大型抑郁症患者的三重网络连接变化与健康对照通过结构网络成像在电治疗治疗治疗后通过结构网络成像
Enkmurun Chibaatar1, Keita Watanabe2, Patrick M Quinn3
1Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan.
Journal of affective disorders
|August 20, 2023
概括
电治疗 (ECT) 有效地改善了主要抑郁症 (MDD) 患者的突出网络 (SN) 的结构连接. 此外,ECT还使大脑网络通信正常化,这表明它可以纠正MDD中的异常连接.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 医疗成像医学成像
背景情况:
- 大型抑郁症 (MDD) 与大脑网络连接的改变有关.
- 三重网络模型,包括突出网络 (SN),中央执行网络 (CEN) 和默认模式网络 (DMN),为理解这些变化提供了一个框架.
- 研究动态结构网络连接 (dSNC) 对于理解治疗效应至关重要.
研究的目的:
- 研究电治疗 (ECT) 对MDD患者的dSNC的影响.
- 评估在SN,CEN和DMN内部和之间结构连接的变化.
- 评估ECT在MDD中规范异常网络相互作用的有效性.
主要方法:
- 招募了21名首次发病,从未服用过药物的MDD患者和21名健康对照 (HCs).
- 向MDD患者每周三次进行双边ECT,持续4-5周.
- 利用基于源的形态测量 (SBM) 和部分最小方程结构方程建模 (PLS-SEM) 来分析MRI衍生的三重网络结构连接在ECT前后.
主要成果:
- 在ECT前MDD患者的SN结构连接性明显低于HC患者 (p=0.010).
- 在ECT后,与ECT前相比,SN的结构连接性显著增加 (p=0.002).
- 在ECT前的MDD患者表现出CEN和DMN之间的病态连接,在ECT后正常化,显示出类似于HCs的直接SN-DMN连接. 调解分析显示,在ECT前MDD患者中,SN通过CEN对DMN有显著的间接影响 (β=0.363,p=0.008).
结论:
- ECT似乎是对MDD的有效治疗方法,它解决了SN中的结构异常.
- 在MDD患者中,ECT使SN,CEN和DMN之间的异常直接和间接通信通道正常化.
- ECT提供了一种最小侵入性的方法来纠正MDD中的网络功能障碍.
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