{"title":"不仅仅是静态的:内在大脑活动的时间动态预测抑郁症患者的自杀意念。","authors":"Jiao Li, Xujun Duan, Qian Cui, Huafu Chen, Wei Liao","doi":"10.1017/S0033291718001502","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is associated with high risk of suicide. Conventional neuroimaging works showed abnormalities of static brain activity and connectivity in MDD with suicidal ideation (SI). However, little is known regarding alterations of brain dynamics. More broadly, it remains unclear whether temporal dynamics of the brain activity could predict the prognosis of SI.</p><p><strong>Methods: </strong>We included MDD patients (n = 48) with and without SI and age-, gender-, and education-matched healthy controls (n = 30) who underwent resting-state functional magnetic resonance imaging. We first assessed dynamic amplitude of low-frequency fluctuation (dALFF) - a proxy for intrinsic brain activity (iBA) - using sliding-window analysis. Furthermore, the temporal variability (dynamics) of iBA was quantified as the variance of dALFF over time. In addition, the prediction of the severity of SI from temporal variability was conducted using a general linear model.</p><p><strong>Results: </strong>Compared with MDD without SI, the SI group showed decreased brain dynamics (less temporal variability) in the dorsal anterior cingulate cortex, the left orbital frontal cortex, the left inferior temporal gyrus, and the left hippocampus. Importantly, these temporal variabilities could be used to predict the severity of SI (r = 0.43, p = 0.03), whereas static ALFF could not in the current data set.</p><p><strong>Conclusions: </strong>These findings suggest that alterations of temporal variability in regions involved in executive and emotional processing are associated with SI in MDD patients. 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引用次数: 137
摘要
背景:重度抑郁障碍(MDD)与高自杀风险相关。常规神经影像学检查显示MDD合并自杀意念(SI)的静态脑活动和连通性异常。然而,关于大脑动力学的改变,我们所知甚少。更广泛地说,尚不清楚大脑活动的时间动态是否可以预测SI的预后。方法:我们纳入了伴有或不伴有SI的重度抑郁症患者(n = 48),以及年龄、性别和教育程度相匹配的健康对照(n = 30),他们接受了静息状态功能磁共振成像。我们首先使用滑动窗口分析评估了低频波动的动态幅度(dALFF)——内在脑活动(iBA)的代理。此外,iBA的时间变异性(动态)被量化为dALFF随时间的方差。此外,利用一般线性模型从时间变异性预测SI的严重程度。结果:与没有SI的MDD相比,SI组在前扣带皮层背侧、左侧眶额皮质、左侧颞下回和左侧海马中表现出较低的脑动力学(时间变异性较小)。重要的是,这些时间变量可以用来预测SI的严重程度(r = 0.43, p = 0.03),而静态ALFF在当前数据集中不能。结论:这些发现表明,涉及执行和情绪处理的区域的时间变异性的改变与重度抑郁症患者的SI有关。这种利用iBA动态的新型预测模型可用于开发用于临床应用的神经标志物。
More than just statics: temporal dynamics of intrinsic brain activity predicts the suicidal ideation in depressed patients.
Background: Major depressive disorder (MDD) is associated with high risk of suicide. Conventional neuroimaging works showed abnormalities of static brain activity and connectivity in MDD with suicidal ideation (SI). However, little is known regarding alterations of brain dynamics. More broadly, it remains unclear whether temporal dynamics of the brain activity could predict the prognosis of SI.
Methods: We included MDD patients (n = 48) with and without SI and age-, gender-, and education-matched healthy controls (n = 30) who underwent resting-state functional magnetic resonance imaging. We first assessed dynamic amplitude of low-frequency fluctuation (dALFF) - a proxy for intrinsic brain activity (iBA) - using sliding-window analysis. Furthermore, the temporal variability (dynamics) of iBA was quantified as the variance of dALFF over time. In addition, the prediction of the severity of SI from temporal variability was conducted using a general linear model.
Results: Compared with MDD without SI, the SI group showed decreased brain dynamics (less temporal variability) in the dorsal anterior cingulate cortex, the left orbital frontal cortex, the left inferior temporal gyrus, and the left hippocampus. Importantly, these temporal variabilities could be used to predict the severity of SI (r = 0.43, p = 0.03), whereas static ALFF could not in the current data set.
Conclusions: These findings suggest that alterations of temporal variability in regions involved in executive and emotional processing are associated with SI in MDD patients. This novel predictive model using the dynamics of iBA could be useful in developing neuromarkers for clinical applications.
期刊介绍:
Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.