Data_Sheet_1_Abnormal Voxel-Based Degree Centrality in Patients With Postpartum Depression: A Resting-State Functional Magnetic Resonance Imaging Study.docx

Postpartum depression (PPD) is a major public health concern with significant consequences for mothers, their children, and their families. However, less is known about its underlying neuropathological mechanisms. The voxel-based degree centrality (DC) analysis approach provides a new perspective for exploring the intrinsic dysconnectivity pattern of whole-brain functional networks of PPD. Twenty-nine patients with PPD and thirty healthy postpartum women were enrolled and received resting-state functional magnetic resonance imaging (fMRI) scans in the fourth week after delivery. DC image, clinical symptom correlation, and seed-based functional connectivity (FC) analyses were performed to reveal the abnormalities of the whole-brain functional network in PPD. Compared with healthy controls (HCs), patients with PPD exhibited significantly increased DC in the right hippocampus (HIP.R) and left inferior frontal orbital gyrus (ORBinf.L). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the above two brain regions is all over 0.7. In the seed-based FC analyses, the PPD showed significantly decreased FC between the HIP.R and right middle frontal gyrus (MFG.R), between the HIP.R and left median cingulate and paracingulate gyri (DCG.L), and between the ORBinf.L and the left fusiform (FFG.L) compared with HCs. The PPD showed significantly increased FC between the ORBinf.L and the right superior frontal gyrus, medial (SFGmed.R) compared with HCs. Mean FC between the HIP.R and DCG.L positively correlated with EDPS scores in the PPD group. This study provided evidence of aberrant DC and FC within brain regions in patients with PPD, which was associated with the default mode network (DMN) and limbic system (LIN). Identification of these above-altered brain areas may help physicians to better understand neural circuitry dysfunction in PPD.

产后抑郁症（Postpartum Depression, PPD）是一项重大公共卫生关切，对母亲、子女及其家庭均会造成严重影响。然而，目前对其潜在神经病理机制的了解仍较为有限。基于体素的度中心度（voxel-based degree centrality, DC）分析方法，为探索产后抑郁症全脑功能网络的内在连接异常模式提供了新视角。本研究招募了29名产后抑郁症患者与30名健康产后女性，于分娩后第四周对所有受试者进行静息态功能磁共振成像（resting-state functional magnetic resonance imaging, fMRI）扫描，随后开展了度中心度图像分析、临床症状相关性分析及基于种子点的功能连接（functional connectivity, FC）分析，以揭示产后抑郁症患者全脑功能网络的异常特征。与健康对照组（healthy controls, HCs）相比，产后抑郁症患者右侧海马体（right hippocampus, HIP.R）与左侧额下回眶部（left inferior frontal orbital gyrus, ORBinf.L）的度中心度显著升高。受试者工作特征（receiver operating characteristic, ROC）曲线分析显示，上述两个脑区的曲线下面积（area under the curve, AUC）均超过0.7。在基于种子点的功能连接分析中，与健康对照组相比，产后抑郁症患者右侧海马体与右侧额中回（right middle frontal gyrus, MFG.R）之间、右侧海马体与左侧扣带回中部及旁扣带回（left median cingulate and paracingulate gyri, DCG.L）之间，以及左侧额下回眶部与左侧梭状回（left fusiform, FFG.L）之间的功能连接均显著降低；而左侧额下回眶部与右侧内侧额上回（right superior frontal gyrus, medial, SFGmed.R）之间的功能连接则显著升高。产后抑郁症组中，右侧海马体与左侧扣带回中部及旁扣带回之间的平均功能连接水平与EDPS评分（EDPS scores）呈正相关。本研究证实了产后抑郁症患者脑区内度中心度与功能连接存在异常，且这些异常与默认模式网络（default mode network, DMN）及边缘系统（limbic system, LIN）相关。对上述异常脑区的识别，有助于临床医生更好地理解产后抑郁症患者的神经环路功能异常。