重性抑郁障碍伴焦虑痛苦特征青少年静息态脑影像学特征

doi:10.11852/zgetbjzz2023-0745

中国儿童保健杂志 ›› 2023, Vol. 31 ›› Issue (12): 1286-1291.DOI: 10.11852/zgetbjzz2023-0745

重性抑郁障碍伴焦虑痛苦特征青少年静息态脑影像学特征

李改智^1,2, 乔丹¹, 牛颖³, 温宇娇², 刘志芬², 张克让^1,2

1.山西医科大学第一临床医学院,山西太原 030001;
2.山西医科大学第一医院精神卫生科,山西太原 030001;
3.山西医科大学医学科学院

收稿日期:2023-07-27 修回日期:2023-09-30 发布日期:2023-12-04 出版日期:2023-12-10
通讯作者: 刘志芬,E-mail:liuzhifen5581@163.com;张克让,E-mail:krzhang_sxmu@vip.163.com
作者简介:李改智(1987-),女,副教授,博士学位,主要从事儿童青少年精神病学的研究。
基金资助:
国家自然科学基金面上项目(82371551);山西省医学科技创新人才强医计划(2023RC010);山西省“136”兴医工程项目(Y2022136008);山西省科技创新人才团队(202204051001027)

Characteristics of resting-state functional magnetic resonance imaging in adolescents with major depressive disorder comorbid anxious distress

LI Gaizhi^1,2, QIAO Dan¹, NIU Ying³, WEN Yujiao², LIU Zhifen², ZHANG Kerang^1,2

1. The First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi 030001,China;
2. Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China;
3. College of Medical Sciences, Shanxi Medical University

Received:2023-07-27 Revised:2023-09-30 Online:2023-12-10 Published:2023-12-04
Contact: LIU Zhifen, E-mail:liuzhifen5581@163.com; ZHANG Kerang, E-mail: krzhang_sxmu@vip.163.com

摘要/Abstract

摘要： 目的分析伴焦虑痛苦特征的重性抑郁障碍(MDD)青少年静息态脑影像学特征,进一步了解其神经机制。方法采取方便抽样纳入2022年1—12月期间就诊于山西医科大学第一医院精神卫生科门诊的27例MDD伴焦虑痛苦特征青少年和社区招募的36名健康对照。采用3.0T西门子磁共振扫描仪采集静息态脑影像学数据。比较两组青少年一般人口学资料、脑影像学数据的差异,分析差异脑区与临床症状的相关。结果 MDD伴焦虑痛苦特征组和对照组年龄、性别差异无统计学意义(P>0.05)。将年龄、性别、受教育年限作为协变量,MDD组左侧枕中回的Bc值(节点介数)高于健康对照组(P<0.05,FDR校正),双侧枕下回的NCp(节点聚类系数)、NLe(节点局部效率)、以及左侧楔叶的NLe(节点局部效率)低于健康对照组(P<0.05,FDR校正)。差异脑区与汉密尔顿抑郁量表(HAMD)和焦虑量表(HAMA)得分无显著相关性(P＞0.05,FDR校正)。结论伴有焦虑痛苦特征的重性抑郁障碍青少年局部节点的拓扑属性存在异常,表现为双侧枕下回,左侧楔叶以及枕中回,本研究为进一步了解MDD伴有焦虑痛苦特征亚型青少年的神经机制提供脑影像学的证据支持。

关键词: 重性抑郁障碍, 焦虑痛苦特征, 青少年

Abstract: Objective To assess the neuroimaging characteristics of adolescents with major depressive disorder (MDD) comorbid anxious distress, in order to understand the underlying neuro-mechanism. Methods A convenient sample of 27 adolescents with MDD with anxious distress who visited the outpatient clinic of the Department of Psychiatry of the First Hospital of Shanxi Medical University from January to December 2022, and 36 healthy controls were included in this study. All participants completed a case report form and underwent fMRI data collection.Difference in general demographic data and fMRI data between the two groups were compared,and the correlation between the differentiated brain areas and clinial symptoms was analyzed. Results No significant difference was observed in age and gender between the two groups(P>0.05). However, after adjusting for age, gender and educational level, the Bc value in the left middle occipital gyri (MOG) was significantly higher in MDD with anxious distress group (P<0.05, FDR correction). Additionally, the NCp/NLe value of the bilateral inferior occipital gyri (IOG) and NLe of the left cuneus were significantly lower compared to the healthy control group (P<0.05, FDR correction).However, the Bc/NCp/NLe value of the differentiated brain areas did not show any correlation with the scores on the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) (P＞0.05, FDR correction). Conclusions The topology properties of adolescents with MDD and anxious distress differ from those of healthy controls, particularly in the bilateral IOG, left cuneus, and MOG. These findings further the understanding of MDD with anxious distress.

