Resting-State Functional Connectivity in Treatment-Resistant Depression
Resting-State Functional Connectivity in Treatment-Resistant Depression
复制标题
难治性抑郁症的静息态功能连接
DOI：
10.1176/appi.ajp.2010.10101419
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发表时间：
2011-06-01
影响因子：
17.7
通讯作者：
Gong, Qiyong
中科院分区：
文献类型：
--
作者：
Lui, Su;Wu, Qizhu;Gong, Qiyong
目的：作者使用静息状态功能连接MRI评估难治性和非难治性重度抑郁症患者的脑网络。方法：在横断面研究中，28例难治性重度抑郁症患者，32例非难治性重度抑郁症患者和48例健康对照者在3-T MR系统上使用梯度回波回波平面成像序列进行扫描。在文献中确定的与情绪调节相关的13个感兴趣的区域被选为种子区域。为每个种子提取一个参考时间序列，并用于与大脑其余部分的体素相关分析。三组间基于体素的z值图比较采用单向方差分析，随后采用年龄和疾病持续时间作为无兴趣协变量的事后t检验。结果：与健康对照受试者相比，两组患者双侧前额叶-边缘-丘脑区域的连通性显著降低。然而，非难治性组的连通性下降比难治性组分布更广，尤其是在前扣带皮层和杏仁核、海马和双侧脑岛；相比之下，顽固性组主要在双侧前额叶区域和丘脑区域显示功能连接中断。结论：难治性抑郁症主要与丘脑-皮质回路的功能连通性中断有关，而非难治性抑郁症与边缘-纹状体-苍白体-丘脑回路的功能连通性下降有关。这些结果表明，非难治性和难治性抑郁症在分布式脑中具有明显的功能缺陷
Objective: The authors used resting-state functional connectivity MRI to evaluate brain networks in patients with refractory and nonrefractory major depressive disorder.Method: In a cross-sectional study, 28 patients with refractory major depression, 32 patients with nonrefractory major depression, and 48 healthy comparison subjects underwent scanning using a gradient-echo echo-planar imaging sequence on a 3-T MR system. Thirteen regions of interest that have been identified in the literature as relevant to mood regulation were selected as seed areas. A reference time series was extracted for each seed and used for voxel-wise correlation analysis with the rest of the brain. Voxel-based comparisons of z-value maps among the three groups were performed using one-way analysis of variance followed by post hoc t tests with age and duration of illness as covariates of no interest.Results: Relative to healthy comparison subjects, both patient groups showed significantly reduced connectivity in prefrontal-limbic-thalamic areas bilaterally. However, the nonrefractory group showed a more distributed decrease in connectivity than the refractory group, especially in the anterior cingulate cortex and in the amygdala, hippocampus, and insula bilaterally; in contrast, the refractory group showed disrupted functional connectivity mainly in prefrontal areas and in thalamus areas bilaterally.Conclusions: Refractory depression is associated with disrupted functional connectivity mainly in thalamo-cortical circuits, while nonrefractory depression is associated with more distributed decreased connectivity in the limbic-striatal-pallidal-thalamic circuit. These results suggest that nonrefractory and refractory depression are characterized by distinct functional deficits in distributed brain