Widespread white matter but focal gray matter alterations in depressed individuals with thoughts of death.
Widespread white matter but focal gray matter alterations in depressed individuals with thoughts of death.
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DOI：
10.1016/j.pnpbp.2015.05.001
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发表时间：
2015-10-01
影响因子：
5.6
通讯作者：
MacFall, James R.
中科院分区：
文献类型：
--
作者：
Taylor, Warren D.;Boyd, Brian;McQuoid, Douglas R.;Kudra, Kamil;Saleh, Ayman;MacFall, James R.
过去的研究表明，有自杀想法或行为的抑郁症患者表现出特定的神经解剖学改变。这可能代表了一种独特的表现型，其特征是神经影像学上的特定发现，但尚不清楚这些发现是否适用于有轻微死亡想法的个体。我们在未接受抗抑郁治疗的复发性重度抑郁症门诊患者中研究了这个问题。我们检查了165名受试者：53名没有死亡想法的抑郁症患者，21名有死亡想法的抑郁症患者，91名健康对照受试者。参与者完成3T颅MRI，包括解剖和弥散张量成像采集。除了皮质厚度外，自动化方法还测量了区域灰质体积。白质分析检查了特定纤维束内的扩散测量，并包括体向比较。经过多次比较调整后，有死亡想法的抑郁组在区域灰质体积上没有表现出差异，但在额顶区和脑岛确实表现出皮层厚度的减少。有死亡想法的抑郁组在分数各向异性和径向扩散率方面也表现出广泛的白质差异。这些差异主要在顶叶后白质区和靠近基底节区和丘脑的中央白质束观察到。轻微的死亡想法与突出网络、默认模式网络和丘脑皮质回路区域的结构改变有关。需要进一步的工作来了解这些发现的病理基础。
Past work demonstrates that depressed individuals with suicidal thoughts or behaviors exhibit specific neuroanatomical alterations. This may represent a distinct phenotype characterized by specific findings on neuroimaging, but it is unclear if these findings extend to individuals with milder thoughts of death. We examined this question in outpatients with recurrent Major Depressive Disorder not receiving antidepressant treatment. We examined 165 subjects: 53 depressed without thoughts of death, 21 depressed with thoughts of death, and 91 healthy comparison subjects. Participants completed 3T cranial MRI, including anatomical and diffusion tensor imaging acquisitions. Automated methods measured regional gray matter volumes in addition to cortical thickness. White matter analyses examined diffusion measures within specific fiber tracts and included voxelwise comparisons. After adjustment for multiple comparisons, the depressed group with thoughts of death did not exhibit differences in regional gray matter volume, but did exhibit reduced cortical thickness in frontoparietal regions and the insula. This depressed group with thoughts of death also exhibited widespread white matter differences in fractional anisotropy and radial diffusivity. These differences were observed primarily in posterior parietal white matter regions and central white matter tracts adjacent to the basal ganglia and thalamus. Mild thoughts of death are associated with structural alterations in regions of the salience network, default mode network, and thalamocortical circuits. Further work is needed to understand the pathological basis of these findings.
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