Shared and Distinct Fractional Amplitude of Low-Frequency Fluctuation Patterns in Major Depressive Disorders With and Without Gastrointestinal Symptoms

Xiaoya Fu; Huabing Li; Meiqi Yan; Jindong Chen; Feng Liu; Jingping Zhao; Wenbin Guo

doi:10.3389/fpsyt.2021.744898

Shared and Distinct Fractional Amplitude of Low-Frequency Fluctuation Patterns in Major Depressive Disorders With and Without Gastrointestinal Symptoms

Front Psychiatry. 2021 Dec 2:12:744898. doi: 10.3389/fpsyt.2021.744898. eCollection 2021.

Authors

Xiaoya Fu¹, Huabing Li², Meiqi Yan¹, Jindong Chen¹, Feng Liu³, Jingping Zhao¹, Wenbin Guo^{1

4}

Affiliations

¹ National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.
² Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China.
³ Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
⁴ Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, China.

Abstract

Objective: Gastrointestinal (GI) symptoms are fairly common somatic symptoms in depressed patients. The purpose of this study was to explore the influence of concomitant GI symptoms on the fractional amplitude of low-frequency fluctuation (fALFF) patterns in patients with major depressive disorder (MDD) and investigate the connection between aberrant fALFF and clinical characteristics. Methods: This study included 35 MDD patients with GI symptoms (GI-MDD patients), 17 MDD patients without GI symptoms (nGI-MDD patients), and 28 healthy controls (HCs). The fALFF method was used to analyze the resting-state functional magnetic resonance imaging data. Correlation analysis and pattern classification were employed to investigate the relationship of the fALFF patterns with the clinical characteristics of patients. Results: GI-MDD patients exhibited higher scores in the HRSD-17 and suffered more severe insomnia, anxiety/somatization, and weight loss than nGI-MDD patients. GI-MDD patients showed higher fALFF in the right superior frontal gyrus (SFG)/middle frontal gyrus (MFG) and lower fALFF in the left superior medial prefrontal cortex (MPFC) compared with nGI-MDD patients. A combination of the fALFF values of these two clusters could be applied to discriminate GI-MDD patients from nGI-MDD patients, with accuracy, sensitivity, and specificity of 86.54, 94.29, and 70.59%, respectively. Conclusion: GI-MDD patients showed more severe depressive symptoms. Increased fALFF in the right SFG/MFG and decreased fALFF in the left superior MPFC might be distinctive neurobiological features of MDD patients with GI symptoms.

Keywords: fractional amplitude low-frequency fluctuation; functional magnet resonance imaging (fMRI); gastrointestinal symptoms; major depressive disorder; somatic symptoms.