Brain structural alterations in MDD patients with gastrointestinal symptoms: Evidence from the REST-meta-MDD project.
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Liu Peng-Hong, Li Yan, Zhang Ai-Xia, Sun Ning, Li Gai-Zhi, Chen Xiao, Bai Tong-Jian, Bo Qi-Jing, Chen Guan-Mao, Chen Ning-Xuan, Chen Tao-Lin, Chen Wei, Cheng Chang, Cheng Yu-Qi, Cui Xi-Long, Duan Jia, Fang Yi-Ru, Gong Qi-Yong, Guo Wen-Bin, Hou Zheng-Hua, Hu Lan, Kuang Li, Li Feng, Li Kai-Ming, Li Tao, Liu Yan-Song, Liu Zhe-Ning, Long Yi-Cheng, Luo Qing-Hua, Meng Hua-Qing, Peng Dai-Hui, Qiu Hai-Tang, Qiu Jiang, Shen Yue-Di, Shi Yu-Shu, Wang Fei, Wang Kai, Wang Li, Wang Xiang, Wang Ying, Wu Xiao-Ping, Wu Xin-Ran, Xie Chun-Ming, Xie Guang-Rong, Xie Hai-Yan, Xie Peng, Xu Xiu-Feng, Yang Hong, Yang Jian, Yao Jia-Shu, Yao Shu-Qiao, Yin Ying-Ying, Yuan Yong-Gui, Zhang Hong, Zhang Lei, Zhang Zhi-Jun, Zhou Ru-Bai, Zhou Yi-Ting, Zhu Jun-Juan, Zou Chao-Jie, Si Tian-Mei, Zuo Xi-Nian, Yan Chao-Gan, Zhang Ke-Rang
Аннотация
METHOD: Subjects were recruited from 13 clinical centers and categorized into three groups, each of which is based on the presence or absence of GI symptoms: the GI symptoms group (MDD patients with at least one GI symptom), the non-GI symptoms group (MDD patients without any GI symptoms), and the healthy control group (HCs). Structural magnetic resonance images (MRI) were collected of 335 patients in the GI symptoms group, 149 patients in the non-GI symptoms group, and 446 patients in the healthy control group. The 17-item Hamilton Depression Rating Scale (HAMD-17) was administered to all patients. Correlation analysis and logistic regression analysis were used to determine if there was a correlation between the altered brain regions and the clinical symptoms.
RESULTS: There were significantly higher HAMD-17 scores in the GI symptoms group than that of the non-GI symptoms group (P < 0.001). Both GMV and GMD were significant different among the three groups for the bilateral superior temporal gyrus, bilateral middle temporal gyrus, left lingual gyrus, bilateral caudate nucleus, right Fusiform gyrus and bilateral Thalamus (GRF correction, cluster-P < 0.01, voxel-P < 0.001). Compared to the HC group, the GI symptoms group demonstrated increased GMV and GMD in the bilateral superior temporal gyrus, and the non-GI symptoms group demonstrated an increased GMV and GMD in the right superior temporal gyrus, right fusiform gyrus and decreased GMV in the right Caudate nucleus (GRF correction, cluster-P < 0.01, voxel-P < 0.001). Compared to the non-GI symptoms group, the GI symptoms group demonstrated significantly increased GMV and GMD in the bilateral thalamus, as well as decreased GMV in the bilateral superior temporal gyrus and bilateral insula lobe (GRF correction, cluster-P < 0.01, voxel-P < 0.001). While these changed brain areas had significantly association with GI symptoms (P < 0.001), they were not correlated with depressive symptoms (P > 0.05). Risk factors for gastrointestinal symptoms in MDD patients (p < 0.05) included age, increased GMD in the right thalamus, and decreased GMV in the bilateral superior temporal gyrus and left Insula lobe.
CONCLUSION: MDD patients with GI symptoms have more severe depressive symptoms. MDD patients with GI symptoms exhibited larger GMV and GMD in the bilateral thalamus, and smaller GMV in the bilateral superior temporal gyrus and bilateral insula lobe that were correlated with GI symptoms, and some of them and age may contribute to the presence of GI symptoms in MDD patients.