Comparative Study Of Abnormal White Matter Integrity In Adolescence And Early Adulthood Patients With Major Depressive Disorder

Objective: Major depressive disorder(MDD)is a severe mental disease with high prevalence rate,disability rate and suicide rate,with low mood,decreased interest and loss of pleasure as its core symptoms.Most MDD patients’ first episode is in adolescence or early adulthood.Its pathogenesis is still unclear,and there is a lack of specific markers for auxiliary diagnosis.Adolescent and early adult MDD patients have different clinical manifestations,suggesting that they may have various pathogenesis.This study uses Diffusion Tensor Imaging(DTI)technology of brain Magnetic Resonance Imaging(MRI)combined with clinical psychological evaluation data to compare and study the differences in white matter integrity between adolescents and early adults with MDD,explore the similarities and differences in the abnormal changes of white matter in the brain of adolescents and early adults with MDD,and look for possible specific markers of the changes of white matter in the brain of adolescents with MDD.Methods: This study included 168 subjects aged 13-24 years,including 44 adolescent MDD patients(ad MDD)aged 13-17 years,and 37 adolescent healthy control(ad HC)matched with age,sex and education(year);46 patients with early adult MDD patients(ea MDD)aged 18-24 years,and 41 healthy controls(ea HC)matched with their age,sex.First,all the subjects and the legal guardians of minors voluntarily signed the informed consent form.Then demographic data were collected,and the diagnosis of ad MDD group was determined using the K-SADS-PL,and the diagnosis of ea MDD group was determined by the SCID.The clinical symptoms were quantified by Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA)and Young’s Mania Scale(YMRS).DTI technology of brain MRI was performed to obtain the image data of white matter integrity.The index was fractional anisotropy(FA).After scanning,the subjects were followed up by telephone for at least three months to ensure accurate diagnosis.The collected demographic data and clinical symptom evaluation results were statistically analyzed in SPSS software.On the MATLAB platform,PANDA software package is used to preprocess the white matter brain image,SPM software package is used to statistically analyze the image,DPABI software package is used to perform GRF correction,locate the brain clusters with statistical differences,PANDA is used to locate the white matter brain regions of the different brain clusters,DIPABI is used to extract the FA value of the different brain regions,and the extracted FA values are involved in the subsequent correlation analysis.In SPSS software,the FA values extracted from abnormal brain regions and clinical symptom scores were analyzed by partial correlation with age and sex as control variables.Results: 1.Compared with ad HC,the FA values of ad MDD in the white matter of External.capsule.L,Superior.longitudinal.fasciculus.L and Superior.corona.radiata.L increased(P<0.05).2.Compared with ea HC,there was no statistically significant difference in FA value of the whole white matter of ea MDD.3.Partial correlation analysis showed that there was a positive correlation between the FA values of the white matter of External.capsule.L and the HAMA scores in ad MDD(r=0.400,P=0.016).Conclusion: 1.The integrity of white matter in External.capsule.L,Superior.longitudinal.fasciculus.L and Superior.corona.radiata.L of adolescent patients with MDD has significant abnormal changes.2.There was no significant abnormal change in white matter integrity in patients with MDD in early adulthood.3.The change of the integrity of the white matter in External.capsule.L of the adolescent patients with MDD related to the severity of anxiety symptoms.4.Adolescent and early adult patients with MDD have different white matter changes.