Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group.
Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group.
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主要抑郁症的皮层脑改变：来自谜的主要抑郁症工作组的发现。
DOI：
10.1038/mp.2015.69
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发表时间：
2016-06
影响因子：
11
通讯作者：
Hibar DP
中科院分区：
文献类型：
--
作者：
Schmaal L;Veltman DJ;van Erp TG;Sämann PG;Frodl T;Jahanshad N;Loehrer E;Tiemeier H;Hofman A;Niessen WJ;Vernooij MW;Ikram MA;Wittfeld K;Grabe HJ;Block A;Hegenscheid K;Völzke H;Hoehn D;Czisch M;Lagopoulos J;Hatton SN;Hickie IB;Goya-Maldonado R;Krämer B;Gruber O;Couvy-Duchesne B;Rentería ME;Strike LT;Mills NT;de Zubicaray GI;McMahon KL;Medland SE;Martin NG;Gillespie NA;Wright MJ;Hall GB;MacQueen GM;Frey EM;Carballedo A;van Velzen LS;van Tol MJ;van der Wee NJ;Veer IM;Walter H;Schnell K;Schramm E;Normann C;Schoepf D;Konrad C;Zurowski B;Nickson T;McIntosh AM;Papmeyer M;Whalley HC;Sussmann JE;Godlewska BR;Cowen PJ;Fischer FH;Rose M;Penninx BW;Thompson PM;Hibar DP
与重度抑郁症（MDD）相关的大脑结构改变模式仍未解决。部分原因是神经影像学研究的样本量较小，导致统计能力有限、疾病异质性以及临床特征和大脑形态之间复杂的相互作用。为了解决这个问题，我们对来自全球 15 个研究样本的 1728 名 MDD 患者和 7199 名对照者的三维脑磁共振成像数据进行了荟萃分析，以确定能够有力地区分 MDD 患者与健康对照的皮层下脑体积。相对于对照组，患者的海马体积显着较低（Cohen's d=-0.14，％差异=-1.24）。这种效应是由复发性 MDD 患者驱动的（Cohen's d=−0.17，％差异=−1.44），并且我们检测到首次发作患者和对照之间没有差异。发病年龄⩽21岁与较小的海马体（Cohen's d=−0.20，％差异=−1.85）以及较小的杏仁核（Cohen's d=−0.11，％差异=−1.23）和较大的侧脑室（Cohen's d=0.12，％差异=5.11）的趋势相关。研究纳入时的症状严重程度与任何区域脑容量无关。平均年龄、抗抑郁药物使用者比例和缓解患者比例等样本特征以及方法学特征并没有显着调节 MDD 脑容量的变化。与对照组相比，抗精神病药物使用者比例较高的样本显示，重度抑郁症患者的尾状核体积更大。这项目前全球规模最大的识别皮层下大脑改变的努力显示，重度抑郁症患者的海马体积明显变小，并受到发病年龄和首次发作与复发发作状态的调节。
The pattern of structural brain alterations associated with major depressive disorder (MDD) remains unresolved. This is in part due to small sample sizes of neuroimaging studies resulting in limited statistical power, disease heterogeneity and the complex interactions between clinical characteristics and brain morphology. To address this, we meta-analyzed three-dimensional brain magnetic resonance imaging data from 1728 MDD patients and 7199 controls from 15 research samples worldwide, to identify subcortical brain volumes that robustly discriminate MDD patients from healthy controls. Relative to controls, patients had significantly lower hippocampal volumes (Cohen's d=−0.14, % difference=−1.24). This effect was driven by patients with recurrent MDD (Cohen's d=−0.17, % difference=−1.44), and we detected no differences between first episode patients and controls. Age of onset ⩽21 was associated with a smaller hippocampus (Cohen's d=−0.20, % difference=−1.85) and a trend toward smaller amygdala (Cohen's d=−0.11, % difference=−1.23) and larger lateral ventricles (Cohen's d=0.12, % difference=5.11). Symptom severity at study inclusion was not associated with any regional brain volumes. Sample characteristics such as mean age, proportion of antidepressant users and proportion of remitted patients, and methodological characteristics did not significantly moderate alterations in brain volumes in MDD. Samples with a higher proportion of antipsychotic medication users showed larger caudate volumes in MDD patients compared with controls. This currently largest worldwide effort to identify subcortical brain alterations showed robust smaller hippocampal volumes in MDD patients, moderated by age of onset and first episode versus recurrent episode status.