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Altered cortical morphology in major depression disorder patients with suicidality 有自杀倾向的重度抑郁症患者的皮层形态学改变
Pub Date : 2020-02-26 DOI: 10.2139/ssrn.3546027
Huiru Li, Huawei Zhang, L. Yin, Feifei Zhang, Ziqi Chen, Taolin Chen, Z. Jia, Q. Gong
Major depressive disorder (MDD) is associated with high risk of suicide, but the biological underpinnings of suicidality in MDD patients are far from conclusive. Previous neuroimaging studies using voxel-based morphometry (VBM) demonstrated that depressed individuals with suicidal thoughts or behaviors exhibit specific cortical structure alterations. To complement VBM findings, surface-based morphometry (SBM) can provide more details into gray matter structure, including the cortical complexity, cortical thickness and sulcal depth for brain images. This study aims to use SBM to investigate cortical morphology alterations to obtain evidence for neuroanatomical alterations in depressed patients with suicidality. Here, 3D T1-weighted MR images of brain from 39 healthy controls, 40 depressed patients without suicidality (patient controls), and 39 with suicidality (suicidal groups) were analyzed based on SBM to estimate the fractal dimension, gyrification index, sulcal depth, and cortical thickness using the Computational Anatomy Toolbox. Correlation analyses were performed between clinical data and cortical surface measurements from patients. Surface-based morphometry showed decreased sulcal depth in the parietal, frontal, limbic, occipital and temporal regions and decreased fractal dimension in the frontal regions in depressed patients with suicidality compared to both healthy and patient controls. Additionally, in patients with depression, the sulcal depth of the left caudal anterior cingulate cortex was negatively correlated with Hamilton Depression Rating Scale scores. Depressed patients with suicidality had abnormal cortical morphology in some brain regions within the default mode network, frontolimbic circuitry and temporal regions. These structural deficits may be associated with the dysfunction of emotional processing and impulsivity control. This study provides insights into the underlying neurobiology of the suicidal brain.
重度抑郁症(MDD)与高自杀风险相关,但MDD患者自杀的生物学基础还远没有定论。先前使用基于体素形态学(VBM)的神经影像学研究表明,有自杀想法或行为的抑郁个体表现出特定的皮层结构改变。为了补充VBM的发现,基于表面的形态测量(SBM)可以提供更多关于灰质结构的细节,包括大脑图像的皮层复杂性、皮层厚度和脑沟深度。本研究旨在利用SBM研究抑郁症自杀患者的皮层形态学改变,以获得神经解剖学改变的证据。本研究采用SBM对39例健康对照、40例无自杀倾向抑郁患者(患者对照组)和39例有自杀倾向患者(自杀组)的脑三维t1加权MR图像进行分析,利用计算解剖工具箱估计分形维数、旋转指数、脑沟深度和皮质厚度。临床数据与患者皮质表面测量值之间进行相关性分析。表面形态测量显示,与健康和对照组相比,自杀倾向抑郁症患者的顶叶、额叶、边缘、枕叶和颞叶区域的沟深度下降,额叶区域的分形维数下降。此外,在抑郁症患者中,左侧尾侧前扣带皮层的沟深与汉密尔顿抑郁评定量表得分呈负相关。伴有自杀倾向的抑郁症患者在大脑默认模式网络、额叶回路和颞叶等部分区域存在皮层形态异常。这些结构性缺陷可能与情绪处理和冲动控制功能障碍有关。这项研究为自杀者大脑的潜在神经生物学提供了见解。
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Psychoradiology
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