The Features Of Functioning Impairment And Its Association With Rs-fMRI In Major Depressive Disorder

Background: major depressive disorder(MDD)is often associated with cognitive impairment.Developing an accurate and effective battery to measure cognitive deficits in MDD is necessary for both research and clinical practice.At the same time,neuroimaging studies have found that the pathological mechanism of depression may be related to abnormal brain function.Cognitive dysfunction is related to the abnormal changes of brain structure and function.There are few reports on cognitive function,brain function and the relationship between them in patients with first-episode MDD,so we have carried out this study.Objective: 1.To explore the characteristics of cognitive function in patients with firstepisode MDD;2.this study aimed to examine the psychometric properties of the MATRICS Consensus Cognitive Battery(MCCB)in Chinese MDD patients.3.Analysis of resting brain functional imaging in patients with first-episode severe depression.;4.To investigate the relationship between functional characteristics and resting brain function in patients with first-episode severe depression.Methods: 1.Forty-eight MDD patients,forty-three euthymic patients with bipolar disorder(BD),thirty-two euthymic patients with schizophrenia(SCH)and thirty-five healthy controls were included.The Chinese version of the MCCB,the Montreal Cognitive Assessment(Mo CA),the Hamilton Depression Rating Scale-17(HDRS-17),the Young Mania Rating Scale(YMRS)and the Chinese version of the short functional assessment test(FAST)were administered to assess cognitive impairment and clinical symptoms.MDD patients and healthy controls were examined by resting functional magnetic resonance imaging(f MRI)in a blood-oxygen level-dependent manner.Results: this findings showed that the MCCB had good internal consistency and acceptable test-retest reliability in Chinese MDD patients.Meanwhile,this findings revealed a high correlation between the MCCB and the Mo CA,indicating good concurrent validity of the MCCB.Furthermore,the MCCB showed high discriminant ability between MDD patients and healthy controls,and exploratory factor analysis(EFA)of the MCCB displayed four domains with acceptable internal structure in MDD patients.2.The cognitive function of the MDD patients was impaired in all dimensions compared with the normal control group.The degree of impairement was more severe than that of schizophrenia,and lighter than that of BD patients.3.The MDD group showed a significant lower Re Ho in the right temporal fusiform gyrus,left cerebellar foot,left medial superior frontal gyrus and left supplementary motor.Meanwhile,the MDD group also showed a significant lower ALFF in bilateral cerebellum,left inferior orbital gyrus,left medial suprafrontal gyrus,left caudate nucleus and left supplementary active area.4.The lower Re Ho in the left cerebellum was correlated with the cognitive function dimension of FAST and total anxiety score.We also found a correlation between the lower ALFF in left cerebellum and HAMD depression/anxiety score.The changes of ALFF in left cerebellum were related to functional changes and cognitive impairment.The changes of ALFF in the medial suprafrontal gyrus were correlated with depressive symptoms and some neurocognitive functions.The changes of ALFF in caudate nucleus were correlated with depressive symptoms.