与压力相关的脑结构变化对抑郁严重程度的影响  

Depression Severity is Effected by Stress-Related Structural Brain Changes

作　　者：王云 张宁宁 徐俊 虞晓明 武刚 WANG Yun;ZHANG Ningning;XU Jun(Department of Radiology,Qingpu Branch of Affiliated Zhongshan Hospital of Fudan University,Shanghai 201700,P.R.China)

机构地区：[1]复旦大学附属中山医院青浦分院放射科,上海201700 [2]南京医科大学姑苏学院,南京医科大学附属苏州医院,苏州市立医院放射科,苏州215002

出　　处：《临床放射学杂志》2025年第5期796-801,共6页Journal of Clinical Radiology

摘　　要：目的探讨与压力生活事件(SLE)相关的脑结构变化对抑郁严重程度的影响及其在SLE与抑郁严重程度之间的作用。方法招募88名在过去12个月内至少有一次SLE经历的健康受试者,并对其进行临床评估和MR扫描。分别采用生活事件量表(LES)、流行病学研究中心抑郁量表(CES-D)评估SLE的水平和抑郁症状的严重程度。应用FreeSurfer对三维高分辨率T1加权(3D-T1WI)结构像进行图像重组及自动化分割,获得眶额叶、前扣带的皮层厚度以及海马(包括亚区)、杏仁核(包括亚区)的体积。采用Pearson相关分析检验SLE与眶额叶、前扣带皮层厚度以及海马、杏仁核各亚区体积的相关性。以CES-D评分为因变量,以与SLE相关的脑结构变化、LES总分为自变量,进行多元线性回归分析。建立中介效应模型探讨脑结构变化在SLE与抑郁严重程度之间的中介作用。结果LES总分与眶额叶、前扣带皮层厚度以及CA3/4、齿状回(DG)、基底外侧复合体(BLA)、中心内侧复合体(CMA)体积呈显著负相关(P均<0.001)。较高的抑郁严重程度与较小的眶额叶皮层厚度,较小的CA3/4、BLA体积以及较高的LES总分显著相关(P均<0.05)。中介效应模型表明眶额叶皮层厚度、CA3/4体积、BLA体积分别在SLE与抑郁严重程度之间的关系中起到了显著的中介作用。结论眶额叶皮层厚度、CA3/4、BLA体积可能是解释SLE与抑郁严重程度之间关系的生物学载体,这有利于提高对SLE增加抑郁症易感性的神经生物学机制的认识,为抑郁症的预防、诊疗及预后提供科学的理论指导。Objective To investigate the effect of brain structural changes related to stressful life events(SLE)on depression severity and the role of these changes in the relationship between SLE and depression severity.Methods Eighty-eight healthy subjects who had experienced at least one SLE in the past 12 months were recruited and underwent clinical assessment and MRI scans.The Life Event Scale(LES)and the Center for Epidemiologic Studies Depression Scale(CES-D)were used to evaluate the level of SLE and the severity of depressive symptoms.Structural images from 3D-T 1WI were reconstructed and automatically segmented using FreeSurfer to obtain the cortical thickness of the orbitofrontal cortex and anterior cingulate cortex,as well as the volume of the hippocampus(including subregions)and amygdala(including subregions).Pearson correlation analysis was used to test the correlation between SLE and the thickness of the orbitofrontal cortex and anterior cingulate cortex,and the volume of each subregion of the hippocampus and amygdala.Multiple linear regression analysis was performed with CES-D score as the dependent variable and SLE-related brain structural changes and LES total score as the independent variables.Mediation effect models were established to explore the mediating role of brain structural changes between SLE and depression severity.Results The LES total score was negatively correlated with the thickness of the orbitofrontal cortex and anterior cingulate cortex and the volume of CA3/4,DG,BLA,and CMA(all P<0.001).Higher depression severity was significantly associated with a smaller thickness of the orbitofrontal cortex,smaller volume of CA3/4 and BLA,and a higher LES total score(all P<0.05).Mediation effect models showed that the thickness of the orbitofrontal cortex,volume of CA3/4,and volume of BLA each played a significant mediating role in the relationship between SLE and depression severity.Conclusion The thickness of the orbitofrontal cortex,volume of CA3/4,and volume of BLA may be biological markers that e

关 键 词：压力生活事件(SLE) 脑结构变化 抑郁严重程度 中介效应 

分 类 号：R749.4[医药卫生—神经病学与精神病学]