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| 楔前叶功能连接与抗抑郁药物早期疗效相关性分析 |
| Correlation between functional connectivity of the precuneus and early efficacy to antidepressant treatment in major depressive disorder |
| 投稿时间：2023-12-19 修订日期：2024-06-12 |
| DOI： |
| 中文关键词: 抑郁症,抗抑郁药物治疗,早期改善,楔前叶,功能连接 |
| 英文关键词:major depressive disorder antidepressant treatment early improvement precuneus functional connectivity |
| 基金项目:国家重点研发项目（2016YFC1307200)，四川省科技厅重点研发项目（2022YFS0345），四川大学华西医院135培育项目（ZYJC21083）和四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目（2022HXFH029） |
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| 中文摘要: |
| 背景 默认网络内楔前叶功能活动与抗抑郁药物的疗效有关。然而楔前叶功能网络与抗抑郁药物早期疗效的关系仍不清楚。目的 探索抑郁障碍患者楔前叶功能连接（FC）与抗抑郁药物早期疗效的关系，以期寻找预测抗抑郁药物早期疗效的神经生物标志物。方法 连续纳入2017年7月—2019年2月在四川大学华西医院心理卫生中心就诊的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准的47例抑郁障碍患者。采集患者基线期静息态功能磁共振数据及临床信息。患者接受2周抗抑郁药物治疗，根据治疗2周时16项抑郁症状快速自评量表（QIDS-SR16）评分减分率是否大于20%，将患者分为早期改善组（n=27）和未改善组（n=20）。以双侧楔前叶为种子点，计算楔前叶与全脑FC值，比较两组基线楔前叶FC的差异。采用Pearson相关分析考查差异有统计学意义的脑区的FC值与QIDS-SR16评分及其减分率之间的相关性。结果 早期改善组左侧楔前叶与左侧中央前回、右侧楔前叶与右侧梭状回FC值均高于未改善组（GRF矫正，P＜0.01）。抑郁障碍患者左侧楔前叶与左侧中央前回FC值、右侧楔前叶与右侧梭状回FC值与QIDS-SR16总评分减分率均呈正相关（r=0.475、0.297，P均<0.05）。结论 基线期较低的左侧楔前叶与左侧中央前回、右侧楔前叶与右侧梭状回FC与较差的抗抑郁药物早期疗效有关，楔前叶FC可能是预测抗抑郁药物早期疗效的潜在指标。 |
| 英文摘要: |
| Background The activity in precuneus within default mode network has been reported to be associated with antidepressant response， whereas the relationship between the functional network of precuneus and early response to antidepressant medications remains unclear. Objective To investigate the relationship between precuneus functional connectivity （FC） and early response to antidepressant therapy in patients with major depressive disorder， so as to find a neurobiomarker to predict the early response to antidepressants. Methods A consecutive sample of 47 patients with major depressive disorder who attended the Mental Health Center of West China Hospital of Sichuan University from July 2017 to February 2019 and fulfilled the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited. Baseline resting-state functional magnetic resonance imaging scan findings and clinical assessments were recorded in participants. All patients were subjected to two weeks of antidepressant treatment. Improvement was defined as 20% or greater reduction in baseline 16-Item Quick Inventory of Depressive Symptomatology– Self-Report （QIDS-SR16） by treatment exit， and patients were then classified into early improved group（ n=27） and non-improved group（ n=20）. FC values of precuneus and whole brain were calculated using bilateral precuneus as seed region， and baseline precuneus FC values were compared between two groups. Pearson correlation analysis was utilized to
explore the correlation between FC values in brain regions with statistically significant differences and QIDS-SR16 total scores and reduction rates. Results FC values between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus in early improved group were both higher than those in non-improved group （GRF correction， P<0. 01）. The FC between the left precuneus and the left precentral gyrus， the right precuneus and the right fusiform gyrus were positively correlated with QIDS-SR16 reduction rate （r=0. 475， 0. 297， P<0. 05）. Conclusion Weakened FC between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus are related to poor early response to antidepressant treatment， so FC of precuneus may be a potential predictor of early response to antidepressants. ［Funded by the National Key Research & Development Program of China （number， 2016YFC1307204）； Key Development Project of the Sichuan Provincial Science and Technology Plan（ number， 2018SZ0131） |
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