Disrupted Regional Homogeneity in Major Depressive Disorder With Gastrointestinal Symptoms at Rest.

Meiqi Yan,Huabing Li,Jingping Zhao,Wenbin Guo,Renzhi Huang,Yanqing Tang,Jindong Chen,Feng Liu

doi:10.3389/fpsyt.2021.636820

Abstract

Background: Gastrointestinal (GI) symptoms are prominent in patients with major depressive disorder (MDD). Previous studies have reported brain structural and functional changes in both MDD and digestive system diseases but it remains unclear whether MDD patients with GI symptoms have brain imaging changes.Methods: We recruited 35 MDD patients with GI symptoms, 17 MDD patients without GI symptoms and 28 age-, gender-, and education-matched healthy controls. All participants were scanned by resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with regional homogeneity (ReHo).Results: The GI group showed higher total HRSD-17 scores, anxiety/somatization, weight loss, and sleep disturbance scores compared to the non-GI group. We found increased ReHo in the right inferior parietal gyrus (IPL), bilateral supplementary motor area (SMA), bilateral cerebellum Crus II, left inferior frontal gyrus (IFG), and bilateral superior medial frontal cortex (SMFC) and decreased ReHo in the right posterior cingulate cortex (PCC), bilateral cuneus, and left middle occipital gyrus (MOG) in patients with GI symptoms relative to the HCs. The GI group showed higher ReHo values in the bilateral precuneus than the non-GI group.Conclusion: MDD patients with GI symptoms showed a greater severity of symptoms than MDD patients without GI symptoms, particularly in terms of anxiety/somatization, weight loss, and sleep disturbances. Increased activity in the default-mode network might be associated with GI symptoms in MDD patients.

Highlights

Major depressive disorder (MDD) is a common mental disorder globally, regardless of the level of income [1]
Chronic diarrhea and constipation were significantly more common and prevalent in depressed individuals than non-depressed individuals [5]. Gastrointestinal complaints such as diarrhea, abdominal pain, dyspepsia, constipation, or irritable bowel syndrome (IBS) occurred in 54% of subjects with depressive symptoms while it only occurred in 29% of subjects without depressive symptoms [6]
HRSD-17, 17-item Hamilton Rating Scale for Depression; S1, gastrointestinal (GI) symptoms group; S0, non-gastrointestinal symptoms group. aThe p-value was obtained by analyses of variance. bThe p-value was obtained by a Chi-square test. cThe p-value was obtained by two-sample t tests

Summary

Introduction

Major depressive disorder (MDD) is a common mental disorder globally, regardless of the level of income [1]. Due to the scarcity of mental health resources, coupled with the social stigma of mental disorders, patients with MDD accompanied with somatic symptoms tended to visit general hospitals for the first time or even repeatedly. It is difficult for a general physician to recognize mental illnesses like MDD, whereas a somatic chief complaint would increase the difficulty of identification [9], resulting in a long-term lack of correct diagnosis and effective treatment [10, 11]. Previous studies have reported brain structural and functional changes in both MDD and digestive system diseases but it remains unclear whether MDD patients with GI symptoms have brain imaging changes

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Discussion

Conclusion