摘要
目的探讨伴忧郁特征抑郁症患者腹侧纹状体(VS)与全脑功能连接(FC)改变及其与临床特征之间的相关性。方法选取59例抑郁症患者,分为伴忧郁特征抑郁症组(A组,24例)和不伴忧郁特征抑郁症组(B组,35例),同时招募与之相匹配的31名健康对照作为对照组。采用24项汉密尔顿抑郁量表(HAMD-24)评估患者的抑郁程度,斯奈思-汉密尔顿快感量表(SHAPS)、愉快情绪体验量表(TEPS)评估患者的快感缺失严重程度,3.0T磁共振采集所有被试的静息态磁共振数据。以腹侧纹状体作为种子点,做与全脑的功能连接,比较伴与不伴忧郁特征抑郁症患者腹侧纹状体功能连接的差异,提取差异脑区的功能连接值与临床特征做相关分析。结果三组受教育年限比较差异有统计学意义(P<0.05)。A组MADRS、HAMD-24、SHAPS评分均高于B组(P<0.001),TEPS总分及消费性评分低于B组(P<0.05)。单因素方差分析发现,左侧腹侧纹状体(VS)与左内侧和旁扣带脑回、右背外侧额上回之间团块水平上提取的FC值差异有统计学意义(P<0.05);右侧VS与右颞中回区域之间的提取的团块水平上FC值差异有统计学意义(P<0.05)。与B组相比,A组左VS与左内侧和旁扣带脑回、右背外侧额上回FC值增强(P<0.05)。A组SHAPS评分与左侧VS和左内侧和旁扣带脑回的FC值均呈正相关(P<0.05)。结论VS与左内侧和旁扣带回之间功能协调性的异常可能是伴忧郁特征抑郁症的神经病理基础。
Objective To explore the changes of functional connectivity(FC)in ventral striatum(VS)in patients with melancholic depression and its correlations with clinical features.Methods A total of 59 depressive patients were selected and divided into melancholic depression group(group A,24 cases)and non-melancholic depression group(group B,35 cases).At the same time,31 matched healthy controls were recruited as control group.The patients were assessed with Hamilton Depression Scale-24 items(HAMD-24),Snaith Hamilton Pleasure Scale(SHAPS)and Temporary Experience of Pleasure Scale(TEPS).The resting-state magnetic resonance data of all subjects were gathered using 3.0T magnetic resonance imaging.The FC of the entire cerebrum was obtained using the VS as seeds to compare the differences of FC between patients with and without melancholic features.Finally,extracting the FC values of different cerebrum areas,to conduct correlation analysis between the FC values and clinical features.Results There existed significant difference in educational levels among three groups(P<0.05).Group A showed higher scores of MADRS,HAMD-24,SHAPS and lower scores of TEPS as well as consummatory pleasure than group B(P<0.05).There existed significant differences in FC values among left VS,left medial/lateral cingulate gyrus and right dorsolateral superior frontal gyrus,as well as between right VS and right middle temporal gyrus(P<0.05).Compared to group B,group A showed increased FC values between left VS and right dorsolateral superior frontal gyrus,left medial/lateral cingulate gyrus(P<0.05).Correlation analysis found that the FC value between left VS and left medial/lateral cingulate gyrus was positively correlated with SHAPS score in group A(P<0.05).Conclusion The incoordinate between VS and left medial/lateral cingulate gyrus may be the neuropathological basis of melancholic depression.
作者
梁光利
赵超齐
刘婷婷
张柳怡
胡雨璇
乔娟
LIANG Guangli;ZHAO Chaoqi;LIU Tingting(Graduate School of Xuzhou Medical University,Xuzhou 221000,China)
出处
《精神医学杂志》
2024年第1期18-23,共6页
Journal of Psychiatry
基金
江苏省卫生健康委员会科研面上项目(编号:M2021112)
徐州市科技计划项目(编号:KC2018172,KC2022223)
徐州市卫生健康委员会青年医学科技创新项目(编号:XWKYHT20200018)。
关键词
伴忧郁特征抑郁症
功能磁共振
功能连接
腹侧纹状体
Melancholic depression
Functional magnetic resonance imaging
Functional connectivity
Ventral striatum
