- 권한신청
- P-ISSN1226-9654
- E-ISSN2733-466X
- KCI
우울한 노인과 정상 노인의 휴지기 기능적 두뇌 네트워크 차이: 현저성 네트워크 연결성과 전체 뇌 네트워크 효율성을 중심으로
Differences in Resting-State Functional Network between Depressed and Non-Depressed Elderlies
김호영 (전북대학교)
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초록
휴지기 fMRI 연구에서 현저성 네트워크는 우울 증상과 관련된 정서 조절 및 동기화된 행동과정을 설명할 수 있는 네트워크로 증상의 신경학적인 이해를 돕고, 치료 효과에도 중요한 네트워크로 알려져 있으나, 우울한 노인을 대상으로 한 연구는 부족한 상태이다. 본 연구는 노인우울 집단 18명과, 우울집단과 연령, 성별, 교육 수준이 동등한 비우울 비교집단 18명의 휴지기 상태에서 뇌의 기능적 네트워크를 네트워크 기반 통계(NBS)를 사용하여 비교하였다. 이를 위하여 우울과 관련된 현저성 네트워크 내의 영역들간 연결성(intranetwork connectivity)과 현저성 네트워크, 집행통제 네트워크, 그리고 기본 모드 네트워크 간 연결성(internetwork connectivity)에서 집단 간 차이를 확인하였다. 그 결과, 비우울 비교집단에 비해 우울집단은 현저성 네트워크 내의 미상핵과 편도체간의 연결성이 유의미하게 낮은 것으로 나타났다. 네트워크들 간의 연결성 분석 결과에서는 비우울 비교집단에 비해 우울집단은 집행 통제 네트워크의 좌측 전전두피질과 현저성 네트워크의 좌측 섬엽과의 연결성은 유의하게 더 높았고, 좌측 전전두피질과 기본 모드 네트워크의 양측 두정피질과의 연결성은 유의하게 낮게 나타났다. 또한, 대뇌의 전체 네트워크들을 포함하여 네트워크 효율성의 차이를 확인하기 위해 그래프 이론에 기반하여 분석하였다. 작은 세상 네트워크에서 우울 집단이 유의미하게 낮은 것으로 나타났으며, 이를 이루고 있는 네트워크 통합 지표인 평균 최단경로 길이는 집단 간 차이가 없었으나 네트워크 분리 지표인 군집 계수는 현저성 네트워크, 기본 모드 네트워크 및 측두엽에서 유의미하게 낮은 것으로 나타났다. 본 연구 결과는 우울한 노인들의 증상 기저의 신경심리적 특성을 이해하는데 도움이 될 것이며, 네트워크 연결성과 효율성이 저하된 영역들을 밝힘으로써 경두개 자기자극법과 같은 뇌자극 치료 시 단서가 될 것이다.
- keywords
- late-life depression, resting-state network, network based statistics, graph theory. salience network, 노년기 우울, 휴지기 네트워크, 네트워크 기반 통계(NBS), 그래프 이론, 현저성 네트워크
Abstract
Late-life depression(LLD) is overshadowed by the general physical symptoms of the elderly, making it difficult to diagnose and treatment accurately. In the rs-fMRI study, salience network is a suitable network to describe emotional control and goal-directed behavior processes related to depression symptoms, and is known to be an important network for therapeutic effects, but studies for depressed elderly people are lacking. In this study, we compared the resting-state of 18 LLD group (GDS M=21.78 SD=3.30) and 18 randomized control group(GDS M=8.78 SD=4.42). We used a network based statistic (NBS) for searching network dynamics within the salience network(intra/inter). Thus, connectivity within salience network(caudate-amygdala) was significantly lower in the depressed group, and connectivity between networks(insula-prefrontal cortex-lateral parietal cortex) was found to be contrary to the prior study. In addition, we used a graph theory analysis for identifying inconsistent network topology between groups, LLD group was found to be significantly lower in the small-worldness and clustering coefficient(salience network, default mode network, temporal lobe) although there were no differences between the two groups in characteristic path length. Reduced intra-network connectivity seems to be related to difficulties in behavior and emotion regulation, while reduced inter-network connectivity seems to reflect a reduction in goal-directed behavior rather than a negative reflection on the past. The results of this study suggest that there is intended to help neuropsychological understanding of the symptoms of depressed elderly people, and also help with treatment using TMS(transcranial magnetic stimulation) by examining areas of poor network connectivity and efficiency.
- keywords
- late-life depression, resting-state network, network based statistics, graph theory. salience network, 노년기 우울, 휴지기 네트워크, 네트워크 기반 통계(NBS), 그래프 이론, 현저성 네트워크
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