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Differentiating Melancholic and Non-melancholic Major Depressive Disorder Using Fractional Amplitude of Low-Frequency
Yingying Zhang1, Xilong Cui1, Yangpan Ou1
1National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.
Background:
Melancholic major depressive disorder (MDD) is a network-based brain disorder. However, whether or not network-based changes can be applied to differentiate melancholic (MEL) from non-melancholic (NMEL) MDD remains unclear.
Methods:
Thirty-one MEL patients, 28 NMEL patients, and 32 matched healthy controls (HCs) were scanned using resting-state functional magnetic resonance imaging. Patients were assessed by the Chinese version of Snaith-Hamilton Pleasure Scale (SHAPS-C) and Temporal Experience of Pleasure Scale (TEPS). Fractional amplitude of low-frequency fluctuations (fALFF) and correlation analysis were used to analyze the data.
Results:
Compared with HCs, the MEL group had significantly higher fALFF values in the bilateral inferior frontal gyrus and right supplementary motor area (SMA) and significantly lower fALFF values in the right inferior occipital gyrus (IOG), right middle temporal gyrus (MTG)/left IOG, and bilateral superior occipital gyrus (SOG)/MTG. On the other hand, the NMEL group showed significantly higher fALFF values in the bilateral SMA and significantly lower fALFF values in the bilateral posterior cingulate cortex/precuneus relative to HCs. Compared with the NMEL group, the MEL group showed significantly lower fALFF values in the left anterior cingulate cortex (ACC). A correlation was found between the fALFF values of the right SMA and the SHAPS-C in the MEL group. In addition, correlations were observed between the fALFF values of the left ACC and the TEPS contextual consummatory and total scores in all patients.
Conclusion:
Our study uncovered that MDD exhibited altered brain activity in extensive brain networks, including the default-mode network, frontal-striatal network, reward system, and frontal-limbic network. Decreased fALFF in the left ACC might be applied to differentiate the two subtypes of MDD.
Insights
Major depressive disorder (MDD) subtypes, melancholic (MEL) and non-melancholic (NMEL), show distinct brain activity patterns. Decreased activity in the left anterior cingulate cortex (ACC) may help differentiate MEL from NMEL MDD.
Area of Science:
- Neuroscience
- Psychiatry
- Brain Imaging
Background:
- Major Depressive Disorder (MDD) is increasingly understood as a network-based brain disorder.
- Differentiating subtypes of MDD, such as melancholic (MEL) and non-melancholic (NMEL), is crucial for targeted treatment but remains challenging.
- Network-based brain alterations in differentiating MEL from NMEL MDD require further investigation.
Purpose of the Study:
- To investigate the differences in brain activity patterns between MEL and NMEL MDD subtypes using resting-state functional magnetic resonance imaging (fMRI).
- To identify potential neuroimaging markers for distinguishing between melancholic and non-melancholic depression.
- To explore the relationship between brain activity and clinical measures of depression severity and pleasure deficits.
Main Methods:
- Utilized resting-state fMRI to scan 31 MEL patients, 28 NMEL patients, and 32 healthy controls (HCs).
- Assessed patients using the Chinese version of the Snaith-Hamilton Pleasure Scale (SHAPS-C) and Temporal Experience of Pleasure Scale (TEPS).
- Analyzed brain activity using fractional amplitude of low-frequency fluctuations (fALFF) and correlation analyses.
Main Results:
- The MEL group exhibited higher fALFF in the inferior frontal gyrus and supplementary motor area (SMA), and lower fALFF in the occipital and temporal gyri compared to HCs.
- The NMEL group showed higher fALFF in the SMA and lower fALFF in the posterior cingulate cortex/precuneus compared to HCs.
- Significantly lower fALFF in the left anterior cingulate cortex (ACC) was observed in the MEL group compared to the NMEL group. Correlations were found between fALFF in the right SMA and SHAPS-C in MEL patients, and between left ACC fALFF and TEPS scores in all patients.
Conclusions:
- MDD is associated with altered brain activity across multiple networks, including default-mode, frontal-striatal, reward, and frontal-limbic networks.
- Decreased fALFF in the left ACC presents a potential neuroimaging biomarker for differentiating melancholic from non-melancholic MDD.
- Findings highlight the utility of fMRI in understanding subtype-specific brain alterations in depression.
