自杀未遂抑郁症患者海马在静息态下功能连接的改变

Functional connectivity bias of the hippocampus in suicidal depressed patients during resting state

摘要:

目的：利用静息态功能磁共振成像（resting-state functional magnetic resonance imaging，Rs-fMRI）技术，探索静息状态下自杀未遂抑郁症患者海马的功能连接。方法：76例重症抑郁症（major depressive disorder，MDD）患者，其中43例为自杀未遂抑郁症（suicidal depression，SD）患者，33例为不伴自杀行为抑郁症（non-suicidal depression，NSD）患者，与44名健康对照（healthy controls，HC）共同执行了功能磁共振扫描，通过研究海马与全脑的功能连接，探查3组海马之间功能连接的差异。抑郁症组实验对象的来源为重庆医科大学附属第一医院精神科门诊及住院部抑郁症患者，对照组实验对象来源为志愿者招募，采用的调查方法为横断面调查。结果：与HC组相比，SD组左侧海马与右侧角回功能连接减低，右侧海马与左颞下回、左枕下回功能连接减少。SD组与NSD组相比，左侧海马与左直回功能连接增多，右侧海马功能连接无变化。NSD组与HC组相比，左侧海马与右额中回、左额上回功能连接减少，右侧海马与左颞下回、右眶部额中回、右额中回、右侧角回的功能连接减少。结论：左侧海马与一些额叶的皮质区域之间功能连接的异常，或许是抑郁症患者自杀行为的神经生理机制，这可能与抑郁症患者的认知及行为模式损伤有关。

Abstract:

Objective：To explore the functional connectivity bias of the hippocampus in suicidal depressed patients by resting-state functional magnetic resonance imaging（Rs-fMRI）. Methods：Functional magnetic resonance imaging（fMRI） was performed on 76 patients with major depressive disorder（MDD），of which 43 patients were with suicide attempt history（suicidal depression，SD） and 33 patients without（non-suicidal depression，NSD），and 44 healthy controls（HC）. The differences of the hippocampal functional con－nectivity among the three groups were explored by researching the functional connectivity between hippocampus and the whole brain. The subjects in the SD group and NSD group were the depression patients admitted into the Psychiatric Department of the First Affiliated Hospital of Chongqing Medical University，while the subjects of the control group were recruited as the volunteers. The method used in the experiment was cross-sectional study. Results：Compared with the HC group，the SD group had decreased func－tional connectivity between the left hippocampus and the right angular gyrus，as well as that between the right hippocampus and the left inferior temporal gyrus or left inferior occipital gyrus respectively. Compared with the NSD group，the SD group demonstrated the increased functional connectivity between the left hippocampus and left rectus gyrus，but the same functional connectivity between the right hippocampus and the other brain regions. Compared with the HC group，the NSD group showed the reduced functional connec－tivity between the left hippocampus and the right middle frontal gyrus or left superior frontal gyrus respectively，as well as that be－tween the right hippocampus and the left inferior temporal gyrus，right middle frontal gyrus and its orbital part，or right angular gyrus respectively. Conclusion：The abnormal functional connectivity between the left hippocampus and some cortial regions in frontal lobe may underlie the biomarkers of MDD with suicidal activity，which perhaps contributes to the disturbances in cogni－tion and behavior in MDD.