重度抑郁障碍伴焦虑痛苦青少年灰质体积变化及其与焦虑程度的相关性  

Grey matter volume changes and their correlation with anxiety severity in adolescents with major depressive disorder accompanied by anxiety distress specifier

作　　者：杨荣 郑洪宇 曹小梅[1] 莫大明 杨悦 钟慧 Yang Rong;Zheng Hongyu;Cao Xiaomei;Mo Daming;Yang Yue;Zhong Hui(Department of Child and Adolescents,Affiliated Psychological Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学附属心理医院儿童青少年科,合肥230022

出　　处：《中华行为医学与脑科学杂志》2024年第11期974-978,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：安徽省临床医学研究转化专项(202204295107020005);合肥市卫生健康应用医学科研项目(Hwk2024zd017)。

摘　　要：目的探讨重度抑郁障碍(major depressive disorder,MDD)伴焦虑痛苦(anxious distress specifier,ADS)青少年患者的灰质体积变化及其与焦虑程度的相关性。方法2022年6月至2023年6月纳入在安徽省精神卫生中心儿童青少年科住院的MDD患者71例,根据DSM-5中ADS的定义,将抑郁青少年分为伴焦虑痛苦组(MDD/ADS+组,n=44)与不伴焦虑痛苦组(MDD/ADS-组,n=27),同时招募了性别、年龄、受教育年限与患者组匹配的健康青少年作为对照组(HC组,n=19),通过基于体素的形态学测量(voxel-based morphometry,VBM)比较3组间灰质体积,提取MDD/ADS+组与MDD/ADS-组间差异有统计学意义的脑区的灰质体积值,并使用SPSS 26.0与汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分进行Pearson相关分析。结果MDD/ADS+组右侧背外侧额上回(MNI:x=16.5,y=34.5,z=52.5,t=4.48,P<0.05)与右侧上小脑(MNI:x=49.5,y=-69.0,z=-24.0,t=5.18,P<0.05)的灰质体积明显小于MDD/ADS-组。MDD青少年右侧背外侧额上回灰质体积、右侧上小脑灰质体积与HAMA评分呈负相关(r=-0.249,-0.491,均P<0.05)。结论MDD伴ADS青少年右侧背外侧额上回与右侧上小脑的灰质体积减小,上述脑区可以作为MDD青少年焦虑程度的潜在生物标志物。ObjectiveTo investigate grey matter volume changes and their correlation with the severity of anxiety in adolescents with major depressive disorder(MDD)accompanied by anxious distress specifier(ADS).MethodsFrom June 2022 to June 2023,totally 71 inpatients with MDD in the child and adolescent psychiatry department of Anhui Mental Health Center were included.According to the definition of ADS in the DSM-5,MDD adolescents were divided into the group with anxious distress(MDD/ADS+group,n=44)and the group without anxious distress(MDD/ADS-group,n=27).Healthy adolescents matched in terms of gender,age,education level were recruited as the control group(HC group,n=19).Voxel-based morphometry(VBM)was used to compare changes in grey matter volume among the three groups.Grey matter volume values of brain regions with significant differences between the MDD/ADS+group and MDD/ADS-group were collected,and their correlation with Hamilton anxiety rating scale(HAMA)score were analyzed by Pearson correlation analysis using SPSS 26.0 software.ResultsCompared to the MDD/ADS-group,the MDD/ADS+group showed a significant decrease in grey matter volume in the right dorsolateral prefrontal cortex(MNI:x=16.5,y=34.5,z=52.5,t=4.48,P<0.05)and the right cerebellum(MNI:x=49.5,y=-69.0,z=-24.0,t=5.18,P<0.05).In MDD adolescents,the grey matter volumes of the right dorsolateral prefrontal cortex and the right cerebellum were negatively correlated with HAMA score(r=-0.249,-0.491,both P<0.05).ConclusionIn adolescents with MDD accompanied by ADS,a decrease in gray matter volume is observed in the right dorsolateral prefrontal cortex and the right superior cerebellum.These brain regions may serve as potential biological markers for the severity of anxiety in adolescents with MDD.

关 键 词：灰质体积 焦虑痛苦 重度抑郁障碍 青少年 

分 类 号：R749[医药卫生—神经病学与精神病学]