Aberrant connectivity within the default mode network in first-episode, treatment-naive major depressive disorder
Aberrant connectivity within the default mode network in first-episode, treatment-naive major depressive disorder
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DOI：
10.1016/j.jad.2015.04.052
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发表时间：
2015-09-01
影响因子：
6.6
通讯作者：
Zhong, Yuan
中科院分区：
文献类型：
--
作者：
Chen, Yu;Wang, Chun;Zhong, Yuan
背景：抑郁障碍（MDD）患者的默认模式网络（DMN）功能障碍已被广泛研究。在静息状态功能连接分析中，后扣带皮层（PCC）和内侧前额叶皮层（mPFC）的连接性改变尤其令人感兴趣。最近，更多的注意力已经转向DMN内部的功能连接。然而，DMN内的内部连接模式仍不清楚，在最初发病的MDD.Methods：静息状态下的功能磁共振成像进行了38例首次发作，治疗初治MDD患者沿着与38名匹配的健康对照。使用基于种子的分析来定义DMN，然后执行区域到区域的连接性分析以检查DMN内的功能连接性。结果：DMN内PCC与背内侧前额叶皮质（dmPFC）、PCC与右侧顶下回/角回、左侧丘脑与小脑扁桃体之间的区域-区域连通性均降低。左侧丘脑和小脑扁桃体之间的功能连接与临床汉密尔顿抑郁量表（HDRS）评分呈边缘显著负相关。局限性：值得注意的发病率，死亡率高的风险，和医疗服务利用率高的MDD使目前的结果不确定适用于更复杂的situations.Conclusions：DMN内的每个区域可能有一个特定的，个人的功能作用。明确MDD的病理机制可能不在于DMN的功能连接异常，而在于DMN内部的功能连接异常。(C)2015 Elsevier B. V.版权所有。
Background: Convergent studies have highlighted the dysfunction of default mode network (DMN) in major depressive disorder (MDD). The altered connectivity in posterior cingulate cortex (PCC) and medial prefrontal cortex (mPFC) was especially found to be of interest in the resting state functional connectivity analysis. Recently, more attention has turned to the internal functional connectivity within the DMN. However, the internal connection patterns within the DMN remain unclear at the initial onset of MDD.Methods: Resting-state fMRI was performed on 38 first-episode, treatment-naive MDD patients along with 38 matched healthy controls. Seed-based analysis was used to define the DMN and then a region-to-region connectivity analysis was performed to inspect the functional connectivity within the DMN. Spearman's rank correlation analysis was performed between significantly abnormal connectivities in MDD patients and clinical measurements.Results: Decreased region-to-region connectivities within DMN were found between the PCC and dorsal medial prefrontal cortex (dmPFC), between PCC and the right inferior parietal gyrus/angular, as well as between the left thalamus and cerebellar tonsil. No significant increase in connectivity was found. Moreover, functional connectivity between the left thalamus and cerebellar tonsil revealed a marginal significant negative correlation with clinical Hamilton Depression Rating Scale (HDRS) scores. Limitations: Noteworthiness in morbidity, a high risk of mortality, and a high rate of medical service utilization of MDD make the current results uncertain to apply to the more complicated situations.Conclusions: Each region within DMN may have a specific, individual functional role. The reason to identify the pathological mechanism of MDD may not lie in the abnormal DMN functional connectivity, but rather in the abnormal functional connectivity within DMN. (C) 2015 Elsevier B.V. All rights reserved.