A Comparative Study Of Cerebellum-Brain Dynamic Functional Connectivity In Depressive Patients With And Without Anxiety Symptoms

Objective:Depressive disorder with anxiety symptoms(A-MDD)has a more complex clinical diagnosis than depression without anxiety symptoms(NA-MDD),generally has a longer course of disease,and has lower rates of treatment remission.Recent neuropsychiatric imaging studies reported that patients with A-MDD exhibited structural and functional abnormalities in the cerebellum compared with patients with NA-MDD.This study intends to compare the cerebellum-cerebral functional connectivity and brain structure changes of A-MDD and NA-MDD from two aspects of resting-state functional magnetic resonance imaging(rs-f MRI)and structural magnetic resonance imaging,so as to provide imaging basis for accurate diagnosis and treatment.Methods:75 drug-naive A-MDD patients,59 drug-naive NA-MDD patients,and 52 HC were scanned under 3.0T MRI.After preprocessing the rs-f MRI data,the cerebellum subregions were used as seed to calculate the cerebellum-cerebral dynamic functional connectivity(d FC)value by Hamming window with a sliding window width of 50 TR and a step size of 1TR.One-way analysis of variance(ANOVA)was used to compare the d FC values of the three groups(p<0.05 was considered statistically significant),and the differences between groups were corrected based on the Gaussian random field(GRF)theory(voxel level p< 0.05,cluster level p<0.0083),and post hoc tests were performed for d FC values in different brain regions,least significant difference(LSD)correct,p<0.05.After structural data preprocessing,the gray matter volume was obtained based on voxel-based morphometry(VBM)analysis,and the statistical method of one-way ANOVA was used to compare the gray matter volume value of the three groups(p<0.05 was considered statistically significant),and the differences between groups were corrected based on the GRF theory(voxel level p<0.005,cluster level p<0.0083),post hoc tests were performed for the differing brain area gray matter volume values (LSD correct,p<0.05).Partial correlation analysis was used to analyze the correlation between d FC value,gray matter volume value and clinical variables in different brain regions(p<0.05).Results:1.Comparison of d FC values between groups: The brain regions with statistically significant differences in d FC values after d FC analysis with the cerebellum as the seed were in the left middle temporal gyrus,left medial prefrontal gyrus and left angular gyrus.The post hoc test showed that compared with the HC group,the right Crus I-left middle temporal gyrus in the A-MDD group decreased,the d FC value of the right Crus I-left medial prefrontal cortex,and the d FC value of the right Crus II-the left angular gyrus decreased;compared with the HC group,the d FC value of the right Crus I-left middle temporal gyrus in the NA-MDD patient group decreased;the d FC values in the Crus I-left medial prefrontal cortex decreased,the d FC values in right Crus II-the left angular gyrus decreased.2.Comparison of gray matter volume between groups: The results of one-way ANOVA showed that the gray matter volume of the left cerebellar vermis＿VIII was statistically significant.Post hoc test: increased cerebellar(mainly vermis＿VIII)gray matter volume in A-MDD compared with NA-MDD group;cerebellar vermis＿VIII gray matter volume in NA-MDD compared with HC reduce.Conclusion:1.In both A-MDD and NA-MDD,the d FC value of Crus I-middle temporal gyrus is decreased,and A-MDD has specific Crus I-medial prefrontal gyrsu and Crus II-angular gyrus.Alterations in dynamic functional connectivity of the broader cerebellum-brain,with specific decreased dynamic functional connectivity to the middle temporal gyrus,medial prefrontal gyrus,and angular gyrus.2.The gray matter volume of A-MDD patients and NA-MDD patients differed in the cerebellum,suggesting that the cerebellum may be involved in the physiological mechanism of anxiety-associated symptoms.