Research On The Correlation Between Psychosocial Function And Brain Default Network After Depression Is Clinically Cured

Major Depressive Disorder(MDD)is a chronic mental disorder characterized by high incidence rate,high recurrence rate and high suicide rate.At present,drug therapy is still the first choice.It can not only be used in the treatment of depression in the acute stage,but also can be used in the maintenance treatment after remission and reducing the risk of recurrence.The treatment of depression in the acute stage mainly aims at the clinical remission.The operation standard of clinical remission refers to the Hamilton Depression Scale(HAMD)score ≤ 7 points,that means,after antidepressant treatment,MDD patients’ clinical symptoms no longer meet the criteria of depression diagnosis system.Previous studies have found that the recovery of psychosocial function of patients with clinical depression is lagging behind the recovery of clinical symptoms.The research of resting state functional magnetic resonance(rs-f MRI)also found that the recovery of brain network function in MDD patients was delayed in the recovery of clinical symptoms,and the default mode network(DMN)was considered as an important biological index of clinical symptom severity and clinical treatment.Therefore,the effectiveness and comprehensiveness of using clinical symptom recovery as the standard of depression rehabilitation(HAMD-17 ≤ 7 points)are still insufficient.The purpose of this study is to trace the function of default mode network(DMN)and psychosocial function of clinical cured patients,and explore the relationship between them,so as to explore the rehabilitation mechanism of depression.In this study,convenient sampling method was used.A total of 17 patients(all of them were treated in the Department of psychology,Affiliated Brain Hospital of Nanjing Medical University)who met the admission criteria were enrolled in the study,and the rs-f MRI was performed in the baseline period(rMDD)and the six-month follow-up period(s Mdd).22 cases of standard control group(HCs)matched with the MDD group in gender,age,and educational level were recruited and given the same resting f MRI scan.The Independent Component Analysis(ICA)was selected as the analysis index of spontaneous brain activity.We try to compare the changes of functional connectivity(FC)in the patients with clinical remission who were at the period of baseline and 6 months,and simultaneously compare the difference of FC between MDD group and the normal control group.The correlations between functional connectivity and GQOLI-74 scores were tested through Pearson product difference correlations at 95% confidence level in SPSS24.The results are as follows:DMN network results: The DMN data showed that the functional connectivity of medial orbitofrontal cortex(m OFC＿R)(3,54,-9),Posterior cingulate cortex(PCC＿R)(6,-51,30),and precuneus(PCu)(9,-54,27)in the rMDD group was significantly higher than the HCs group.and no functional connectivity in the rMDD group was found to be lower than the HCs.Furthermore,no significant difference have been found between the s MDD and HCs group.Compared with the rMDD group,the functional connectivity of medial orbitofrontal cortex(m OFC)(3,54,-9)and left medial prefrontal cortex(m PFC＿L)(-3,66,12)in the s MDD group was significantly lower than the rMDD group,and the functional connectivity of left angular gyrus(AG＿L)(-57,-57,33)was significantly higher than the rMDD group.Related results: The angular gyrus showed a significant positive correlation with the mental function dimension and the self-esteem factor in it at baseline and 6 months.m OFC showed a significant negative correlation with Amateur recreation factors at baseline.Dimensions and factors of m PFC and precuneus did not show significant correlation both at Baseline and six-month periods.Conclusion(1)The clinical symptoms of depression patients have basically recovered after reaching the clinical cure standard(HAMD-17 ≤ 7 points)through the treatment of acute stage,but the functional damage of DMN network has not recovered completely.(2)In the 6-month continuous treatment after clinical cure,the recovery of DMN network function is still ongoing.(3)There was a significant correlation between the psychosocial function and the recovery of DMN network function,especially between the angular gyrus and psychosocial function.