四川精神卫生2025，Vol.38Issue(5)：398-404,7.DOI:10.11886/scjsws20250626001
首发重性抑郁障碍患者默认网络功能连接与临床症状的关系
Relationship between default mode network functional connectivity and clinical symptoms in patients with first-episode major depressive disorder
摘要
Abstract
Background The functional changes of the default mode network(DMN)are closely related to the onset of major depressive disorders.However,the relationship between the DMN subsystem(core subsystem,dorsomedial prefrontal cortex subsystem,medial temporal lobe subsystem)and symptoms of first-episode major depressive disorder remains unclear.Objective To investigate abnormal functional connectivity between DMN subsystems and the whole brain in first-episode major depressive disorder patients during the resting-state,and to analyse the correlations between these functional connectivity patterns and clinical symptoms,so as to reveal the potential neural mechanisms from the perspective of DMN subsystem.Methods From September 2020 to September 2023,a total of 64 first-episode outpatients and inpatients meeting the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)were enrolled at the Inner Mongolia Autonomous Region Mental Health Center as the study group.During the same period,54 healthy volunteers matched for age,gender,and years of education were recruited from the community as the control group.Both groups were assessed using the Hamilton Depression Scale-24 item(HAMD-24).Resting-state functional magnetic resonance images(rs-fMRI)of the two groups were acquired using a Siemens 3.0 T scanner,and differences in functional connectivity between DMN subsystems(core subsystem,dorsomedial prefrontal cortex subsystem,medial temporal lobe subsystem)and the whole brain were compared.The functional connectivity values of brain regions with statistically significant differences between the two groups were extracted.Spearman's rank correlation coefficient analysis was used to investigate the correlation between these functional connectivity values and HAMD-24 scores of the study group.Results Ultimately,46 patients and 43 controls completed the study.Compared with the control group,the study group exhibited significantly stronger functional connectivity in the following pathways:between the right superior parietal lobule(core subsystem)and right cerebellar lobule VIII(t=3.954,P<0.05,GRF-corrected),between the right lateral temporal cortex(dorsomedial prefrontal cortex subsystem)and right cerebellar lobule VIII,right and left hippocampi,right medial,and paracingulate gyrus(t=4.595,4.208,5.200,4.038,P<0.05,GRF-corrected),and between the temporoparietal junction(dorsomedial prefrontal cortex subsystem)and left lingual gyrus and right cerebellar lobule VIII(t=3.557,4.274,P<0.05,GRF-corrected).Conversely,weaker functional connectivity was observed between the right inferior frontal gyrus and left gyrus rectus(t=-3.824,P<0.05,GRF-corrected).Furthermore,within the study group,the functional connectivity values between the right lateral temporal cortex and right hippocampus,as well as between the temporoparietal junction and right cerebellar lobule VIII,were both negatively correlated with the HAMD-24 cognitive impairment factor score(r=-0.306,-0.318,P<0.05).Conclusion Increased functional connectivity between the DMN(specifically its core and dorsomedial prefrontal cortex subsystems)and cerebellum,partial limbic system,and lingual gyrus may be associated with the neuropathology of first-episode major depressive disorder.Furthermore,alterations in functional connectivity between the dorsomedial prefrontal cortex subsystem and both the cerebellum and hippocampus in these patients may be related to cognitive function.关键词
首发重性抑郁障碍/磁共振成像/默认网络/功能连接Key words
First-episode major depressive disorder/Magnetic resonance imaging/Default mode network/Functional connectivity分类
临床医学引用本文复制引用
韩子亮,赖永丽,于东升,林武宏,姚萍,刘敏,陈敏,吕东升..首发重性抑郁障碍患者默认网络功能连接与临床症状的关系[J].四川精神卫生,2025,38(5):398-404,7.基金项目
2019年度内蒙古自治区自然科学基金项目(项目名称:首发抑郁症患者全病程管理模式的疗效研究,项目编号:2019MS03038) （项目名称:首发抑郁症患者全病程管理模式的疗效研究,项目编号:2019MS03038）
2023年度内蒙古自治区自然科学基金项目(项目名称:SSRIs治疗首发抑郁症反刍思维与默认网络变化的研究,项目编号:2023MS08028)[Funded by 2019 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project(number,2019MS03038) （项目名称:SSRIs治疗首发抑郁症反刍思维与默认网络变化的研究,项目编号:2023MS08028）
2023 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project(number,2023MS08028)] （number,2023MS08028）
