背景:缺乏预测青少年情绪障碍治疗反应的生物标志物需要进一步研究。Vermis,小脑的一个组成部分,与心境障碍病理生理学有关,并与临床症状和治疗结果有关。我们研究了Vermis功能连接(FC)作为治疗反应识别的早期标记。
方法:一百三十二名患有情绪障碍的青少年,包括重度抑郁障碍或躁郁症,被招募,正在经历严重抑郁发作的人。所有青少年均接受基线和2周治疗静息状态MRI扫描。完成汉密尔顿抑郁量表(HAMD)评估以评估症状的严重程度。患者分为治疗反应型(HAMD降低≥50%,n=75)和治疗无反应的亚组(n=57)。在基线时比较亚组之间的VermisFCs。我们比较了亚组内治疗前后FC的差异。
结果:基线时,与治疗无反应组相比,治疗有反应组左侧颞叶FC更高。FC值显示疗效预后阳性,曲线下面积(AUC)为0.760(95%置信区间:0.678-0.843,p<0.001)。,提示较高的颞叶FC有利于改善治疗反应。此外,治疗后分析显示,在所有患者之间,Vermis-右额叶FC值显着增加,这表明Vermis额叶FCs独立于治疗结果。
结论:样本量相对较小,这可能会限制我们结果的普遍性。
结论:我们的研究表明,疣和皮质之间的FC不仅与症状缓解有关,而且可以预测治疗结果。
The absence of biomarkers for predicting treatment response in adolescent mood disorder calls for further research. The
vermis, a component of the cerebellum, is involved in mood disorder pathophysiology and relates to clinical symptoms and treatment outcomes. We investigated
vermis functional connectivity (FC) as an early marker for treatment response identification.
One hundred thirty-two adolescents with mood disorders including major depressive disorder or bipolar disorder, were recruited, who were experiencing a major depressive episode. All adolescents underwent baseline and 2-week treatment resting-state MRI scans. Hamilton Rating Scale for Depression (HAMD) assessments were completed to assess the severity of symptoms. Patients were divided into treatment-responsive (≥50 % HAMD reduction, n = 75) and treatment-unresponsive subgroups (n = 57).
Vermis FCs were compared between subgroups at baseline. And we compared the pre- and post-treatment FC differences within subgroups.
Higher
vermis-left temporal lobe FC in treatment-responsive group compared to treatment-unresponsive group at baseline. The FC value showed positive prognosis for the efficacy, with the area under the curve (AUC) of 0.760 (95 % confidence interval: 0.678-0.843, p < 0.001), suggesting higher vermis-temporal FC is benefit to improve treatment-response. Furthermore, post-treatment analysis showed significant increases in the
vermis-right frontal lobe FC values between in all patients, suggesting that vermis-frontal FCs were independent of treatment-outcome.
Sample size was relatively small, which may limit the generalizability of our results.
Our study revealed that the FC between the vermis and the cortex is not only associated with symptom alleviation but also predictive of treatment outcomes.