经皮耳穴迷走神经刺激调节难治性抑郁症情绪网络的静息态fMRI研究

打开文本图片集

[Abstract]Objective：Toexploretheimmediateefectsoftranscutaneousauricularvagusnervestimulation（taVNS）onthe striatum in patientswith treatment-resistantdepresson（TRD）.Methods：Atotalof42patientswithTRD（TRDgroup）and 40age-andgender-matchedhealthycontrols（HC group）wereenrolled.TheHamilton Depression Scale（HAMD）scores wererecorded for each subject.Thetwo groups were then stimulated bytaVNS for3O minutes，usinga frequencyof 4Hz/20Hz （20 tostimulatebilateralauricularpoints，totheextentthatthesubjectscouldtolerate.Theresting-statefMRIdatawerecolected twicebeforeandafterstiulationimmediately.Results：4OTRDpatientswereincluded，afterexcluding2casesduetosive headmotion.Therewasaninteractionefectintheleftcaudatenucleusinbothgroupsbeforeandafterstimulation.Posthoc analysisrevealedthattheregionalhomogeneity（ReHo）valueof theleftcaudatenucleusintheTRDgroupwashigherthan that in the control group before stimulation（ P =0.003）.After stimulation，the ReHo value of the left caudate nucleus in the TRD group was significantly decreased（ P<0.001 ）.There were significant differences in the functional connectivity between the left nucleus accumbens and the right perigenual anterior cingutate（pgACC）in the two groups（ P<0.05 ）.Post hoc analysis showed thatthefunctionalconnectivityvaluebetween theleftnucleusacumbosusand therightpgACCinthe TRDgroup wassignificantly reduced after stimulation （ P<0.001 ）.Conclusions ： TRD has abnormal basal ganglia activity. TaVNS can simultaneouslymodulateNac，caudatenucleusandothernucleirelatedtorewardandemotionalnetworks，immediatelyaffecting brain activity. This may also be the key brain region for improving negative emotions in TRD.

[KeyWords]Treatment-resistantdepresion;Transcutaneousauricularvagusnervestimulation；Caudatenucleus；Nucleus accumbens;Instant brain effect;Magnetic resonance imaging

2022年《世界精神病学协会抑郁症重大报告》指出，近10年抑郁症患病率持续升高，到2030年，抑郁症将成为世界第一大疾病[1]。（剩余9999字）