One hundred and fourteen MDD patients and 74 healthy controls (HCs) underwent resting-state functional and perfusion magnetic resonance imaging (MRI) scans as well as overnight polysomnography examination to assess brain function and REM%, with 48 patients completing follow-up visits. Correlation and mediation analyses were conducted to investigate the associations among baseline REM%, multimodal brain imaging measures, and the improvement of depressive symptoms at follow-up in MDD.
We found voxel-wise correlations between baseline REM% and multimodal brain imaging metrics in many brain regions involved in sensorimotor, visual processing, emotion, and cognition in patients with MDD. Moreover, the baseline REM% was correlated with the improvement of depressive symptoms from acute to remitted status in patients through regulating brain activity in the left inferior temporal gyrus and cerebral blood flow in the bilateral paracentral lobule.
Our findings help to identify the neural underpinnings of REM% in depression and highlight REM% as a potential prognostic biomarker to predict disease progression. These may inform future novel interventions of MDD from the perspective of regulating REM sleep.
方法:114名MDD患者和74名健康对照(HCs)接受了静息状态功能和灌注磁共振成像(MRI)扫描以及过夜多导睡眠图检查,以评估脑功能和REM%。48例患者完成随访。进行了相关性和中介分析,以调查基线REM%之间的关联,多模态脑成像测量,MDD患者随访时抑郁症状的改善情况。
结果:我们发现基线REM%和多模态脑成像指标在许多涉及感觉运动的脑区之间存在体素相关性,视觉处理,情感,MDD患者的认知和认知。此外,基线REM%与通过调节左颞下回的脑活动和双侧中央旁小叶的脑血流量,改善患者抑郁症状从急性到缓解状态相关.
结论:我们的发现有助于确定REM%在抑郁症中的神经基础,并强调REM%是预测疾病进展的潜在预后生物标志物。这些可能会从调节REM睡眠的角度为未来的MDD新干预提供信息。