The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder.
The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder.
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DOI：
10.1016/j.nicl.2016.04.008
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Sun X
中科院分区：
文献类型：
--
作者：
Lu Y;Liang H;Han D;Mo Y;Li Z;Cheng Y;Xu X;Shen Z;Tan C;Zhao W;Zhu Y;Sun X
以往的MRI研究证实重度抑郁症（MDD）患者的边缘-皮质-纹状体-丘脑（LCSPT）网络或边缘-皮质-纹状体-丘脑-皮层（LCSTC）回路存在异常，但对皮层下结构异常的研究很少。因此，我们试图确定局灶性皮质下灰质（GM）变化是否可能在早期出现在MDD中。我们招募了30名首发、未经治疗的重度抑郁症（MDD）患者和26名健康对照。采用基于体素的形态测量法评估皮质灰质变化，采用自动体积和形状分析分别评估皮质下GM结构的体积和形状变化。此外，我们使用概率神经束造影方法来证明皮质下和皮质GM之间的关系。与健康对照相比，重度抑郁症患者双侧壳核和左侧丘脑的体积显著减少（fwe校正，p < 0.05）。同时，基于顶点的形状分析显示，MDD患者双侧壳核背外侧和腹内侧以及左丘脑背外侧和腹内侧的区域收缩（fwe校正，p < 0.05）。此外，在左侧丘脑背侧的局部萎缩与代表严重程度的临床变量之间发现了负相关。此外，概率神经束造影显示双侧壳核和左丘脑的形状变形区域与额叶和颞叶有联系，这与重度抑郁症有关。我们的研究结果表明，壳核和丘脑的结构异常可能存在于MDD的早期阶段，这支持了皮层下结构在MDD病理生理中的作用。同时，本研究表明这些皮质下结构异常可能是重度抑郁症的潜在特征标记。壳核和丘脑结构异常可能是早期MDD的潜在特征标志。LCSTC回路或LCSPT回路的异常可能与MDD的病理生理有关。与体积分析和VBM分析相比，形状分析对细微的结构变化更为敏感。
Previous MRI studies confirmed abnormalities in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) network or limbic-cortico-striatal-thalamic-cortical (LCSTC) circuits in patients with major depressive disorder (MDD), but few studies have investigated the subcortical structural abnormalities. Therefore, we sought to determine whether focal subcortical grey matter (GM) changes might be present in MDD at an early stage. We recruited 30 first episode, untreated patients with major depressive disorder (MDD) and 26 healthy control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetric and shape analyses were used to assess volume and shape changes of the subcortical GM structures, respectively. In addition, probabilistic tractography methods were used to demonstrate the relationship between the subcortical and the cortical GM. Compared to healthy controls, MDD patients had significant volume reductions in the bilateral putamen and left thalamus (FWE-corrected, p < 0.05). Meanwhile, the vertex-based shape analysis showed regionally contracted areas on the dorsolateral and ventromedial aspects of the bilateral putamen, and on the dorsal and ventral aspects of left thalamus in MDD patients (FWE-corrected, p < 0.05). Additionally, a negative correlation was found between local atrophy in the dorsal aspects of the left thalamus and clinical variables representing severity. Furthermore, probabilistic tractography demonstrated that the area of shape deformation of the bilateral putamen and left thalamus have connections with the frontal and temporal lobes, which were found to be related to major depression. Our results suggested that structural abnormalities in the putamen and thalamus might be present in the early stages of MDD, which support the role of subcortical structure in the pathophysiology of MDD. Meanwhile, the present study showed that these subcortical structural abnormalities might be the potential trait markers of MDD. Structural abnormalities in putamen and thalamus might be the potential trait marker of MDD at the early stage. The abnormality of LCSTC circuits, or LCSPT circuit, may contribute to the pathophysiology of MDD. The shape analysis is more sensitive to subtle structural changes than volumetric and VBM analysis.