)患者的脑结构网络的特征性改变。方法本研究为横断面研究,研究对象为2013年6月至2022年9月在江苏大学附属宜兴医院分娩后于精神心理咨询门诊就诊的PPD患者(PPD组),以及根据年龄、受教育年限、体重指数匹配同期产后复诊的产妇(非PPD产妇组)和同时期在本院就诊或体格检查的非孕妇(非产妇组)。收集3组的一般人口学资料,以及磁共振弥散张量成像(diffusion tensor imaging,DTI)数据。利用解剖学模板将大脑划分为90个脑区并构建脑结构网络,应用基于网络的统计分析法(network-based statistics,NBS)进一步筛选和构建子网络。通过多因素logistics回归模型和受试者工作特征曲线评估子网络鉴别PPD的效能。白质连边的连接强度及脑结构网络拓扑属性参数的比较采用两独立样本t检验,结果用错误发现率法(false discovery rate,FDR)校正。结果(1)共纳入116例受试者,其中非孕妇组40例,非PPD产妇组40例,PPD组36例。PPD组爱丁堡产后抑郁量表评分分别高于非孕妇组和非PPD产妇组[(18.0±4.1)与(2.5±1.2)分和(6.1±2.1)分,F=340.40,组间两两比较时t值分别为24.65、10.60和16.16;P值均<0.001]。(2)与非孕妇组相比,产妇组脑结构网络中9条白质连边(左侧背外侧额上回-左侧前扣带和旁扣带回、左侧背外侧额上回-右侧杏仁核、左侧背外侧额上回-左侧脑岛、左侧脑岛-左侧豆状壳核、左侧脑岛-左侧海马、左侧海马-右侧杏仁核、左侧海马-左侧楔前叶、左侧前扣带和旁扣带回-右侧杏仁核,以及右侧杏仁核-右侧海马)的连接强度降低(P值均<0.05,FDR校正),未发现连接强度升高的连边。非PPD产妇组与PPD组上述9条边的连接强度差异无统计学意义。(3)基于上述9条连边成功构建产妇组特征性子网络,且具有典型的小世界属性(σ>1)。与非PPD产妇组相比,PPD组的特征路径长度增加[(3.904±0.3Objective To investigate the features of the brain structural network in patients with postpartum depression(PPD).Methods This cross-sectional study included PPD patients who visited the mental health counseling clinic after delivery at the Jiangsu University Affiliated Yixing Hospital from June 2013 to September 2022(PPD group).Matched non-PPD postpartum women based on age,years of education,and body mass index who came for postpartum follow-up(non-PPD postpartum group),and non-pregnant women who visited the hospital or underwent physical examinations during the same period(non-pregnant group)were also included.Demographic data and diffusion tensor imaging(DTI)data were collected for all three groups.The brain was partitioned into 90 regions using an anatomical template to construct the brain structural network.Network-based statistics(NBS)were applied to further screen and construct subnetworks.The efficacy of the subnetworks in identifying PPD was evaluated through multivariable logistics regression models and receiver operating characteristic curves.A comparison of the connectivity strength of white matter tracts and topological attributes of brain structural network parameters was conducted using independent samples t-tests,and the results were corrected using the false discovery rate(FDR)method.Results(1)A total of 116 subjects were included,with 40 in the non-pregnant group,40 in the non-PPD postpartum group,and 36 in the PPD group.PPD group had higher Edinburgh Postnatal Depression Scale(EPDS)scores than the non-pregnant and non-PPD postpartum groups[(18.0±4.1)scores vs.(2.5±1.2)and(6.1±2.1)scores,F=340.40;t=24.65,10.60 and 16.16 in pairwise comparison;all P<0.001].(2)Compared to the non-pregnant group,there was a decrease in the connectivity strength of nine white matter tracts within the brain structural network of the postpartum group(including left dorsolateral superior frontal gyrus-left anterior cingulate and paracingulate gyrus,left dorsolateral superior frontal gyrus-right amygdala,left dorsola

关 键 词：产后抑郁症 弥散张量成像 脑结构网络 拓扑属性 

分 类 号：R714.6[医药卫生—妇产科学] R749.4[医药卫生—临床医学]