首次发病青少年抑郁症患者大脑表面形态改变及其与心理特征的关联分析  

Changes in brain surface morphology and their association with psychological characteristics in adolescents with first-episode major depressive disorder

作　　者：邓霏 李雪 马伶丽 戴林栖 郁仁强[4] 李晓[3] 洪素 况利[1] Deng Fei;Li Xue;Ma Lingli;Dai Linqi;Yu Renqiang;Li Xiao;Hong Su;Kuang Li(The Mental Health Center,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Psychiatry,University-Town Hospital of Chongqing Medical University,Chongqing 400133,China;Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院精神医学中心,重庆400016 [2]重庆医科大学附属大学城医院精神科,重庆400133 [3]重庆医科大学附属第一医院精神科,重庆400016 [4]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中华精神科杂志》2024年第10期661-668,共8页Chinese Journal of Psychiatry

基　　金：重庆医科大学附属第一医院2023年“学科登峰计划”科研项目(cyyy-xkdfjh-cgzh-202304);重庆市英才计划(CQYC20210203105)。

摘　　要：目的探讨首次发病青少年抑郁症患者大脑表面形态的改变及其与心理特征的关联。方法纳入2021年10月至2022年7月就诊于重庆医科大学附属第一医院精神科的48例首次发病青少年抑郁症患者(抑郁症组)和同期招募的本市社区35名健康对照者(对照组),采用17项汉密尔顿抑郁量表(17-item Hamilton Depression Scale,HAMD 17)、患者健康问卷(Patient Health Questionnaire-9,PHQ-9)、情绪调节问卷(Emotion Regulation Questionnaire,ERQ)、Barratt冲动量表(Barratt Impulsiveness Scale 11,BIS-11)、心理弹性量表(Connor-Davidson Resilience Scale,CD-RISC)分别评估抑郁症状、情绪调节能力、冲动性水平以及心理弹性功能,并进行大脑结构磁共振成像(structure magnetic resonance imaging,sMRI)扫描,计算皮质厚度值、分形维数值、脑沟深度值、脑回指数值,然后采用双样本t检验、卡方检验及非参数统计检验进行组间比较,统计结果采用无阈值聚类增强(threshold-free cluster enhancement,TFCE)及错误发现率(false discovery rate,FDR)进行多重比较校正;采用皮尔逊相关分析对2组差异脑区皮质厚度值、分形维数值与量表评分进行相关分析。采用多元线性回归分析,分析临床症状对差异脑区的皮质厚度值的影响。结果与对照组相比,抑郁症组左侧枕叶皮质厚度减少(FDR校正,P<0.05),右侧脑岛、右侧颞上回、右侧颞横回分形维数增加(TFCE未校正,P<0.001)。相关分析显示,左侧枕叶皮质厚度值与ERQ中认知重评评分(r=0.315,P=0.029)、CD-RISC评分(r=0.366,P=0.016)、BIS-11中非计划冲动性评分(r=0.354,P=0.014)呈正相关;将年龄作为控制变量,皮质厚度值与非计划冲动性评分的偏相关分析结果显示两者仍存在线性相关(r=0.467,P=0.001);但经过Bonferroni校正后上述相关均无统计学意义。结论相对于健康个体,首次发病青少年抑郁症患者右侧岛叶、右侧颞上回、右侧颞横回分形维数增加和左�Objective This study aims to explore the changes in brain surface morphology and their association with psychological characteristics in adolescents experiencing their first episode of major depressive disorder.Methods This study included 48 adolescents with first-episode major depressive disorder(depression group)admitted to the Department of Psychiatry of the First Affiliated Hospital of Chongqing Medical University from October 2021 to July 2022.At the same period,35 healthy controls(control group)were also enrolled,from communities of Chongqing.All participants underwent assessments for depressive symptoms,emotion regulation capacity,impulsiveness,and psychological resilience using the 17-item Hamilton Depression Scale(HAMD 17),the Patient Health Questionnaire-9(PHQ-9),the Emotion Regulation Questionnaire(ERQ),the Barratt Impulsiveness Scale-11(BIS-11),and the Connor-Davidson Resilience Scale(CD-RISC).Structure magnetic resonance imaging(sMRI)was utilized to evaluate brain surface morphology.The values of cortical thickness,fractal dimension,sulcus depth,and cortical gyrification index were calculated.The index of brain surface morphology between the two groups was compared using the two-sample t-test,chi-square test,and non-parametric statistical tests with multiple comparisons correction using threshold-free cluster enhancement(TFCE)and false discovery rate(FDR).Pearson correlation analyses were used to analyze the correlation between the scores of each scale(HAMD 17,PHQ-9,ERQ,BIS-11,and CD-RISC)and the cortical thickness values and fractal dimension in the depression group.In addition,multiple linear regression was used to analyze the impact of clinical symptoms on the cortical thickness values in the depression group.Results Compared with the control group,the depression group exhibited a significant reduction in the cortical thickness of the left occidental(FDR corrected,P<0.05)and an increase of the fractal dimension in the right insula,right superior temporal gyrus,and right transverse temporal gyrus(T

关 键 词：抑郁症 青少年 皮质厚度 分形维数 脑沟深度 脑回指数 

分 类 号：R749.4[医药卫生—神经病学与精神病学]