Altered Brain Function in Drug-Naïve Major Depressive Disorder Patients With Early-Life Maltreatment: A Resting-State fMRI Study.

Zhexue Xu,Atsushi Kamiya,Jing Zhang,Ting Wang,Di Wang,Miao Qu,Shu Zhang,Xi Ren,Xiaolei Zhu,Jiliang Fang

doi:10.3389/fpsyt.2019.00255

Abstract

Childhood Maltreatment (CM) is an important risk factor for major depressive disorder (MDD). Previous studies using emotional task-state functional magnetic resonance (task-state fMRI) found that altered brain function in prefrontal-limbic regions was the key neuropathological mechanism in adult MDD patients with experience of early-life maltreatment. However, to the best of our knowledge, there is no published study investigating brain function in MDD patients with CM experience using resting-state fMRI (rs-fMRI). In present study, we aimed to detect altered resting-state brain activity in MDD patients with CM experience, and identify significantly activated brain regions, which may provide new insights into the neural mechanism underlying the relationship between MDD and CM experience. The results showed MDD patients with CM experience were associated with increased amplitude of low-frequency fluctuation (ALFF) and altered function connection (FC) in the prefrontal cortex, when compared to MDD patients without CM. Of note, left frontal middle gyrus (LFEG) was found as a specific brain region which differentiates MDD patients with CM from patients without CM. These results suggest that rs-fMRI is a useful method in studying the correlation between MDD and CM experience and altered function of LFEG in resting-state may explain the correlation between MDD and CM experience.

Highlights

Major depressive disorder (MDD) has become the single largest contributor to nonfatal health loss globally in 2015 [1]
major depressive disorder (MDD) with Childhood Maltreatment (CM) had a higher CM score than MDD without CM and healthy controls (HC) (MDD with CM: 63.33 ± 4.03; MDD without CM: 31.16 ± 5.63, HC: 30.83 ± 4.02, p < 0.01), and there was no significant difference found between MDD without CM and HC
We found that under scan of resting-state functional magnetic resonance imaging (fMRI) (rs-fMRI), compared with HC, MDD patients with CM had enhanced amplitude of low-frequency fluctuation (ALFF) in prefrontallimbic regions, left orbital part of inferior frontal gyrus, right orbital part of middle frontal gyrus, which is similar to the results from previous task-state fMRI studies in MDD with CM [23, 24]

Summary

Introduction

Major depressive disorder (MDD) has become the single largest contributor to nonfatal health loss globally in 2015 [1]. Poor family relationship and social support in adulthood have been thoroughly studied as environmental risks for MDD, unpleasant psychical or physical experiences during childhood were often overlooked. Childhood maltreatment (CM) has recently gained greater attention because it may confer susceptibility to depression in later-life. Clinical evidence from retrospective and prospective rs-fMRI on MDD with CM cohort studies suggests that CM could markedly increase the risk of MDD [2,3,4,5]. It is important to identify the neural mechanisms underlying the impact of CM on MDD pathophysiology, for pursuing early intervention and mechanism-based treatment strategies

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