Brain Functional Differences in Drug-Naive Major Depression with Anxiety Patients of Different Traditional Chinese Medicine Syndrome Patterns: A Resting-State fMRI Study
Brain Functional Differences in Drug-Naive Major Depression with Anxiety Patients of Different Traditional Chinese Medicine Syndrome Patterns: A Resting-State fMRI Study
复制标题
不同中医证型初治抑郁伴焦虑患者脑功能差异：静息态功能磁共振研究
DOI：
10.1155/2020/7504917
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发表时间：
2020-02-18
影响因子：
--
通讯作者：
Li, Li
中科院分区：
文献类型：
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作者：
Du, Yi;Zhao, Jingjie;Li, Li
重性抑郁障碍（MDD）在我国发病率高，检出率低，尤其是合并焦虑的MDD。文献表明，重度抑郁伴焦虑（MDA）患者更可能提名躯体症状，而不是心理症状作为他们的主诉。在中医理论中，MDD患者的临床症状主要分为虚实两种不同的证型。本研究拟利用静息态功能磁共振成像（rs-fMRI）技术研究其脑功能差异，以期发现其脑功能机制。在我们的研究中，42名药物初治的MDA患者被分为两组（21名为缺乏组，21名为过量组），另外19名未受影响的参与者在正常对照组（NC）。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和脑功能磁共振成像（fMRI）对各组进行测量和分析。我们首先使用度中心性（DC）来映射大脑区域的功能差异，利用这些区域作为种子点，并使用基于种子的功能连接（FC）分析来识别组之间的特定功能连接。气虚组HAMD总分、HAMA总分、HAMD躯体因子分均高于实证组。在DC分析中，与NC组相比，在缺乏和过度组的右楔前叶中发现了显著降低。在FC分析中，与NC组和过量组相比，缺乏组的右侧楔前叶与双侧楔叶以及右侧舌回的网络连接显著降低。通过我们的研究发现楔前叶功能障碍可能与MDA有关，并且缺乏症患者的躯体和情绪症状更严重，我们意识到进一步的研究需要更大的样本量和多脑模式观察。
Major depressive disorder (MDD), especially combined with anxiety, has a high incidence and low detection rate in China. Literature has shown that patients under major depression with anxiety (MDA) are more likely to nominate a somatic, rather than psychological, symptom as their presenting complaint. In the theory of Traditional Chinese Medicine (TCM), clinical symptoms of MDD patients are mainly categorized into two different syndrome patterns: Deficiency and Excess. We intend to use resting-state functional magnetic resonance imaging (rs-fMRI) to investigate their brain functional differences and hopefully to find their brain function mechanism. For our research, 42 drug-naive MDA patients were divided into two groups (21 for Deficiency and 21 for Excess), with an additional 19 unaffected participants in the normal control (NC) group. We took Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), and brain fMRI scan for each group and analyzed the data. We first used Degree Centrality (DC) to map the functional differences in brain regions, utilized these regions as seed points, and used a seed-based functional connectivity (FC) analysis to identify the specific functional connection between groups. The Deficiency group was found to have higher HAMD scores, HAMA scores, and HAMD somatic factor than the Excess group. In the DC analysis, significant decreases were found in the right precuneus of both the Deficiency and Excess groups compared to the NC group. In the FC analysis, the right precuneus showed significant decreased network connectivity with the bilateral cuneus, as well as the right lingual gyrus in the Deficiency group when compared to the NC group and the Excess group. Through our research, it was found that precuneus dysfunction may have a relationship with MDA and Deficiency patients have more severe physical and emotional symptoms, and we realized that a larger sample size and multiple brain mode observations were needed in further research.