Study On The Abnormal Morphology And Dysfunction Of Cerebral Cortex In Patients With Post-stroke Depression

BackgroundPost stroke depression(PSD)refers to the persistent depression after stroke,which prolongs the recovery time of stroke and increases the mortality.At present,the diagnosis of PSD mainly depends on medical history and clinical symptoms supplemented by psychological scale,lacking objective experimental data,pathological and imaging examination support,which is easy to miss diagnosis and misdiagnosis.With the rapid development of MRI technology,a series of new imaging technologies have been produced,such as resting state functional magnetic resonance imaging,structural magnetic resonance imaging and so on,which are widely used in the exploration of neuropsychiatric diseases for non-invasive,non-radioactive and accurate location of brain functional areas Research.ObjectivesThe purpose of this study is to analyze the relationship between neuroanatomy,neurofunctional imaging and mental state,compare the differences between patients with PSD and control group,confirm that neuroanatomy and neurofunctional changes after stroke are related to depression,preliminarily analyze its neurobiological mechanism,and clarify the post-stroke depression.The biological mechanism of depression provides the basis.In order to open up a new way for the diagnosis and treatment of PSD.MethodsFrom January 2017 to January 2019,twenty patients with PSD(PSD group)and 19 age-,gender ratio-,and education level-matched non-depressed controls(Control group)were enrolled in our hospital.They were selected for 3D T1W1 brain structure image and resting state functional MRI scanning.Independent ICA was used to observe the change of functional connection of the default mode network(DMN)in PSD patients,and SBM was used to detect the changes of brain morphology.At the same time,based on ReHo,functional connectivity(FC)and small world attributes,the whole brain structure,brain functional connectivity and brain network topological property were analyzedIt is helpful to clarify the changes of brain structure and function in PSD patients,so as to preliminarily explore the relationship among neuroanatomy,neurofunction and mental state in PSD patientsResultsReHo:Compared with the control group,the right parahippocampal gyrus and the left cerebellar peduncle(P<0.001,cluster threshold>20mm3,unadjusted)ReHo values was increased.ICA:the left precuneus functional connectivity was increased in the PSD group(P=0.011,adjusting for false discovery rate[FDR])and the right cuneus functional connectivity was decreased(P=0.006,adjusting for FDR).Pearson analysis:1.The functional connection value of the right cuneus was negatively correlated with the HAMD-17 scores(r=-0.574,P=0.008).There was no significant difference between the left anterior cuneiform function connection value and hamd-17 scores(r=-0.080,P=0.737).2.the ReHo values of the right parahippocampal gyrus was positively correlated with 17-item Hamilton Depression Rating Scale scores.(r=0.556,P=0.011).There was no significant difference between ReHo value and hamd-17 scores(r=-0.161,p=0.497).SBM:Compared with the control group,differences were statistically significant in Sulcus depth of right caudal anterior cingulate gyrus、right posterior cingulate、right lingual gyrus and fractal dimension of right superior frontal gyrus in PSD group.There was no significant difference in cortical thickness and gyrification index.Functional connection:The regions of interest(ROI)were bilateral posterior cingulate cortex(PCC),bilateral medial prefrontal cortex(MPFC),and bilateral precuneus,the values of ROI-wise FC were calculated between the bilateral posterior cingulate Gyrus,the bilateral medial prefrontal cortex and the bilateral precuneus ROI-wise FC,the results indicated that there was no significant difference in ROI connection between PSD Group and Control Group(P>0.05).Brain network topological property:Using graph theory to analyze the topological property of brain network in PSD group,the results show that PSD group does not have small World property(P>0.05)ConclusionIt is clear that some brain areas of PSD patients are dysfunctional.The structure disorder of some brain regions in PSD patients was clarified.The changes of neuroanatomy and neurofunction in PSD patients after stroke were related to depression.