Differentiating Melancholic and Non-melancholic Major Depressive Disorder Using Fractional Amplitude of Low-Frequency Fluctuations.

Yingying Zhang,Jingping Zhao,Yangpan Ou,Wenbin Guo,Jindong Chen,Guangrong Xie,Feng Liu,Huabing Li,Xilong Cui

doi:10.3389/fpsyt.2021.763770

Abstract

BackgroundMelancholic major depressive disorder (MDD) is a network-based brain disorder. However, whether or not network-based changes can be applied to differentiate melancholic (MEL) from non-melancholic (NMEL) MDD remains unclear.MethodsThirty-one MEL patients, 28 NMEL patients, and 32 matched healthy controls (HCs) were scanned using resting-state functional magnetic resonance imaging. Patients were assessed by the Chinese version of Snaith–Hamilton Pleasure Scale (SHAPS-C) and Temporal Experience of Pleasure Scale (TEPS). Fractional amplitude of low-frequency fluctuations (fALFF) and correlation analysis were used to analyze the data.ResultsCompared with HCs, the MEL group had significantly higher fALFF values in the bilateral inferior frontal gyrus and right supplementary motor area (SMA) and significantly lower fALFF values in the right inferior occipital gyrus (IOG), right middle temporal gyrus (MTG)/left IOG, and bilateral superior occipital gyrus (SOG)/MTG. On the other hand, the NMEL group showed significantly higher fALFF values in the bilateral SMA and significantly lower fALFF values in the bilateral posterior cingulate cortex/precuneus relative to HCs. Compared with the NMEL group, the MEL group showed significantly lower fALFF values in the left anterior cingulate cortex (ACC). A correlation was found between the fALFF values of the right SMA and the SHAPS-C in the MEL group. In addition, correlations were observed between the fALFF values of the left ACC and the TEPS contextual consummatory and total scores in all patients.ConclusionOur study uncovered that MDD exhibited altered brain activity in extensive brain networks, including the default-mode network, frontal-striatal network, reward system, and frontal-limbic network. Decreased fALFF in the left ACC might be applied to differentiate the two subtypes of MDD.

Highlights

Major depressive disorder (MDD), a common mental disorder, is marked by a persistent negative mood, anhedonia [1], cognitive impairments [2], and additional symptoms, such as psychomotor changes, appetite dropping, sleep disturbance, fatigue, inattention, and sense of valuelessness [3]
A correlation was found between the fALFF values of the right SMA and the Snaith–Hamilton Pleasure Scale (SHAPS)-C in the MEL group
Correlations were observed between the fALFF values of the left ACC and the Temporal Experience of Pleasure Scale (TEPS) contextual consummatory and total scores in all patients

Summary

Introduction

Major depressive disorder (MDD), a common mental disorder, is marked by a persistent negative mood, anhedonia [1], cognitive impairments [2], and additional symptoms, such as psychomotor changes, appetite dropping, sleep disturbance, fatigue, inattention, and sense of valuelessness [3]. Distinct from non-melancholic (NMEL) MDD, MEL MDD is characterized by MEL features of anhedonia (refers to impaired mood reactivity, reward dysfunction, and diminished interest), psychomotor disturbance, and cognitive impairment (including attention shift, visual learning, implicit learning, and executive functions) [3, 6, 9,10,11,12,13,14,15,16,17,18,19]. Melancholic major depressive disorder (MDD) is a network-based brain disorder. Whether or not network-based changes can be applied to differentiate melancholic (MEL) from non-melancholic (NMEL) MDD remains unclear

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Conclusion