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JAMA Psychiatry：新生物标志物揭示儿童重度抑郁症

2014-11-17 MedSci译 MedSci原创

重度抑郁症前岛叶儿童标志物抑郁症
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已有强烈证据显示，多种神经生物标志物与抑郁症相关。一项在线发表于11月12日《美国医学会杂志•精神病学》的研究揭示了一项全新的生物学标志物对儿童重度抑郁症的诊断价值。 该研究由密苏里州圣路易斯华盛顿大学精神心理学研究所的Andy C. Belden博士及其团队所开展。Belden声称这是迄今为止第一个借助检查前岛叶(AI)体积的改变作为潜在生物标志物来评估儿童期重度抑郁症(MDD)病程的研究。

已有强烈证据显示，多种神经生物标志物与抑郁症相关。一项在线发表于11月12日《美国医学会杂志•精神病学》的研究揭示了一项全新的生物学标志物对儿童重度抑郁症的诊断价值。


该研究由密苏里州圣路易斯华盛顿大学精神心理学研究所的Andy C. Belden博士及其团队所开展。Belden声称这是迄今为止第一个借助检查前岛叶(AI)体积的改变作为潜在生物标志物来评估儿童期重度抑郁症(MDD)病程的研究。

研究者通过检查学龄前有重度抑郁症发作史的孩子前岛叶体积是否有改变，学龄前重度抑郁症发作（Preschool-onset MDD,PO MDD）时的某些特异性症状（病理性内疚）和 AI体积是否有关，AI体积是否可以预测日后MDD起病等几个方面来评估AI的诊断价值。

华盛顿大学的研究者设计了一项前瞻性纵向研究,306名儿童(年龄范围：3.00-5.11岁)和他们的监护人在10年里定期完成了6次DSM诊断评估评分以此作为学龄前研究基础，其中的145名学龄期儿童(年龄范围： 6.11-12.11年)完成了磁共振成像扫描。

进行分析研究主要的数据资料是DSM诊断评分、全脑调整后使用磁共振成像测量的AI体积和MRI成像后任何时间发生MDD的学龄儿童诊断数据。

分析结果显示：和无PO MDD既往病史的孩子相比，先前有PO MDD的孩子在学龄期MRI图像上有相对较小的左侧和右侧AI体积 (Wilks Λ = 0.94, F2,124 = 3.37, P = 0.04, Cohen d = 0.23)，然而有趣的是， PO MDD对AI的影响可以用学龄前病理性内疚来更好地解释——有病理性内疚的孩子有着更为显著左右前岛叶体积改变 (Λ = 0.91, F2,120 = 6.17, P = 0.003, d = 0.30)。对孩子MDD发作情况、学龄前病理性内疚、磁共振成像时性别年龄进行共变量分析后发现，学龄儿童的右侧前岛野体积缩小是对患有重度抑郁障碍的孩子的一个有着显著性意义的诊断指标 (odds ratio, 0.96; 95% CI, 0.01-0.75; P = 0.03)。

这些结果提供的证据表明,AI结构和体积的异常与童年早期的抑郁障碍经历具有神经生物学相关性。这个发现与目前在成人MDD患者中发现有脑岛功能和结构改变的发现是相一致的，这告诉我们磁共振成像中AI体积改变或可能是抑郁症的一个目标生物标志物。

原始出处：

Belden AC, Barch DM, Oakberg TJ, et al. Anterior Insula Volume and Guilt: Neurobehavioral Markers of Recurrence After Early Childhood Major Depressive Disorder.JAMA Psychiatry. Published online November 12, 2014.

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    2015-01-17 diushouji

    #Psychiatry#

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    2015-05-03 hukaixun

    #标志物#

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    2014-11-19 zhu_jun9842

    #生物标志#

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    2014-11-19 zhu_jun9842

    #生物标志#

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