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

Psychosom Med. 2019 Jun;81(5):434-440. doi: 10.1097/PSY.0000000000000697.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Central Amygdaloid Nucleus / diagnostic imaging
  • Central Amygdaloid Nucleus / physiopathology*
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology*
  • Connectome*
  • Depressive Disorder / diagnostic imaging
  • Depressive Disorder / physiopathology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Medically Unexplained Symptoms*
  • Middle Aged
  • Severity of Illness Index