| Resting state functional magnetic resonance(fMRI) in depression has been widely applied in the study of pathogenesis and treatment in depression recently, the study agreed that the pathological basis of depression is not a single brain region damage, but is associated with the abnormal function connectivity of different brain regions, which forms functional related neural circuits and brain networks. Cognitive behavior therapy (CBT) can bring recovery of abnormal neural correlates of depression, after treatment, the clinical depressive symptoms of patients can have a long-term and continuous change. Researches at home and abroad only set up two time points like before and after the treatment, the change process to functional brain activity of CBT for depression cannot be present, moreover, the results at present are not consistent.This research recruit depressive inpatients(n =18) mainly in the XXXX hospital and healthy subjects matched in gender, age and the level of education. Participants recruited need to fill out demographic sheet,and researchers had to rating the Hamilton Depression Scale (HAMD) for patients which must conducted in double-blind. Two groups of participants carried out resting state fMRI scans within 48h at baseline, to compare the difference of spontaneous brain activity between patients and health subjects with low frequency Amplitude fluctuations (ALFF).The control group accepted individual CBT, they should came for rfMRI scanning after 6 week, 24 week CBT, to explore different brain activity changes in different CBT treatment periods.Based on our ALFF results, we set the left and right side of the precuneus as regions of interest, then we use whole brain functional connectivity analysis (FC) to further explore the changes of brain connections with CBT for patients with depressive disorder. The results are as follows:1 ALFF results: (1) Comparing the depression group and healthy group at baseline, depressed patients presents enhanced alff at the right side of lingual gyrus,and significantly reduced alff at the left side of medial occipital gyrus (p < 0.01);(2) Compared to the baseline period, after 6 weeks CBT treatment, depression group presents significantly increased alff at the left temporal gyrus, and significantly decreased alff at the left side of the linguilis gyrus, the left side of the orbital frontal cortex and the left inferior precuneus (p < 0.01).(3) Compared to the baseline period,after 24 weeks CBT treatment, the depression group presents significantly increased alff at the left frontal gyrus, the left fusiform gyrus and left inferior orbital frontal gyrus, significantly decreased alff at the right side of medial occipital gyrus, and right precuneus (p < 0.01);2 FC results: (1) Comparing the depression group and healthy group at baseline,the depressed patients presents lower functional connectivity between left precuneus and the supplementary motor areas (p < 0.05);(2) Compared to the baseline period, after 6 weeks CBT treatment, depressed patients presents lower functional connectivity between left precuneus and frontal gyrus, right precuneus; lower functional connectivity between right precuneus and cingulate,enhanced functional connectivity between right precuneus and right precentral gyrus(p < 0.05);(3) Compared to the baseline period, after 24 weeks CBT treatment, depressed patients presents lower functional connectivity between left precuneus and left parahippocampal gyrus, precentral gyrus, enhanced functional connectivity between the left precuneus and right precentral gyrus enhancement; enhanced functional connectivity between the right precuneus and precentral gyrus,lower functional connectivity between right precuneus and temporal gyrus (p < 0.05).The study found that:(1) After 6 weeks CBT treatment, depressed patients restrain brain regions activated in default mode network by activating regions in cognitive control network and salience,the patients' attention transfering ability enhanced ;(2) After 24 weeks CBT treatment, a wide scale of functional connectivity repaired in regions of cognitive control network, and patients' response inhibition ability recovered;(3) Early period of the CBT treatment could repair the pathological brain regions of depressed patients, after that, CBT could stable strengthen those brain regions and the functional connectivity. |
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