Longitudinal Study Of Structural And Functional Characteristics Of Hypothalamus In Patients With Depression

Objective:Previous studies have found abnormalities in the structure or function of hypothalamus in patients with depression,but it is unclear what changes will happen about these abnormalities change after treatment and how these changes relate to the severity of depressive symptoms.Therefore,this study explored the structural and functional characteristics of hypothalamus before and after treatment in patients with depression by longitudinal tracking and analyzed the relationship between the severity of depressive symptoms.Methods:We recruited two groups of participants as the diseased group and the healthy group.The mini international neuropsychiatric interview and the hamilton depression scale-24 items(HAMD-24)were used to screen the subjects.Structural and resting state functional magnetic resonance scans were performed on eligible subjects.After three months of drug treatment in the diseased group,the above scans were performed again in the diseased group and healthy group.Analyze the difference in brain structure before and after treatment in patients with depression.Then the lateral nucleus of the hypothalamus were taken as the ROIs to analyze the functional connectivity abnormalities between the hypothalamus and the whole brain in patients with depression,and the relationship between these functional connectivity abnormalities and the severity of depression in patients with depression was also analyzed.Finally,the amplitude of low frequency fluctuation values(ALFF)in the lateral hypothalamic nucleus were extracted to analyze the relationship between ALFF abnormalities in the hypothalamus and the severity of depression in patients with depression before and after treatment.Results:Gray matter volume in multiple brain regions(such as frontal lobe,temporal lobe,and cerebellum)reduced in patients with depression.After three months of treatment,the brain structure did not change significantly.In patients with depression before treatment,the functional connections between the bilateral lateral nucleus of the hypothalamus and the orbitofrontal gyrus,and the supraorbital gyrus wereweakened;the functional connections between the right hypothalamic lateral nucleus and the caudate nucleus and right occipital lobe weakened;The functional connections between the lateral hypothalamic nucleus and the middle temporal gyrus,left amygdala and other brain regions weakened.In addition,the functional connection between the right hypothalamic lateral nucleus and the right supraorbital gyrus,middle temporal gyrus,etc.in patients with depression before treatment was negatively correlated with the extent of depression;the functional connectivity between right lateral hypothalamic nucleus and right lateral temporal lobe,cerebellum,etc.is positively correlated with the degree of depression.The functional connectivity between the left lateral hypothalamic nucleus and cerebellar corpus callosum,and lingual gyrus was positively correlated with the degree of depression.Compared with healthy people after treatment,the functional connectivity of the right lateral hypothalamic nucleus and cerebellum was enhanced in patients with depression,and the functional connections between the left lateral hypothalamus and the cerebellum,left thalamus,and parahippocampal gyrus were enhanced.In patients with depression and before treatment,the functional connectivity between the left lateral hypothalamic nucleus and the left superior gyrus and the left middle temporal gyrus was significantly enhanced.The functional connections between the left lateral hypothalamic lateral nucleus and the cerebellum,mid-temporal gyrus,and frontal gyrus in patients with depression after treatment were positively correlated with the degree of depression.There was no significant difference in ALFF before and after treatment of lateral hypothalamic nucleus,and it was also not related to the degree of depressive symptoms.Conclusion:(1)There was no abnormality in the lateral hypothalamic nucleus structure before and after treatment.(2)There was a significant decrease in functional connectivity between hypothalamus and multiple brain regions in patients with depression before treatment.These brain regions mainly originate from the limbic system-cortico-striatal-thalamic circuit andare accompanied by a decrease in gray matter volume of the circuit.The functional connection between hypothalamus and temporal lobe in patients with depression after treatment is significantly improved.(3)Functional connection between the hypothalamus and middle temporal gyrus was associated with the outcome of depression.