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Resting-State Functional Connectivity Between Centromedial Amygdala and Insula as Related to Somatic Symptoms in Depressed Patients

A Preliminary Study

Zu, Meidan, MD; Wang, Anzhen, MS; Bai, Tongjian, MD; Xie, Wen, MS; Guan, Jianjun, MS; Tian, Yanghua, MD, PhD; Wang, Kai, MD, PhD

doi: 10.1097/PSY.0000000000000697
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Objective Somatic symptoms are prevalent in patients with depression. The centromedial amygdala (CMA) is a key brain region that mediates autonomic and somatic responses. Abnormal function in the CMA may contribute to the development of somatic symptoms in depressed patients.

Methods We compared the resting-state functional connectivity (RSFC) based on the seed of the left and right CMA between 37 patients with depression and 30 healthy controls. The severity of depressive and somatic symptoms was assessed using the Hamilton Depression Rating Scale (HDRS) and the 15-item somatic symptom severity scale of the Patient Health Questionnaire (PHQ-15). Correlation analysis was performed to investigate the relationship between the RSFC and clinical variables (HDRS and PHQ-15) in depressed patients.

Results Compared with healthy controls, patients with depression exhibited decreased RSFC between the CMA and insula, and superior temporal gyrus. In addition, functional connectivity between the left CMA and left insula was negatively correlated with PHQ-15 (r = −0.348, p = .037) in depressed patients. No significant relation was found between the RSFC and HDRS in depressed patients.

Conclusions Functional connectivity between the CMA and insula is reduced in depressive patients, which is associated with the severity of somatic symptoms. Our findings may provide a potential neural substrate to interpret the co-occurrence of depression with somatic symptoms.

From the Department of Neurology (Zu, Bai, Tian, K. Wang), the First Affiliated Hospital of Anhui Medical University; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders (Zu, Bai, Tian, K. Wang); Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health (Zu, Bai, Tian, K. Wang); Anhui Mental Health Center (A. Wang, Xie, Guan); National Clinical Research Center for Mental Disorders (Tian), China; and Department of Medical Psychology (K. Wang), the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.

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Address correspondence to Yanghua Tian, MD, PhD, Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Jixi Rd 218, 230032, Hefei, Anhui Province, China. E-mail: ayfytyh@126.com; Kai Wang, MD, PhD, Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Jixi Rd 218, 230032, Hefei, Anhui Province, China. E-mail: wangkai1964@126.com

Zu, A. Wang, and Bai equally contributed to this work.

Received for publication April 19, 2018; revision received February 24, 2019.

Online date: April 19, 2019

Copyright © 2019 by American Psychosomatic Society
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