| BackgroundPathogenesis of depressive disorder is unclear. Depressive disorder, which is a serious mental disease, has a high prevalence, recurrence rate, disability rate, suicide rate. The prevalence of major depressive disorder(MDD) in children and adolescents increased year by year. With the rapid development of imaging technology, more and more people begin to pay close attention to neuroimaging studies of MDD. Previous neuroimaging studies of adult patients with MDD have reported sectional dysfunction in brain regions. Because the neurobiological processes of the same mental illness differ in adults and adolescents owing to the immaturity of the neural networks that regulate and process emotions during adolescence, adolescent MDD may potentially predict depression in adults. In summary, this fully demonstrates the importance of study on cognitive function and brain imaging to adolescent MDD. Objective1 To explore the characteristics of cognitive function, the brain activity in resting state and white matter changes in microscopic structure of first-episode adolescent MDD;2 To explore the correlation between cognitive function and brain imaging in first-episode adolescent MDD.Methods46 cases in line with "The Diagnostic and Statistical Manual of Mental Disorders"(4th edition, DSM-IV) diagnostic criteria for MDD in patients with first-episode adolescent MDD and 46 normal controls, using 17- item Hamilton Depression Rating Scale(17-HAMD) were evaluated, 17-HAMD ? 17 points included in the depression group, 17-HAMD <7 points included in the control group. Then in turn for conventional MR sequences, resting-state functional MRI and diffusion tensor imaging scans tests. Finally, the partial coherence of the two groups are different brain regions(Re Ho) value, fractional low-amplitude(fALFF) value and age of onset, duration and severity of the disease was analyzed. Results1 The correlation of cognitive function and fMRI1.1 Cognitive function results: WSCT showed the correct time to think, non-persistent number of errors, not the number of categories between the two groups completed no significant difference(P> 0.01). Completed adolescent depression group classification number, the number of correct answers, the number of sustained response were less than the control group(P <0.01); the total number of responses, the number of responses errors, wrong time to think, to complete the first classification response number, continuous errors were more than the normal control group(P <0.01). TMT between the two groups showed that the TMT-A number of errors was no significant difference(P> 0.01). The adolescent depression group TMT-A completion time, TMT-B completion time, TMT-B number of errors were more than the control group(P <0.01).Correlation analysis results: the patients' age, years of education, duration and severity of the disease associated with abnormal cognitive function line correlation analysis found that years of education and TMT-B time was negatively correlated(r =-0.313, P = 0.049). The study find age, disease duration, disease severity and the presence of abnormal cognitive function was no correlation(P> 0.05).1.2 ReHo analysis results: adolescent depression group and normal control group ReHo value increased brain areas are mainly located in the left side of the brain, the left inferior frontal gyrus / orbital gyrus, right front center back / paracentral lobule left middle temporal gyrus, the left middle frontal gyrus / middle frontal gyrus, the difference was statistically significant(P <0.01); ReHo value decreased brain regions are widely distributed in the left occipital gyrus, bilateral frontal straight back, right side superior temporal gyrus, right middle temporal gyrus, the difference was statistically significant(P <0.01).Correlation analysis results: the abnormal brain regions ReHo value and duration, disease severity was no correlation(P> 0.05).The abnormal cognitive function and abnormal ReHo value do correlation analysis showed that the right front center back / paracentral lobule was positively correlated with the number of correct answers(r = 0.378, p = 0.043); the right of the central gyrus / paracentral leaflets with the wrong answer, perseverative errors were negatively correlated(r =-0.368, p = 0.049; r =-0.436, p = 0.018).1.3 fALFF analysis results: adolescent depression group compared with the control group fALFF value increased mainly located in the left superior frontal gyrus, the left inferior frontal gyrus and right parahippocampal gyrus, left anterior cingulate gyrus, central back right front, left side of the brain, the left paracentral lobule, the difference was statistically significant(P <0.01); fALFF value reduced bilateral caudate nucleus region, the difference was statistically significant(P <0.01).Correlation analysis results: the abnormal brain regions fALFF no relations with age, disease duration, disease severity(p> 0.05).The abnormal cognitive function and abnormal fALFF value do correlation analysis showed that the left inferior frontal gyrus and time TMT-A, TMT-B error count was positively correlated(r = 0.537, p = 0.003; r = 0.371, p = 0.048); the left middle temporal gyrus was positively correlated with TMT-B the number of errors(r = 0.383, p = 0.040); the center of the right front back and TMT-B time, TMT-B error count was positively correlated(r = 0.424, p = 0.022; r = 0.545, p = 0.002); the left side of the brain and TMT-B time was positively correlated(r = 0.514, p = 0.004).2 The correlation of cognitive function and DTI2.1 Cognitive function results: WSCT showed the correct time to think, non-persistent number of errors, not the number of categories, classification number, the number of correct answers, the number of sustained response between the two groups completed no significant difference(P> 0.01). The total number of responses, the number of responses errors, wrong time to think, continuous errors were more than the normal control group(P <0.01). TMT between the two groups showed that the number of errors TMT-A and TMT-B was no significant difference(P> 0.01). The adolescent depression group TMT-A completion time and TMT-B completion time more than the control group(P <0.01).Correlation analysis results: the patients group' age, years of education, duration and severity of the disease associated with abnormal cognitive function line correlation analysis found that years of education and TMT-A time was negatively correlated(r=-0.337,P=0.044), that years of education, the higher TMT-A test completion time is shorter. The study did not find age, disease duration, disease severity and the presence of abnormal cognitive function correlation(P> 0.05).Total response number of patients, the error response number, the wrong time to think, persistent errors, TMT-B completion time of the patients group was positively correlated with 17-HAMD score(r = 0.461, P = 0.005; r = 0.468, P = 0.004; r = 0.468, P = 0.004; r = 0.514, P = 0.001; r = 0.438, P = 0.008).Total response count, error response number, wrong time to think, sustained errors, TMT-B completion time of the patients group was positively correlated with duration(r = 0.342, P = 0.041; r = 0.335, P = 0.046; r = 0.417, P = 0.011; r = 0.410, P = 0.013; r = 0.381, P = 0.022).The abnormal cognitive function with age was no correlation.2.2 DTI analysis results: adolescent depression group and normal control group compared to white matter microstructure differences of the corpus callosum(P <0.05).Correlation analysis results: the corpus callosum FA value, 17-HAMD score and disease duration was negatively correlated(r =-0.366, p = 0.028; r =-0.481, p = 0.003),.The patient group differences in brain(corpus callosum) FA value and abnormal cognitive function do Correlation analysis showed that the corpus callosum and cognitive function in FA values was no correlation(p> 0.05). Conclusions1 Adolescent MDD patients has a wide range of ReHo, fALFF abnormalities, mainly in the frontal lobe, temporal lobe, occipital lobe, anterior cingulate, caudate nucleus, the brain and other brain regions. Early spontaneous neural activity in these brain abnormalities may be a potential neuropathological basis of adolescent MDD. In addition, abnormal neural activity in brain regions associated with age, years of education have a certain relevance. The right front center back / paracentral lobule abnormal brain regions ReHo value and the left inferior frontal gyrus, left superior temporal gyrus, middle frontal gyrus on the right, the left middle cerebral fALFF value anomalies and executive function decline.2 Adolescent MDD has corpus callosum white matter fiber damage, suggesting that patients with depression early stage of abnormal white matter microstructure exists, this may be a potential neuropathological basis of adolescent MDD. In addition, more severe depression, the longer the duration, the more severe the corpus callosum white matter fiber damage. However, the present study found no corpus callosum white matter fiber damage and cognitive dysfunction. |
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