【研究进展】抑郁症共病焦虑障碍的脑灰质体积异常研究

Title: Gray matter volume abnormalities in depressive patients with and without anxiety disorders

Short title: Gray matter abnormalities in anxious depression

Authors’ names:

Haochen Qi^1△ BE, Yuping Ning^2△MD, Jie Li² MD, Shengwen Guo¹ DE, Minyue Chi¹ BE, Minjian Gao³ BE, Yangbo Guo² MD, Yuling Yang² MD，Hongjun Peng^2* MD, Kai Wu^1* MD

Authors’ affiliations:

¹ Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China

² Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

³ School of Computer Science and Engineering, South China University of Technology, Guangzhou, China

^△ These authors contributed equally to this work.

Corresponding authors:

^* Hongjun Peng, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Post code: 510370; Tel.: +86-20-81268184; Fax: +86-20-81891391; E-mail: penghjgz@163.com.

^* Kai Wu, Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China. Post code: 510006; Tel.: +86-20-3938-0660; E-mail: kai.wu.22@gmail.com.

List of abbreviations：

GMV: gray matter volume; NC: normal controls; DP: depressive patients without anxiety disorder; DPA: depressive patients with anxiety disorder; MDD: major depressive disorder; MRI: magnetic resonance imaging; VBM: voxel-based morphometry; DMPFC: dorsomedial prefrontal cortex; GAD: generalized anxiety disorder; SCID: structured clinical interview; HAMD: Hamilton Depressive Rating Scale; SDS: Zung’s Self-Rating Depression Scale; HAMA: Hamilton Anxiety Scale; SAS: Self-Rating Anxiety Scale; SSRIs: selective serotonin reuptake inhibitors; CSF: cerebrospinal fluid; GLM: General Linear Model; ANOVA: Analysis of Variance; TGMV: total gray matter volume; ROI: region-of-interest; RGMV: regional gray matter volume; INS: insula; IFGtriang: triangular part of the inferior frontal gyrus; PreCG: precentral gyrus; SOG: superior occipital gyrus; ORBmed: medial part of orbitofrontal cortex; ROL: rolandic operculum; PoCG: postcentral gyrus; IFG: inferior frontal gyrus; REC: rectus; ITG: inferior temporal gyrus; MTG: middle temporal gyrus; PHG: parahippocampal gyrus; HIP: hippocampus; SFGdor: dorsal part of superior frontal gyrus; LING: lingual gyrus; SMA: supplementary motor area; ANG: angular gyrus; AMYG: amygdala.

Abstract

back.ground:

  Comorbidity with anxiety disorder is a relatively common occurrence in major depressive disorder. However, the unique and shared neuroanatomical characteristics of depression and anxiety disorders have not been fully identified. The aim of this study was to identify gray matter abnormalities and their clinical correlates in depressive patients with anxiety and depressive patients without anxiety disorders.

Methods:

  We applied voxel-based morphometry and ROI analyses of gray matter volume (GMV) in normal controls (NC group, n=28), depressive patients without anxiety disorder (DP group, n=18), and depressive patients with anxiety disorder (DPA group, n=20). The correlations between regional GMV and clinical data were analyzed.

Results:

  The DP group showed decreased GMV in the left insula and left triangular part of the inferior frontal gyrus when compared to the NC group. Compared to the NC group, the DPA group showed greater GMV in the midbrain, medial prefrontal cortex, and primary motor/somatosensory cortex. Moreover, the DPA group showed greater GMV than the DP group in the frontal, insula, and temporal lobes. Most gray matter anomalies were significantly correlated with depression severity or anxiety symptoms. These correlations were categorized into four trend models, of which three trend models (i.e., Model I, II, and IV) revealed the direction of the correlation between regional GMV and depression severity to be the opposite of that between regional GMV and anxiety symptoms. Importantly, the left insula showed a trend Model I, which might be critically important for distinguishing depressive patients with and without anxiety disorder.

Conclusion:

  Our findings of gray matter abnormalities, their correlations with clinical data, and the trend models showing opposite direction may reflect disorder-specific symptom characteristics and help explain the neurobiological differences between depression and anxiety disorder.

Key words: anxiety; depression; gray matter volume; voxel-based morphometry.