Abnormal cerebellar volume in acute and remitted major depression
Abnormal cerebellar volume in acute and remitted major depression
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DOI：
10.1016/j.pnpbp.2016.06.005
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发表时间：
2016-11-03
影响因子：
5.6
通讯作者：
Wolf, Robert C.
中科院分区：
文献类型：
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作者：
Depping, Malte S.;Wolf, Nadine D.;Wolf, Robert C.
在重度抑郁症（MDD）患者中，皮质体积异常是有据可查的，但小脑的发现是异质性的。目前尚不清楚小脑结构异常是否与疾病状态或药物有关。在这项研究中，使用结构MRI，我们调查了临床急性（有和没有精神治疗）和缓解的MDD患者的小脑体积。从急性用药（n = 29）、急性未用药（n = 14）和缓解患者（n = 16）中获得3 T下的高分辨率结构MRI数据。来自29名健康对照的数据用于比较目的。使用小脑优化的基于体素的分析方法研究小脑体积。MDD急性发作患者显示左侧小脑IX区体积增加，用药和未用药个体均如此（聚类校正后p < 0.05）。缓解患者表现出双侧增加面积IX体积。在缓解期，但不是在急性病患者，第九区体积显着相关的措施，抑郁症的严重程度，评估由汉密尔顿抑郁量表（HAMD）。此外，缓解患者的IX区体积与抗抑郁药治疗的持续时间显著相关。在急性病患者中，使用临床变量，如HAMD，疾病或治疗持续时间和抑郁发作次数，没有建立显着的关系。这些数据表明，小脑IX区，一个非运动区域，属于一个大规模的脑功能网络与已知的相关性的核心抑郁症状的表达，表现出异常的体积在患者的临床严重程度或药物治疗。因此，这些数据暗示了这种疾病的一个可能的特征标记。然而，考虑到双侧性和与临床评分的相关性（至少在缓解患者中），目前的研究结果提出了小脑体积也可能反映成功治疗的可能性。(C)2016 Elsevier Inc. All rights reserved.
Abnormal cortical volume is well-documented in patients with major depressive disorder (MDD), but cerebellar findings have been heterogeneous. It is unclear whether abnormal cerebellar structure relates to disease state or medication. In this study, using structural MRI, we investigated cerebellar volume in clinically acute (with and without psychotropic treatment) and remitted MDD patients. High-resolution structural MRI data at 3 T were obtained from acute medicated (n = 29), acute unmedicated (n = 14) and remitted patients (n = 16). Data from 29 healthy controls were used for comparison purposes. Cerebellar volume was investigated using cerebellum-optimized voxel-based analysis methods. Patients with an acute MDD episode showed increased volume of left cerebellar area IX, and this was true for both medicated and unmedicated individuals (p < 0.05 cluster-corrected). Remitted patients exhibited bilaterally increased area IX volume. In remitted, but not in acutely ill patients, area IX volume was significantly associated with measures of depression severity, as assessed by the Hamilton Depression Rating Scale (HAMD). In addition, area IX volume in remitted patients was significantly related to the duration of antidepressant treatment. In acutely ill patients, no significant relationships were established using clinical variables, such as HAMD, illness or treatment duration and number of depressive episodes. The data suggest that cerebellar area IX, a non-motor region that belongs to a large-scale brain functional network with known relevance to core depressive symptom expression, exhibits abnormal volume in patients independent of clinical severity or medication. Thus, the data imply a possible trait marker of the disorder. However, given bilaterality and an association with clinical scores at least in remitted patients, the current findings raise the possibility that cerebellar volume may be reflective of successful treatment as well. (C) 2016 Elsevier Inc. All rights reserved.