Lower cognitive control network connectivity in stroke participants with depressive features.
Lower cognitive control network connectivity in stroke participants with depressive features.
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DOI：
10.1038/s41398-017-0038-x
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发表时间：
2018-03-09
影响因子：
6.8
通讯作者：
Brodtmann A
中科院分区：
文献类型：
--
作者：
Egorova N;Cumming T;Shirbin C;Veldsman M;Werden E;Brodtmann A
大约三分之一的人在缺血性中风后患上抑郁症，但其潜在机制仍知之甚少。中风后抑郁与额叶梗死有关，主要是左背外侧前额叶皮质（DLPFC）的病变。但抑郁症是一种网络障碍，不能通过病变-症状映射来完全表征。非中风人群中抑郁症的研究人员已经成功地利用双侧DLPFC作为种子进入认知控制网络（CCN），并发现与健康对照组相比，即使是轻度抑郁的受试者，CCN的静息状态连接也会减少。因此，我们的目的是调查中风后抑郁的特点和CCN静息态连接在中风人群之间的关联。我们分析了64名中风参与者的DLPFC静息状态连接，其中20人在中风后3个月表现出患者健康问卷（PHQ-9）评估的抑郁特征。我们直接比较了显示抑郁症状的组与没有抑郁症状的组，并对所有参与者的PHQ-9评分进行了回归分析，控制了年龄，性别，病变体积和卒中严重程度。在两组和回归分析中，卒中后抑郁与左侧DLPFC和右侧缘上回（SMG）之间的连接性降低相关。种子和结果均未与卒中病变重叠。这些发现证实了左侧DLPFC在卒中后抑郁中的重要作用，但现在表明，卒中后与抑郁特征相关的大规模网络中断在DLPFC无病变的情况下发生。
Around one-third of people develop depression following ischaemic stroke, yet the underlying mechanisms are poorly understood. Post-stroke depression has been linked to frontal infarcts, mainly lesions in the left dorsolateral prefrontal cortex (DLPFC). But depression is a network disorder that cannot be fully characterised through lesion-symptom mapping. Researchers of depression in non-stroke populations have successfully tapped into the cognitive control network (CCN) using the bilateral DLPFC as a seed, and found that CCN resting-state connectivity is reduced in even mildly depressed subjects, compared to healthy controls. Hence, we aimed to investigate the association between post-stroke depressive features and the CCN resting-state connectivity in a stroke population. We analysed DLPFC resting-state connectivity in 64 stroke participants, 20 of whom showed depressive features assessed with the Patient Health Questionnaire (PHQ-9) at 3 months after stroke. We directly compared groups showing symptoms of depression with those who did not, and performed a regression with PHQ-9 scores in all participants, controlling for age, gender, lesion volume and stroke severity. Post-stroke depression was associated with lower connectivity between the left DLPFC and the right supramarginal gyrus (SMG) in both group and regression analyses. Neither the seed nor the results overlapped with stroke lesions. These findings confirm an important role of the left DLPFC in post-stroke depression, but now show that large-scale network disruptions following stroke associated with depressive features occur without lesions in the DLPFC.
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