Key words: major depressive disorder, anxious distress, adolescent

中图分类号:

R749

李改智, 乔丹, 牛颖, 温宇娇, 刘志芬, 张克让. 重性抑郁障碍伴焦虑痛苦特征青少年静息态脑影像学特征[J]. 中国儿童保健杂志, 2023, 31(12): 1286-1291.

LI Gaizhi, QIAO Dan, NIU Ying, WEN Yujiao, LIU Zhifen, ZHANG Kerang. Characteristics of resting-state functional magnetic resonance imaging in adolescents with major depressive disorder comorbid anxious distress[J]. Chinese Journal of Child Health Care, 2023, 31(12): 1286-1291.

参考文献

[1] Drysdale AT, Grosenick L,Downar J, et al. Resting-state connectivity biomarkers define neurophysiological subtypes of depression[J]. Nat Med,2017,23(1):28-38.
[2] Gaspersz R, Nawijn L, Lamers F, et al. Patients with anxious depression: Overview of prevalence, pathophysiology and impact on course and treatment outcome[J]. Curr Opin Psychiatry,2018,31(1):17-25.
[3] Thase ME, Weisler RH, Manning JS, et al. Utilizing the DSM-5 anxious distress specifier to develop treatment strategies for patients with major depressive disorder[J]. J Clin Psychiatry,2017,78(9):22046.
[4] Braund TA, Palmer DM, Williams LM, et al. Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report[J]. Aust N Z J Psychiatry,2019,53(8):782-793.
[5] Tsai J, Thase ME, Mao Y, et al. Lurasidone for major depressive disorder with mixed features and anxiety: A post-hoc analysis of a randomized, placebo-controlled study[J]. CNS Spectr,2017,22(2):236-245.
[6] McIntyre RS, Weiller E, Zhang P, et al. Brexpiprazole as adjunctive treatment of major depressive disorder with anxious distress: Results from a post-hoc analysis of two randomised controlledtrials[J].J Affect Disord,2016,201:116-123.
[7] Nelson JC. Anxious depression and response to treatment[J]. Am J Psychiatry,2008,165(3):297-299.
[8] Ma X, Liu J, Liu T, et al. Altered resting-state functional activity in medication-naive patients with first-episode major depression disorder vs. healthy control: A quantitative meta-analysis[J]. Front Behav Neurosci,2019,13:89.
[9] Zhang L, Cui X, Ou Y, et al. Abnormal long- and short-range functional connectivity in patients with first-episode drug-naive melancholic and non-melancholic major depressive disorder[J]. J Affect Disord, 2023,320:360-369.
[10] Gong L, Hou Z, Wang Z, et al. Disrupted topology of hippocampal connectivity is associated with short-term antidepressant response in major depressive disorder[J]. J Affect Disord, 2018,225:539-544.
[11] American Psychiatric Association. Diagnostic and statistical manual of mental disorders:DSM-5[M]. American Psychiatric Pub, 2013.
[12] Hamilton M.A Rating scale for depression[J].J Neurol Neurosurg Psychiatry,1960,23:56-62.
[13] Hamilton M.The assessment of anxiety states by rating[J].Br J Med Psychol,1959,32(1):50-55.
[14] Guo H, Cheng C, Cao X, et al. Resting-state functional connectivity abnormalities in first-onset unmedicated depression[J]. NeuralRegen Res,2014, 9(2):153-163.
[15] Chen CJ, Liu ZJ, Xi C, et al. Multimetric structural covariance in first-episode major depressive disorder:A graph theoretical analysis[J]. J Psychiatry Neurosci, 2022, 47(3):e176-e185.
[16] Dong Q, Liu J, Zeng L, et al. State-independent microstructural white matter abnormalities in major depressive disorder[J]. Front Psychiatry, 2020,11:431.
[17] Zhang J, Wang J, Wu Q, et al. Disrupted brain connectivity networks in drug-naive, first-episode major depressive disorder[J]. Biol Psychiatry,2011,70(4):334-342.
[18] Wang X, Tan H, Li X, et al. Resting-state functional magnetic resonance imaging-based identification of altered brain the fractional amplitude of low frequency fluctuation in adolescent major depressive disorder patients undergoing electroconvulsive therapy[J]. Front Psychiatry, 2022,13:972968.
[19] Guo Z, Chen L, Tang LR, et al. Association between decreased interhemispheric functional connectivity of the insula and duration of illness in recurrent depression[J]. J Affect Disord, 2023,329:88-95.
[20] Hou Z, Kong Y, He X, et al. Increased temporal variability of striatum region facilitating the early antidepressant response in patients with major depressive disorder[J].Prog Neuropsychopharmacol Biol Psychiatry, 2018,85:39-45.
[21] Desseilles M, Balteau E, Sterpenich V, et al. Abnormal neural filtering of irrelevant visual information in depression[J]. J Neurosci,2009,29(5):1395-1403.
[22] Veer IM, Beckmann CF, van Tol MJ, et al. Whole brain resting-state analysis reveals decreased functional connectivity in major depression[J]. Front Syst Neurosci,2010,4:41.
[23] Parker JG, Zalusky EJ, Kirbas C. Functional MRI mapping of visual function and selective attention for performance assessment and presurgical planning using conjunctive visual search[J]. Brain and Behav,2014,4(2):227-237.
[24] Štillová K, Jurák P, Chládek J, et al. The posterior medial cortex is involved in visual but not in verbal memory encoding processing: An intracerebral recording study[J]. J Neural Transm, 2013,120(3):391-397.
[25] Yuan J, Yu H, Yu M, et al. Altered spontaneous brain activity in major depressive disorder: An activation likelihood estimation Meta-analysis[J]. J Affect Disord,2022,314:19-26.
[26] Li G, Rossbach K, Zhang A, et al. Resting-state functional changes in the precuneus within first-episode drug-naive patients with MDD[J].Neuropsychiatr Dis Treat,2018,14:1991-1998.
[27] Marwood L, Wise T, Perkins AM, Cleare AJ. Meta-analyses of the neural mechanisms and predictors of response to psychotherapy in depression and anxiety[J].Neurosci Biobehav Rev,2018,95:61-72.

