Cancan He1, Liang Gong1, Chunming Xie1, and Yingying Yin1
1Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China, People's Republic of
Synopsis
In this study, 75
unmedicated MDD patients and 42 cognitively normal(CN) subjects underwent the resting-state
functional magnetic resonance imaging (R-fMRI) scan. We found that the
MDD patients showed dysfunctional connectivity in wide-spread amygdala functional connectivity(AFC) networks, and these
abnormal amygdala connectivity were influenced the trait property in MDD. Further
analysis revealed that MDD patients with lower HAMA scores showed milder
depressive symptom and greater AFC strength while MDD patients with higher HAMA
scores showed more severe depressive symptom and lower AFC strength. Beyond
that, the mediation effects of AFC networks on the association between anxiety
and depression all reached a significant level in MDD patients.Background
Anxiety is frequently existed in the major
depressive disorder (MDD), and more importantly, anxiety often promotes more
severe and difficult to treatment for the MDD patients. However, the potential
mechanism of how anxiety worsen depression remains unclear.
Methods
In this study, 75
unmedicated MDD patients and 42 cognitively normal(CN) subjects underwent the resting-state
functional magnetic resonance imaging (R-fMRI) scan. Bilateral amygdala were
selected to construct amygdala functional connectivity (AFC) networks . Multivariate
linear regression analysis was performed to investigate neural substrates of anxiety
and depression, as well as the interactive effects of both anxiety and
depression on AFC network in MDD patients. Furthermore, mediation analysis was employed
to explore whether AFC networks mediate the association between anxiety and
depression in MDD patients.
Results
Severer anxious symptoms were found in the MDD
patients than in the CN subjects. Compared with CN subjects, MDD patients
showed a wide-spread reduced functional connectivity in AFC network, including
insular, inferior temporal gyrus, temporal pole, fusiform area, hippocampus,
parahippocampus and inferior parietal lobe; whilst the
increased amygdala connectivity was also found in the posterior cingulate
cortex and precuneus within the left AFC network, and in the prefrontal cortex
and left superior temporal gyrus within the right AFC network. Multivariate
linear regression analysis manifested that the main effects of the anxiety on
the bilateral AFC network were illustrated in Figure2A, and main effects of depression
on the bilateral AFC networks were observed in the brain regions shown in
Figure2B. More importantly, the interactive effects of the anxiety and
depression on the bilateral AFC networks were seen in Figure2C. In addition, the
AFC networks correlated with course of disease in MDD patients were marked in
Figure2D. Further analysis revealed that MDD patients with lower HAMA scores showed
milder depressive symptom and greater AFC strength while MDD patients with
higher HAMA scores showed more severe depressive symptom and lower AFC
strength. Beyond that, the mediation effects of AFC networks on the association
between anxiety and depression all reached a significant level in MDD patients.
Conclusions
The MDD patients
showed dysfunctional connectivity in wide-spread AFC network, and these
abnormal amygdala connectivity were influenced the trait property in MDD. In
addition, common and distinct neural circuits involving anxiety and depression
were also separately identified. More importantly, the amygdala connectivity can
modulate the effects of anxiety on depression in MDD patients. These findings
suggested that the abnormally intrinsic amygdala connectivity could play a crucial
role in the neuropathology of MDD combined with anxiety. This research not only
demonstrated that there were interactive neural links beneath the comorbidity
of anxiety among MDD patients; but also provided some clues for further treatment
target on the neural circuits of this comorbidity.
Acknowledgements
This work was supported by the National Natural
Science Foundation of China ( 81171323, 91332118); Six Talent Peaks Project in Jiangsu Province
(2014-WSN-042)References
No reference found.