The prognosis and changes of regional brain gray matter volume in MDD with gastrointestinal symptoms
The prognosis and changes of regional brain gray matter volume in MDD with gastrointestinal symptoms
复制标题
伴胃肠道症状MDD的预后及局部脑灰质体积变化
DOI：
10.2147/ndt.s197351
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发表时间：
2019-01-01
影响因子：
3.2
通讯作者：
Zhang, Kerang
中科院分区：
文献类型：
--
作者：
Liu, Penghong;Li, Gaizhi;Zhang, Kerang
目的：抑郁症（MDD）伴发胃肠道症状是常见的。然而，很少有研究集中在临床特点和其可能的机制，而脑灰质（GM）结构是重要的发病机制，胃肠道症状。本研究旨在探讨伴有胃肠道症状的MDD患者的基本临床特征和局部GM体积变化。方法：选取49例抑郁症患者和30例年龄、性别、文化程度相匹配的健康对照者。根据GI状态将MDD患者分为两组：MDD伴GI症状组（n=27）和MDD不伴GI症状组（n=22）。采用汉密尔顿抑郁量表（HAMD）进行评定。获取T1加权解剖图像并进行分析。相关性分析用于确定区域GM体积变化与GI症状和抑郁症状之间的可能关联。结果：有胃肠道症状组治疗2周HAMD减分率明显高于无胃肠道症状组（P<0.05）。三组间区域GM体积差异有统计学意义（高斯随机场校正，体素P <0.01，聚类P <0.05）。与非胃肠道症状组比较，胃肠道症状组左侧海马、左侧海马旁回、右侧海马旁回的GM体积显著增加，右侧额中回、右侧中央前回、右侧楔前叶、右侧上级枕回的GM体积显著减少（GRF校正，体素P <0.01，聚类P <0.05）。这些改变的大脑区域与胃肠道症状相关，而不是抑郁症状。结论：GI MDD患者局部脑GM体积改变可能是GI症状的发病机制。此外，胃肠道症状可预测MDD的预后。
Objective: It is common that major depressive disorder (MDD) is accompanied by gastrointestinal (GI) symptoms. However, few studies have focused on the clinical characteristics and its possible mechanism, while brain gray matter (GM) structure is important in the pathogenesis of GI symptoms. In this study, we aimed to investigate the basic clinical characteristics and regional GM volume changes in MDD accompanied by GI symptoms. Method: Patients with MDD (n=49) and age, gender, and educational level-matched healthy controls (n=30) were recruited. Patients with MDD were divided into two groups based on the GI status: MDD with (n=27) and without (n=22) GI symptoms. The 24-item Hamilton Depression Rating Scale (HAMD) was administered. T1-weighted anatomical images were obtained and analyzed. Correlation analysis was used to identify the possible associations between changed regional GM volume and GI symptoms and depressive symptoms. Results: The HAMD reductive ratio for 2 weeks of treatment in the GI symptoms group was significantly higher than the non-GI symptoms group (P<0.05). The regional GM volume showed significant differences among the three groups (Gaussian Random Field [GRF] correction, voxel-P<0.01, cluster-P <0.05). Compared with non-GI symptoms group, GI symptoms group exhibited significantly increased GM volume in the left hippocampus, left parahippocampal gyrus, right parahippocampal gyrus; and decreased GM volume in the right middle frontal gyrus, right precentral gyrus, right cuneus, right precuneus, right superior occipital gyrus (GRF correction, voxel-P <0.01, cluster-P <0.05). These altered brain areas were correlated with the GI symptoms, not depressive symptoms. Conclusion: The changed regional brain GM volume in GI-MDD group may be the pathogenesis for the GI symptoms. In addition, the GI symptoms may predict the prognosis of MDD.