A longitudinal study of vortioxetine intervention on whole-brain cortical structure in depression patients based on surface-based morphometry
10.3760/cma.j.cn113661-20240516-00149
- VernacularTitle:基于表面形态测量的伏硫西汀干预抑郁症患者全脑皮质结构纵向研究
- Author:
Yingna LI
1
;
Yuhan TONG
;
Wenzhou LIANG
;
Liying ZHAO
;
Zhiren WANG
Author Information
1. 北京回龙观医院医学影像中心，北京100096
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Pharmacological treatment;
Vortioxetine;
Magnetic resonance imaging;
Gyrification index;
Fractal dimension;
Sulcus depth
- From:
Chinese Journal of Psychiatry
2025;58(5):347-355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Using surface-based morphometry (SBM), this study longitudinally tracks dynamic changes in whole-brain cortical morphological parameters in depression patients before and after vortioxetine treatment. Through three-dimensional topological characterization, we investigate the neuroanatomical correlations between cortical structural reorganization and improvements in affective symptoms and cognitive functions.Methods:Prospectively collected clinical data from 22 outpatients with depression (10 males and 12 females, aged 18-50 years, mean age 28.1±9.1) who attended Beijing Huilongguan Hospital clinic from October 2018 to December 2019. An age-matched healthy control group ( n=21; 10 males and 11 females, aged 22-44 years, mean age 30.8±6.6) was recruited concurrently. The Hamilton Rating Scale for Anxiety (HAMA), the 17-item Hamilton Depression Scale (HAMD 17), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to evaluate the severity of depressive symptoms and cognitive function in patients. Structural magnetic resonance imaging (sMRI) was performed to assess brain structural indices in depression patients before and after vortioxetine treatment, as well as in healthy controls. Whole-brain cortical structure measurements were calculated for all subjects using CAT12 software. Paired-sample t-tests were used to compare changes in cortical structure and clinical scale scores in depression patients before and after treatment, and two-sample t-tests were conducted to compare whole-brain cortical structure differences between patients (pre-and post-treatment) and healthy controls. Multiple regression analysis in SPM 12 was applied to examine the correlation between post-treatment cortical structural indices and clinical and cognitive scale scores in patients. Spearman correlation analysis was used to evaluate the correlation between changes in whole-brain cortical structure and cognitive function before and after vortioxetine treatment. Results:After vortioxetine treatment, patients with depression exhibited significant reductions in HAMA and HAMD 17 scores, along with significant increases in immediate memory, delayed memory, and total RBANS scores, with statistically significant differences observed ( t=8.43, 12.28, -4.71, -2.41, -3.86 respectively; all P<0.05), while there were no significant changes in visual span, language function, or attention ( P>0.05). Compared to healthy controls, depression patients showed a significantly reduced gyrification index in the right insula/superior temporal gyrus before treatment (28.74±1.20 vs 27.44±1.17; t=4.47, P<0.001), but no significant differences in whole-brain cortical structure were observed before and after treatment or between post-treatment patients and healthy controls ( P>0.05). Correlation analysis indicated that fractal dimension was negatively correlated with HAMA and HAMD 17 scores after treatment, while gyrification index was positively correlated with HAMD 17 ( rpartial=-0.79, -0.83, 0.72; P<0.05). Visual span was positively correlated with fractal dimension ( rpartial=0.78) and negatively correlated with gyrification index ( rpartial=-0.73, P<0.05). Sulcal depth was negatively correlated with attention and RBANS total scores ( rpartial=-0.77, -0.75; P<0.05). Additionally, changes in gyrification index in the left fusiform gyrus were positively correlated with changes in attention ( r=0.51), changes in gyrification index in the left posterior cingulate gyrus were positively correlated with changes in immediate memory ( r=0.58), and changes in sulcal depth in the left superior frontal gyrus were negatively correlated with changes in language ability ( r=-0.79) (both P<0.05). Conclusion:Vortioxetine treatment can improve anxiety and depressive symptoms in depression patients, as well as enhance certain cognitive functions, while also affecting cortical structure in the specific cortical area. Changes in cortical structure after vortioxetine treatment are closely related to clinical symptom improvement and cognitive function changes.
