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ENGLISH ABSTRACT
青少年首发抑郁症患者前扣带回和杏仁核功能连接异常改变研究
朱妍
李淑英
吕培培
王源莉
李飞燕
陈苑
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1674-6554.2018.06.005
Abnormal changes of functional connectivity between anterior cingulate cortex and amygdala in adolescents patients with first-episode depression
Zhu Yan
Li Shuying
Lyu Peipei
Wang Yuanli
Li Feiyan
Chen Yuan
Authors Info & Affiliations
Zhu Yan
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Li Shuying
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Lyu Peipei
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wang Yuanli
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Li Feiyan
Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Chen Yuan
Department of Magntic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
·
DOI： 10.3760/cma.j.issn.1674-6554.2018.06.005
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摘要

目的研究青少年首发抑郁症患者前扣带回(anterior cingulate cortex，ACC)和杏仁核功能连接(FC)改变。

方法选取30例首发青少年抑郁症患者(患者组)和29例青少年健康志愿者(HC组)。采用静息态功能磁共振技术对患者组和HC组进行扫描，选取ACC和杏仁核为感兴趣区。研究杏仁核和ACC与全脑脑区FC改变是否存在差异及异常FC是否与临床特征相关。

结果与HC组相比，患者组左侧杏仁核与双侧颞中回、左侧枕中回、右侧内侧前额叶皮层(medial prefrontal cortex，MPFC)(MNI x，y，z：9，66，15)( t＝2.80)FC上升，与右侧丘脑(15，－21，18)( t＝－2.85)FC下降；右侧杏仁核与右侧颞中回、右侧MPFC(MNI x，y，z：6，69，12)( t＝2.41)的FC上升，与左侧额中回、右侧额中回、左侧尾状核(MNI x，y，z：－15，－9，21)( t＝－2.53)、右侧丘脑(MNI x，y，z：12，－36，12)( t＝－3.01)、右侧小脑(MNI x，y，z：3，－84，－33)( t＝－2.45)FC下降；左侧ACC与右侧眶部额中回FC上升，与右侧眶部额下回、左侧三角部额下回、右侧小脑(12，－87，－24)( t＝－2.36)FC下降；右侧ACC与左侧尾状核(MNI x，y，z：－15，21，6)( t＝－2.29)、右侧颞中回、右侧MPFC(MNI x，y，z：9，54，36)( t＝－2.41)、右侧眶部额下回、右侧角回(MNI x，y，z：45，－51，21)( t＝－3.01)、左侧背外侧额上回FC(MNI x，y，z：－21，33，36)( t＝－2.61)FC下降。左侧杏仁核与左侧颞中回功能连接z值( r＝0.50， P<0.05)、左侧杏仁核与右侧颞中回功能连接z值( r＝0.45， P<0.05)与HAMD评分呈正相关。右侧杏仁核与右侧额中回功能连接z值与病程呈正相关( r＝0.63， P<0.05)。

结论青少年首发抑郁症患者杏仁核和前扣带回存在广泛功能连接紊乱。功能连接异常改变可能是抑郁症发病的神经病理机制。

青少年抑郁症;静息态功能磁共振;功能连接;杏仁核;前扣带回
ABSTRACT

ObjectiveTo study the resting-state functional connectivity(FC) changes of anterior cingulate cortex(ACC) and amygdala in adolescent patients with medication-naive first-episode major depressive disorder(MDD).

MethodsMedication-naive first-episode MDD adolescents( n=30) and pair-wise matched healthy controls(HCs, n=29) underwent resting-state functional magnetic resonance images(fMRI). To study whether there were different in FC changes between amygdala and ACC and whole brain regions, and whether abnormal FC was related to clinical characteristics.

ResultsCompared with HCs, the adolescent MDD patients showed decreased FC between the left amygdala and right thalamus(MNI x, y, z: 15, -21, 18)( t=-2.85)and increased FC between the left amygdala and the bilateral temporal middle gyrus, left occipital gyrus, right medial prefrontal cortex(MPFC)(MNI x, y, z: 9, 66, 15)( t=2.80). The right amygdale showed decreased FC with bilateral middle frontal gyrus, left caudate(MNI x, y, z: -15, -9, 21)( t=-2.53), right thalamus(MNI x, y, z: 12, -36, 12)( t=-3.01), right cerebellum(MNI x, y, z: 3, -84, -33)( t=-2.45) and increased FC with right temporal middle gyrus, right MPFC(MNI x, y, z: 6, 69, 12)( t=2.41). The left ACC showed decreased FC with left cerebellum(MNI x, y, z: 12, -87, -24)( t=-2.36), left frontal inferior triangle gyrus, right frontal inferior orbital gyrus and increased FC with right frontal middle orbital gyrus.The right ACC showed decreased FC with left caudate(MNI x, y, z: -15, 21, 6)( t=-2.29), right temporal middle gyrus, right MPFC(MNI x, y, z: 9, 54, 36)( t=-2.29), right frontal inferior orbital gyrus, right angular(MNI x, y, z: 45, -51, 21)( t=-3.01), left dorsolateral prefrontal cortex(MNI x, y, z: -21, 33, 36)( t=-2.61). The increased FC between the left amygdale and bilateral temporal middle gyrus showed positive correlation with the score of HAMD( r=0.50, P<0.05; r=0.45, P<0.05). And the FC between the right amygdale and right middle frontal gyrus was positive correlation with duration of disease( r=0.63, P<0.05).

ConclusionThere is widespread FC disorder in amygdala and ACC in adolescents patients with first-episode depression.Abnormal FC changes may be the neuropathological mechanism of depression.

Adolescent major depressive disorder;Resting-state fMRI;Functional connectivity;Amygdala;Anterior cingulated cortex
Li Shuying, Email: mocdef.6ab212116gniyuhsil
Key Project of Healthy and Family Planning Commission of Henan Province (201502006); Social Development Project of Science and Technology Department of Henan Province(152102310046)
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引用本文

朱妍,李淑英,吕培培,等. 青少年首发抑郁症患者前扣带回和杏仁核功能连接异常改变研究[J]. 中华行为医学与脑科学杂志,2018,27(6)：505-510.

DOI:10.3760/cma.j.issn.1674-6554.2018.06.005

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青少年抑郁症导致自伤、自残等行为可能性极大 [ 1 ]，并且抑郁症状可延续至成年 [ 2 ]。抑郁症患者多个脑区整合异常，功能连接存在改变 [ 3 ]。其中前扣带回(anterior cingulate cortex，ACC)和杏仁核是研究的热点核团。青少年抑郁症患者ACC及杏仁核与大脑广泛脑区存在功能连接紊乱 [ 4 , 5 , 6 , 7 , 8 , 9 ]，且部分功能连接异常改变与临床特征，如病程、疾病严重程度等相关 [ 5 , 6 , 8 , 9 ]。既往研究提示青少年抑郁症患者ACC和杏仁核功能连接异常，但连接模式特点尚未达成一致，可能受样本量、服药与否及分析方法不同等因素影响。本研究拟通过静息态功能磁共振(functional magnetic resonance images，fMRI)技术，探讨青少年首发抑郁症患者ACC和杏仁核功能连接特点，减少药物及共患病的影响。以ACC及杏仁核为感兴趣区，与全脑脑区进行功能连接，并与临床特征做相关分析，为青少年抑郁症发病的神经病理机制提供可靠依据。
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李淑英，Email： mocdef.6ab212116gniyuhsil
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河南省科技厅社发攻关项目 (152102310046)
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