伴不同严重程度失眠的抑郁症患者与健康对照之间基于皮层表面的 度中心性比较:来自抑郁症脑影像大数据联盟的证据
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首都医科大学科研培育基金( PYZ25178);研究型病房卓越临床研究计划平行项目 (BRWEP2024W072120104)


Comparison of cortical surface-based degree centrality between depressive disorder patients with different severities of insomnia and healthy controls: evidence from the DIRECT
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    目的 采用基于皮层表面的度中心性指标检测抑郁症患者失眠严重程度相关的脑功能 异常。方法 纳入抑郁症脑影像大数据联盟(DIRECT) 9 个分中心的317 例抑郁症患者和287 名健康对 照者为研究对象,采集所有受试者的静息态功能磁共振成像数据。采用17项汉密尔顿抑郁量表(HAMD-17) 评估患者的抑郁严重程度,并根据HAMD-17 失眠分量表的总分将患者进一步分为失眠高分组(≥ 4 分, n=202)和失眠低分组(≤ 3 分,n=115)。采用DPABISurf 工具箱进行数据预处理和基于皮层表面的度中 心性计算。采用单因素协方差分析方法比较失眠高分组、失眠低分组和健康对照组之间在基于皮层表 面的度中心性上的差异。提取差异有统计学意义脑区的度中心性值,在抑郁症患者中采用Spearman 相 关分析方法检测亚组患者度中心性与抑郁、失眠严重程度的相关性。结果 3 组受试者性别、平均帧 位移比较,差异无统计学意义(均P> 0.05);失眠高分组年龄、调整后HAMD-17 总分及服用药物患者比 例均高于失眠低分组,受教育年限低于健康对照组,差异均有统计学意义(均P < 0.05)。失眠高分组 和失眠低分组右侧布罗德曼3b 区(未回归全脑平均信号时:F=16.35,P< 0.001;回归全脑平均信号时: F=10.38,P< 0.001)和右侧额叶10 区后极(未回归全脑平均信号时:F=12.87,P< 0.001;回归全脑平均 信号时:F=12.38,P< 0.001)的皮层表面度中心性低于健康对照组,且该结果不受全脑平均信号的影响; 而失眠高分组和失眠低分组皮层表面度中心性比较,差异无统计学意义(P> 0.05)。在失眠高分组中, 右侧布罗德曼3b 区的度中心性与调整后的HAMD-17 总分呈正相关(未回归全脑平均信号时:r=0.19, P=0.006;回归全脑平均信号时:r=0.16,P=0.021)。结论 抑郁症患者右侧布罗德曼3b 区和右侧额叶 10 区后极基于皮层表面的度中心性降低可能反映抑郁症本身的核心病理特征,而非伴随失眠严重程 度波动的状态依赖性改变。

    Abstract:

    Objective To investigate brain functional abnormalities associated with the severity of insomnia in patients with depressive disorder using the cortical surface-based degree centrality. Methods A total of 317 patients with depressive disorder from 9 subcenters of the Depression Imaging REsearch ConsorTium (DIRECT) and 287 healthy controls were included in the study. Resting-state functional magnetic resonance imaging data were collected from all participants. The severity of depressive disorder in patients was evaluated using the 17-item Hamilton Depression Scale( HAMD-17). Patients were further divided into a high-insomnia group( ≥ 4, n=202) and a low-insomnia group( ≤ 3, n=115) based on the total scores of the HAMD-17 Insomnia Subscale. DPABISurf toolbox was used for data preprocessing and cortical surface-based degree centrality calculation. One-way covariance analysis was used to compare differences in cortical surface-based degree centrality among the high-insomnia group, low-insomnia group, and healthy control group. The degree centrality values of brain regions with statistically significant differences were extracted, and Spearman correlation was used to analyze the correlation between degree centrality and the severity of depressive disorder and insomnia in subgroups of patients with depressive disorder. Results There were no statistically significant differences in gender or mean framewise displacement among the three groups of participants( all P>0.05). The age, adjusted HAMD-17 total score, and proportion of patients taking medication in the high-insomnia group were higher than those in the low-insomnia group, and the education years were lower than those in the healthy control group, with statistically significant differences( all P<0.05). The cortical surface-based degree centrality of right Brodmann area 3b in the high-insomnia group and the low-insomnia group( without global signal regression: F=16.35, P < 0.001; with global signal regression: F=10.38, P < 0.001) and the posterior pole of the right frontal lobe area 10( without global signal regression: F=12.87, P<0.001; with global signal regression: F=12.38, P< 0.001) was lower than that in the healthy control group, and these differences were statistically significant and were not affected by the global signal. There was no statistically significant difference in the cortical surfacebased degree centrality between the high-insomnia group and the low-insomnia group( P> 0.05). In the highinsomnia group, the degree centrality in right Brodmann area 3b was positively correlated with the adjusted HAMD-17 total score( without global signal regression: r=0.19, P=0.006; with global signal regression: r=0.16, P=0.021), and the difference was statistically significant. Conclusions Reduced cortical surfacebased degree centrality in the right Brodmann area 3b and the posterior pole of the right frontal lobe area 10 in patients with depressive disorder may reflect the core pathological feature of depressive disorder itself, rather than a state-dependent change associated with fluctuations in the severity of insomnia

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张志芳,薄奇静,李峰,等.伴不同严重程度失眠的抑郁症患者与健康对照之间基于皮层表面的 度中心性比较:来自抑郁症脑影像大数据联盟的证据[J].神经疾病与精神卫生,2026,26(8):564-572. DOI:10.3969/j. issn.1009-6574.2026.08.005.

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  • 在线发布日期: 2026-08-18