[Analysis of abnormal dynamic functional connectivity of the raphe nucleus in adolescent patients with first-episode depression on resting-state functional magnetic resonance imaging].

Objective: To investigate the dynamic functional connectivity (dFC) abnormalities of the raphe nucleus in adolescent patients with first-episode depression and its correlation with clinical characteristics and cognitive function. Methods: A total of 30 adolescent patients with untreated depression [Depression Groups, 17 males and 13 females, median age 16.5 (15.0, 17.0) years] and 29 age-, gender-and education-[Healthy Controls, 17 males and 12 females, median age 17.0 (16.0, 18.0) years] matched healthy controls underwent resting functional MRI examinations and their clinical data were obtained in the First Affiliated Hospital of Zhengzhou University.The raphe nuclei was subdivided into dorsal raphe nuclei (DRN) and median raphe nuclei (MRN). Seed-based dFC of the raphe nucleus was conducted to analyze the abnormal dFC between DRN and whole brain gray matter as well as MRN. Clinical characteristics and cognitive function were evaluated using HAMD-17 and Wisconsin card sorting (WSCT), respectively. The difference of dFC between the two groups was compared. The variance values of dFC in the different brain regions were extracted and subsequently used for evaluating the correlation between the scores of HAMD-17 as well as cognitive tests. Results: Compared with HC, the depression group had an significantly increased variance of dFC in the right superior temporal gyrus (MNI coordinate:33,-12,-12; voxel size 468; t=4.715), extending to the right insula, lentiform nucleus, putamen and Rolandic_Oper_R (aal) (GRF correction, voxel-P<0.005,cluster-P<0.05). Significant negative correlations were observed between the variance in the different brain regions and the total scores andthe factor of retardation scores of HAMD-17 as well the total time, the time of correct thinking, the time of mistake thinking and the number of non-persistent errors of WSCT in depression groups (r=-0.388, -0.365, -0.488, -0.470, -0.412, -0.390, respectively, all P<0.05). Conclusion: The variability of the dFC between the DRN and the temporal insula regions as well as striatum was increased in adolescent patients with untreated depression and associated with the severity and cognitive abnormality.目的： 探讨首发青少年抑郁症患者中缝核动态功能连接（dFC）的异常改变，及其与临床特征、认知功能的相关性。 方法： 前瞻性收集2019年10月至2020年10月于郑州大学第一附属医院精神科就诊的30例首发未用药青少年抑郁症患者［病例组，男17例，女13例，年龄［M（Q1，Q3）］16.5（15.0，17.0）岁］；以及年龄、性别及受教育年限相匹配的29例健康志愿者［对照组，男17例，女12例，年龄17.0（16.0，18.0）岁］的资料。所有受试者均行静息态功能磁共振成像（rs-fMRI）扫描。将中缝核分为中缝背核（DRN）和中缝中央核（MRN），采用基于种子点的dFC方法分析病例组DRN、MRN与全脑灰质dFC的异常改变。采用汉密尔顿抑郁量表（HAMD）-17、威斯康星卡片分类测验（WSCT）对病例组进行临床特征、认知功能评估。比较两组受试者dFC差异是否具有统计学意义；提取差异脑区dFC的变异值，并分析与HAMD-17评分、认知功能指标的相关性。 结果： 与对照组相比，病例组DRN与右侧颞上回dFC（MNI坐标：33，-12，-12；体素大小为468；t=4.715）的变异值升高，范围延伸至右侧脑岛、豆状核、壳核、中央沟盖等脑区（GRF校正，voxel-P<0.005，cluster-P<0.05）。病例组差异脑区的变异值与HAMD-17中总分、迟缓因子得分，以及WSCT中总用时间、正确思考时间、错误思考时间、非持续错误数呈负相关（r分别为-0.388、-0.365、-0.488、-0.470、-0.412、-0.390，均P<0.05）。 结论： 首发青少年抑郁症患者DRN与颞岛叶皮层、纹状体等脑区dFC的不稳定性增加，并与疾病严重程度和认知功能改变存在相关性。.