Magnetic Resonance Imaging Case Control Study On Brain Structural And Functional Abnormalities Of First-episode Medication-naive Adolescents With Major Depressive Disorder

Objective:To investigate the gray matter volume abnormalities on brain three dimension structure of first-episode medication-naive adolescents with major depressive disorder compared with healthy control group,so as to explore the probable pathophysiological mechanism of adolescent major depression.Methods:Firstly according to American Diagnostic and Statistical Manual on Mental Health 4th edition(DSM-IV) criteria and Development and Wellbeing Assessment(DAWBA) clinically interviewing,18 first-episode medication-naive adolescents (male 10,female 8,mean age 15.77±1.18) with major depressive disorder and 18 age and sex-matched healthy adolescents (mean age 16.18±0.94) were chosen to fill the forms of Chinese version of The Screen for child anxiety related emotional disorders(SCARED) and short Mood and Feelings Questionnaire(sMFQ),to appraise the severity of their symptoms. Then both groups were scanned using 3T magnetic resonance imaging,and voxel based morphometry approach on Statistical Parametrical Mapping was used to analyse the data. The VBM gray matter volume of both groups were compared using two sample t-test.Results:Compared with the control group, in depressive group gray matter volume increased in left superior temporal gyrus and bilateral middle temporal gyrus,especially in BA 22 and BA19;,whereas gray matter volume decreased in left frontal lobe (BA11,47),right parietal lobe(BA 7,40),left parietal lobe (BA 5),right insular(BA 13)and right temporal lobe (BA 13).Conclusion:This first-episode medication naive adolescent major depressive disorder research manifested that gray matter volume in MDD group mainly decreased in left frontal lobe(BA11,47),right parietal lobe(BA 7,40),left parietal lobe (BA 5),right insular(BA 13)and right temporal lobe (BA 13).Though gray matter volume also manifested increase in left superior temporal gyrus and bilateral middle temporal gyrus especially in BA 22 and BA19.This research did not show significant abnormalities in amygdala, hippocampus and anterior cingulate cortex which were reported in some adult major depressive disorder related researches.Objective:To explore basic characteristics among Chinese 10-12 ys children using International Affective Picture System, and compare the acquired data base with the data supplied by IAPS.Methods:70 children were sampled in a local school, using the selected 126 pictures from IAPS,each one rated valence,arousal and dominance by self assessment.Results:(1) The scores of present study of three-dimension assessment were highly correlated with the children's assessment data base provided by IAPS,whereas still existed significant difference in valence scores. (2) In some positive pictures it manifested sex difference.Conclusion:IAPS is highly generalized and suitable for children internationally, though needs localized tests database in Chinese children for further application.Objective:To investigate the functional abnormalities using emotional picture stimuli on first-episode medication-naive adolescents with major depressive disorder compared with normal control group,so as to explore the pathophysiological mechanism of adolescent depression.Methods:Firstly according to American Diagnostic and Statistical Manual on Mental Health 4th edition(DSM-IV) criteria and Development and Wellbeing Assessment(DAWBA) clinically interviewing,18 first episode medication naive adolescents(male 10,female 8,mean age 15.77±1.18) with major depressive disorder and 18 age and sex-matched healthy adolescents (mean age 16.18±0.94) were chosen to fill the forms of Chinese version of The Screen for child anxiety related emotional disorders(SCARED) and short Mood and Feelings Questionnaire(sMFQ)to appraise the severity of their symptoms. Then both groups were scanned using 3T fuctional magnetic resonance imaging watching positive,neutral or negative pictures selected from International Affective Picture System (IAPS),then Statistical Parametrical Mapping software was used to analyze the data. The different activation or deactivation of both groups were compared using two sample t-test.Results:Compared with the control group, in depressive group decreased activation were mainly found in left parietal lobe (postcentral gyrus BA7),left temporal (fusiform gyrus BA 20)when watching positive pictures; when watching neutral pictures increased activation mainly in left occipital lobe (fusiform gyrus BA 19) and decreased activation mainly in left frontal lobe (inferior frontal gyrus BA 46);when watching negative pictures mainly manifested increased activation in right medial frontal gyrus (BA 8)and left superior temporal gyrus(BA 38).Conclusion:This first-episode medication-naive adolescent major depressive disorder functional magnetic resonance imaging research using IAPS manifested that functional activation differences between MDD group and control group were mainly found decreased when watching positive pictures; when watching neutral pictures some regions activation increased and some regions decreased;when watching negative pictures mainly manifested increased activation. There was a clue that BA 10 in depressive group may function as coordinator and attention allocator with multi emotion information centers.This research did not show significant abnormalities in amygdala and hippocampus which were mostly reported in adult major depressive disorder related researches.Objective:To investigate the resting-state functional abnormalities using amplitude of low frequency fluctuation algorithm on first-episode medication-naive adolescents with major depressive disorder compared with healthy control group,so as to explore the probable brain pathophysiological spontaneous activities of adolescent depression.Methods:Firstly according to American Diagnostic and Statistical Manual on Mental Health 4th edition(DSM-IV) criteria and Development and Wellbeing Assessment(DAWBA) clinically interviewing,18 first episode medication naive adolescents (male 10,female 8,mean age15.77±1.18) with major depressive disorder and 18 age and sex-matched healthy adolescents (mean age 16.18±0.94) were chosen to fill the forms of The Screen for child anxiety related emotional disorders(SCARED) and short Mood and Feelings Questionnaire (sMFQ) to appraise the severity of their symptoms. Then both groups were scanned using 3T fuctional magnetic resonance imaging,and amplitude of low frequency fluctuation ALFF algorithm of Rest software based on Statistical Parametrical Mapping software was used to analyse the data. The different ALFF change in whole brain regions of both groups were compared using two sample t-test.Results:Compared with the control group,in depressive group significant increased ALFF change manifested in left hippocampal gyrus (BA 30),right parietal postcentral gyrus (BA 2),right insular (BA 13),left inferior frontal gyrus (BA 6),left parietal precuneus (BA 7),right occipital cuneus(BA 18),left occipital lobe (middle occipital gyrus BA 19),right middle frontal gyrus(BA8),etc. Significant decreased ALFF change manifested in left middle temporal gyrus(BA 21),left caudate, left superior frontal gyrus (BA 6),etc.Conclusion:This research using amplitude of low frequency fluctuation (ALFF) algorithm explored the brain resting state abnormalities of first-episode medication-naive adolescent with major depressive disorder compared with healthy control group. It manifested regional increased ALFF change and decreased ALFF change at the same time. The increased ALFF regions include left hippocampal gyrus (BA 30), right parietal postcentral gyrus(BA 2),right insular,etc.;whereas decreased ALFF regions include left thalamus, left middle temporal gyrus (BA 21),left caudate etc. Some regions mentioned may associated with default mode network, and there was a clue that thalamus may exist decreased spontaneous neuron activities in depressive subjects,thus may lead to compensated increased neuron quantity later.