重性抑郁障碍伴焦虑痛苦特征青少年静息态脑影像学特征

Characteristics of resting-state functional magnetic resonance imaging in adolescents with major depressive disorder comorbid anxious distress

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	王雯雷, 张俊, 厚磊, 张荣, 夏木斯叶·木依都力, 董言, 者炜, 沙吾拉西·热加甫, 方萍, 阿迪拉·苏力旦. 新疆7～17岁儿童青少年超重肥胖和血压关系的关联研究[J]. 中国儿童保健杂志, 2024, 32(9): 953-957.
[2]	王爱, 周冰倩, 于健, 曹虹. 儿童青少年骨健康的评估及其影响因素[J]. 中国儿童保健杂志, 2024, 32(9): 980-983.
[3]	程轲, 王宝西, 王春晖, 宋丽佳, 习颖, 郭薇, 杨茜, 兰莉. 5~14岁儿童青少年体成分与骨密度的关联[J]. 中国儿童保健杂志, 2024, 32(8): 844-849.
[4]	任庆新, 安娜, 黄建萍, 陈睿, 张卫兵, 吴越. 南通市中小学生脊柱侧弯现状及影响因素[J]. 中国儿童保健杂志, 2024, 32(8): 868-874.
[5]	鲁果果, 黄晓金, 李国华, 赵永利. 青少年血清维生素D水平与非酒精性脂肪性肝病相关性的Meta分析[J]. 中国儿童保健杂志, 2024, 32(8): 897-901.
[6]	查彩慧, 欧婉杏. 青少年非自杀性自伤的识别和干预[J]. 中国儿童保健杂志, 2024, 32(7): 697-699.
[7]	罗学荣, 汤信海, 申艳梅. 青少年抑郁症的评估与管理[J]. 中国儿童保健杂志, 2024, 32(7): 700-703.
[8]	尤丽君, 左霞云, 余春艳, 廉启国, 房宇航, 涂晓雯, 楼超华. 青春期早期青少年身体满意度与抑郁症状的关联[J]. 中国儿童保健杂志, 2024, 32(7): 713-717.
[9]	张燕妮, 黄翔, 叶轶鹏, 李欣, 彭道福, 宋永晶, 刘宁凌, 蒋竞. 青少年负性情绪与力量素质的关联[J]. 中国儿童保健杂志, 2024, 32(7): 725-731.
[10]	陈顺, 林雪梅, 袁乔英, 刘芳, 肖曙芳, 乐小婧, 张曼, 李仙. 1990—2019年中国儿童青少年1型糖尿病负担分析与模型预测[J]. 中国儿童保健杂志, 2024, 32(7): 746-751.
[11]	刘思佳, 黄垂灿, 樊利春. 家庭伤害对儿童青少年心理认知和社会适应能力发展的影响[J]. 中国儿童保健杂志, 2024, 32(7): 757-761.
[12]	许婷, 刘鹏鸿, 李树峰, 高胜利, 刘丽霞. 网络认知行为疗法对青少年抑郁症状疗效Meta分析[J]. 中国儿童保健杂志, 2024, 32(7): 778-784.
[13]	曹慧, 陈敬, 单蕊, 肖伍才, 张晓蕊, 刘峥. 父母教养方式与青春前期儿童青少年娱乐性视屏时长的关联[J]. 中国儿童保健杂志, 2024, 32(6): 608-612.
[14]	鲍成臻, 高丽丽, 韩历丽. 北京市青少年生存质量现状与健康认知和健康行为的关系[J]. 中国儿童保健杂志, 2024, 32(6): 687-691.
[15]	金彩娥, 李高强, 杨庆伟, 杨顺玲, 王益民. 蒙自市7～17岁儿童青少年超重、肥胖和血压偏高现状分析[J]. 中国儿童保健杂志, 2024, 32(4): 384-388.