产后抑郁症患者静息态下情绪网络功能连接的脑功能磁共振研究

来源 :中国神经精神疾病杂志 | 被引量 : 0次 | 上传用户:wanghua8503
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目的 探讨产后抑郁症(postpartum depression,PPD)患者静息态下情绪网络(affective network,AN)的功能连接(functional connectivity,FC)特点及意义.方法 选取产褥期抑郁症患者23例(PPD组)和健康产妇28名(对照组)进行静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)扫描,以杏仁核(amygdala,AMYG)和膝下前扣带回(subgenual anterior cingulate cortex,sgACC)为感兴趣区(region of interest,ROI),分析AMYG和sgACC与全脑其他脑区FC强度的组间差异,并对PPD组中异常AN-FC强度与爱丁堡产后抑郁量表(Edinburgh postnatal depression scale,EPDS)评分进行相关分析.结果 与对照组相比,PPD组AMYG与额叶、颞叶、海马、小脑、眶额回等FC降低(P<0.05,Alphasim校正),sgACC与顶叶、枕叶、丘脑、颞上回和扣带回皮质等FC增强(P<0.05,Alphasim校正). PPD组左侧AMYG与左侧眶内额上回之间FC强度和EPDS评分呈负相关(r=-0.62,P=0.02).结论 PPD患者情绪网络多个脑区存在功能连接异常,左侧杏仁核与左侧眶内额上回功能连接越弱的患者抑郁程度越严重,这可能为揭示PPD神经机制提供了有效的生物学标记.“,”Objective To explore the characteristics and significance of functional connectivity (FC) of affective network (AN) in patients with postpartum depression (PPD) under resting state. Methods A total of 23 patients with PPD (PPD group) and 28 healthy postpartum women (control group) were examined using resting-state fMRI. As two critical nodes of AN, amygdala (AMYG) and subgenual anterior cingulate cortex (sgACC) were selected as the regions of interest (ROI) to analyze the differences of functional connectivity strength (FCS) of two regions from other brain regions between two groups, followed by Pearson correlation analysis on the abnormal FCS and the Edinburgh postnatal depression scale (EPDS) score in PPD group. Results Compared to the control group, the patients in PPD group showed the extensively reduced FCS (P<0.05, Alphasim correction) between AMYG and frontal cortex, temporal cortex, hippocampus, cerebellum and orbitofrontal cortex, while there were enhanced FCS (P<0.05, Alphasim correction) between sgACC and parietal cortex, occipital cortex, thalamus, superior temporal gyrus and cingulate cortex. Moreover, in PPD group, the reduced FCS between left AMYG and left medial orbitofrontal cortex was negatively correlated with EPDS scores (r=-0.62, P=0.02). Conclusion Patients with PPD have dysfunctional connectivity of AN in multiple brain regions. The weaker FCS between left amygdala and left medial orbitofrontal cortex is, the more severe depression. The dysfunctional connectivity of AN may provide an effective mechanism-based biomarker underlying PPD.
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