A preliminary study of white matter in adolescent depression: relationships with illness severity, anhedonia, and irritability.
A preliminary study of white matter in adolescent depression: relationships with illness severity, anhedonia, and irritability.
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DOI：
10.3389/fpsyt.2013.00152
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发表时间：
2013
影响因子：
4.7
通讯作者：
Gabbay V
中科院分区：
文献类型：
--
作者：
Henderson SE;Johnson AR;Vallejo AI;Katz L;Wong E;Gabbay V
青春期重度抑郁症（MDD）是一种常见的致残性精神疾病，然而，对其神经生物学基础知之甚少。有证据表明，成人的MDD涉及白色和灰质的改变;然而，很少有研究集中在青少年MDD。同样，很少有研究解释抑郁症青少年症状严重程度的广泛差异。在这里，我们的目的是调查白色物质（WM）的微结构之间的17名青少年MDD和16名匹配的健康对照（HC）使用扩散张量成像。我们进一步评估了抑郁症组中工作记忆完整性与抑郁严重程度之间的关系，以及快感缺乏和易怒-青少年抑郁症的两个核心症状。正如预期的那样，与HC相比，MDD青少年在前扣带和前放射冠中表现出WM完整性降低。在MDD组中，更严重的抑郁与胼胝体、前丘脑放射、前扣带回和矢状层的WM完整性降低相关。然而，快感缺乏和易激惹与不同的WM束的变化。具体来说，快感缺乏与奖赏处理相关的神经束紊乱有关，包括内囊的前肢和眶额皮质的投射纤维。易怒与矢状层、前放射冠以及通往前额叶和颞叶皮质的神经束的完整性降低有关。总的来说，这些初步的研究结果提供了进一步的支持的假设，有一个前额叶和边缘情感区域之间的断开抑郁症，具体的临床症状涉及WM束的明显改变。
Major depressive disorder (MDD) during adolescence is a common and disabling psychiatric condition; yet, little is known about its neurobiological underpinning. Evidence indicates that MDD in adults involves alterations in white and gray matter; however, sparse research has focused on adolescent MDD. Similarly, little research has accounted for the wide variability of symptom severity among depressed teens. Here, we aimed to investigate white matter (WM) microstructure between 17 adolescents with MDD and 16 matched healthy controls (HC) using diffusion tensor imaging. We further assessed within the MDD group relationships between WM integrity and depression severity, as well as anhedonia and irritability – two core symptoms of adolescent MDD. As expected, adolescents with MDD manifested decreased WM integrity compared to HC in the anterior cingulum and anterior corona radiata. Within the MDD group, greater depression severity was correlated with reduced WM integrity in the genu of corpus callosum, anterior thalamic radiation, anterior cingulum, and sagittal stratum. However, anhedonia and irritability were associated with alterations in distinct WM tracts. Specifically, anhedonia was associated with disturbances in tracts related to reward processing, including the anterior limb of the internal capsule and projection fibers to the orbitofrontal cortex. Irritability was associated with decreased integrity in the sagittal stratum, anterior corona radiata, and tracts leading to prefrontal and temporal cortices. Overall, these preliminary findings provide further support for the hypotheses that there is a disconnect between prefrontal and limbic emotional regions in depression, and that specific clinical symptoms involve distinct alterations in WM tracts.