Influences of abnormal white matter micro-structures and stressful life events in depression relapse / 中华神经医学杂志

ABSTRACT

Objective:To investigate the influences of abnormal white matter micro-structures and stressful life events in relapse status of patients with major depressive disorder (MDD).Methods:A prospective sutdy was performed; 108 patients with MDD were chosen as study subjects in our hospital from May 2017 to June 2018. All subjects underwent MR imaging scanning, and were followed up for 2 years after treatment (once every 3 months). Their relapse status were assessed by 4 th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The degrees of depression and existence and level of stressful life events in MDD patients were assessed by Hamilton Depression Rating Scale (HDRS) and Life Events Scale (LES). The differences of clinical data and white matter micro-structures between relapse and non-relapse patients were compared. Binary Logistic regression analysis was used to determine the independent influencing factors for MDD relapse. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of influencing factors in MDD relapse. The correlations of white matter fractional anisotropy (FA) values with follow-up HDRS scores and follow-up LES scores were analyzed by Pearson correlation analysis. Results:In the end, 92 patients were enrolled in the study, including 38 relapse patients and 54 non-relapse patients. As compared with those in the non-relapse group, patients in the relapse group showed younger onset age, higher incidence of disease onset, longer course of disease, higher LES scores (baseline), and higher HDRS and LES scores (follow-up), with significant differences ( P<0.05). FA values of the right superior longitudinal fasciculus and corpus callosum in the relapse patients were significantly decreased as compared with those in the non-relapse patients ( P<0.05). Binary Logistic regression analysis showed that FA values of the right superior longitudinal fasciculus ( OR=0.350, 95%CI: 0.168-0.728, P=0.005) and FA values of the corpus callosum ( OR=0.646, 95%CI: 0.438-0.951, P=0.027), and LES scores (follow-up) ( OR=1.483, 95%CI: 1.226-1.793, P=0.000) were independent influencing factors for relapse in MDD patients. ROC curve showed that the area under curve (AUC) of FA values of the right superior longitudinal fasciculus, FA values of the corpus callosum, and LES scores (follow-up) to predict MDD relapse were 0.655, 0.661 and 0.841, respectively. Correlation analysis showed that FA values of the superior right longitudinal fasciculus and FA values of the corpus callosum were significantly negatively correlated with HDRS scores (follow-up) ( r=-0.470, P=0.000; r=-0.398, P=0.004), and LES scores (follow-up) were significantly positively correlated with HDRS scores (follow-up) ( r=0.429, P=0.000). Conclusion:Abnormal white matter micro-structures and stressful life events are closely related to the relapse of MDD.