The Research On The Brain Perfusion In Depression Patients With Family History Based On Arterial Spin Labeled Magnetic Resonance Imaging

Objective1.To investigate the brain perfusion in first-episode depressive patients and healthy people with family history of depression by using arterial spin labeling(ASL).2.We used ASL-MRI(arterial spin labeling-magnetic resonance imaging)to examine alterations in CBF as a predictor for the onset of depression in healthy young adults with a familial risk for depression Methods1.50 first-episode depressive patients(21 patients with family history of depression and 29 without family history of depression)before and after the treatment and 52 healthy subjects(22 subjects with family history of depression and 30 without family history of depression)underwent ASL-MRI scanning.The preprocessing and statistical analysis of CBF perfusion maps were based on SPM12.The degree of depression before and after treatment were assessed by Hamilton Depression Scale(HAMD)17 item versions.2.In this study,200 healthy first-degree relatives of MDD patients(FH+)and 100 healthy control subjects without first-degree relatives suffering from MDD(FH-)were recruited.Subjects meeting the inclusion criteria underwent an MRI at baseline to obtain CBF calculation.We then followed up with these participants every 3 months in order to assess their subsequent onset of a depressive episode.We have conducted 11 follow-up assessments.A total of 32 FH+ subjects had a diagnosis of a depressive disorder(DD/FH+)and underwent a second MRI shortly after the diagnosis and before treatment.Healthy subjects,including 107 FH+ participants who did not develop depression(HC/FH+)and 89 FH-participants(HC/FH-),underwent a second ASL-MRI scan after the 11 th assessment.For statistical analysis,voxel-based comparison of perfusion maps,General linear model analysis,chi-square test,paired t-test,Pearson correlation analysis,logistic regression and a receiver operating characteristic(ROC)curve were used.Results1.Before treatment,compared with healthy subjects,first-episode depressive patients without family history of depression displayed significantly reduced CBF in the left middle frontal gyrus,the left superior occipital gyrus,the left thalamus as well as the right caudate nucleus and increased CBF in the left cingulate gyrus,the right lenticular and the right hippocampus.In contrast,first-episode depressive patients with family history of depression had significant reduced CBF in the left middle frontal gyrus,the superior occipital gyrus and the right amygdala.Compared with patients without family history of depression,patients with family history had reduced CBF in the right amygdala and the left insula.Moreover,compared with healthy subjects without family history,healthy subjects with family history showed reduced CBF in the right amygdala.2.After treatment,except for the right amygdala of patients with the family history and the left superior occipital gyrus of patients in the two groups,the patients had significantly recovered CBF in other brain regions.The depression of the two groups were improved after the treatment,but depression of patients in family history group was significant improved than that in family history group.3.At baseline,compared with the HC/FH+ and HC/FH-groups,the DD/FH+ group showed significantly increased CBF in the right amygdala.4.At follow-up,compared with the HC/FH+ and HC/FH-groups,the DD/FH+ group showed significantly reduced CBF in the right amygdala and the the left middle frontal gyrus and increased CBF in the left hippocampus.Furthermore,compared with the HC/FH-group,the HC/FH+ group had decreased CBF in the right amygdala.5.In the longitudinal comparison,the DD/FH+group showed reduced CBF in the right amygdala and left frontal gyrus,and the the HC/FH+ group showed reduced CBF in the right amygdala.6.For the FH+ group,the CBF of the right amygdala at follow-up was significantly negatively correlated with HAMD scores at follow-up(r=-0.191,P=0.024).Furthermore,the increased CBF in the right amygdala at baseline compared with follow-up was significantly correlated with the increase in HAMD scores(%HAMD)(r=0.444,P<0.001).There was a significant correlation between the initial CBF of the right amygdala and HAMD scores at follow-up in the DD/FH+ and HC/FH+ groups(r=0.556,P<0.001 and r=0.323,P<0.001,respectively).7.Logistic regression(?= 0.198,P <0.001,OR = 1.22)and an ROC curve analysis(p<0.001,AUC:0.86)showed that the increased CBF in the right amygdala at baseline predicted the subsequent onset of depression in the FH+ group.Conclusion1.The brain perfusion changed in first-episode depressive patients and healthy subjects with family history of depression,with the main affected brain region being the right amygdala.In addition,family history has an important impact on the treatment of patients with first-episode depression.2.Among healthy young adults with familial risk for depression,those who exhibited increased CBF in the amygdala were susceptible to developing depression.