Shared and Distinct Fractional Amplitude of Low-Frequency Fluctuation Patterns in Major Depressive Disorders With and Without Gastrointestinal Symptoms.

Xiaoya Fu,Meiqi Yan,Jingping Zhao,Huabing Li,Jindong Chen,Wenbin Guo,Feng Liu

doi:10.3389/fpsyt.2021.744898

Abstract

Objective: Gastrointestinal (GI) symptoms are fairly common somatic symptoms in depressed patients. The purpose of this study was to explore the influence of concomitant GI symptoms on the fractional amplitude of low-frequency fluctuation (fALFF) patterns in patients with major depressive disorder (MDD) and investigate the connection between aberrant fALFF and clinical characteristics.Methods: This study included 35 MDD patients with GI symptoms (GI-MDD patients), 17 MDD patients without GI symptoms (nGI-MDD patients), and 28 healthy controls (HCs). The fALFF method was used to analyze the resting-state functional magnetic resonance imaging data. Correlation analysis and pattern classification were employed to investigate the relationship of the fALFF patterns with the clinical characteristics of patients.Results: GI-MDD patients exhibited higher scores in the HRSD-17 and suffered more severe insomnia, anxiety/somatization, and weight loss than nGI-MDD patients. GI-MDD patients showed higher fALFF in the right superior frontal gyrus (SFG)/middle frontal gyrus (MFG) and lower fALFF in the left superior medial prefrontal cortex (MPFC) compared with nGI-MDD patients. A combination of the fALFF values of these two clusters could be applied to discriminate GI-MDD patients from nGI-MDD patients, with accuracy, sensitivity, and specificity of 86.54, 94.29, and 70.59%, respectively.Conclusion: GI-MDD patients showed more severe depressive symptoms. Increased fALFF in the right SFG/MFG and decreased fALFF in the left superior MPFC might be distinctive neurobiological features of MDD patients with GI symptoms.

Highlights

As one of the most widespread mental illnesses across the world, major depressive disorder (MDD) is a serious public health problem and markedly impairs patient’s quality of life
The results showed that classification based on the combination of the fALFF values in the right superior frontal gyrus (SFG)/middle frontal gyrus (MFG) and the left superior MPFC reached a higher accuracy (86.54%) than did those based on fALFF of the right SFG/MFG (76.92%) or the left superior MPFC (84.62%) alone
The sensitivity and specificity were 100 and 58.82%, respectively, when using the fALFF values of the left superior MPFC to discriminate between GI-MDD patients and nGI-MDD patients

Summary

Introduction

As one of the most widespread mental illnesses across the world, major depressive disorder (MDD) is a serious public health problem and markedly impairs patient’s quality of life. It is extremely common for patients with MDD to report somatic symptoms, such as constipation and stomachache. A multicenter study showed that half of MDD patients had multiple unexplained somatic symptoms [1]. In elderly patients with MDD, the prevalence of somatic symptoms is even higher [2]. Over 70% of patients with depressive episodes reported concomitant GI symptoms [5]. Patients with GI symptoms have a greater probability of suffering from severe depression or anxiety [5, 6]

Methods

Results

Conclusion