Is Activity Changes of the DMN an Indicator of Women's Depression After Breast Cancer Surgery?

Abstract ObjectiveTo investigate the correlation between changes of the brain’s default mode network (DMN) activity and clinical scale scores in patients with depression after breast cancer surgery using resting-state functional magnetic resonance imaging (rs-fMRI) based on the amplitude of low frequency fluctuations (ALFF) and the regional homogeneity (ReHo), to explore whether activity changes of the DMN can be an indicator of women’s depression after breast cancer surgery.MethodsThe institutional Ethics Committee has approved this prospective study. Twenty-three patients were followed after breast cancer surgery, including 12 cases with postoperative depression and 11 cases without depression. All patients underwent rs-fMRI. The ALFF and ReHo values were obtained and converted to Z values for statistical analysis. Pearson and Spearman correlation analysis were performed to correlate the clinical scale scores with ALFF value and ReHo value. A two sample T-test was conducted for ALFF and ReHo values of patients in two groups.ResultsThe ALFF value of the right precuneus was negatively correlated with the Hamilton anxiety scale (HAMA) score (r = -0.43, P < 0.05). The full-scale attention quotient (FSAQ) score was positively correlated with the ALFF value of the left angular gyrus (r = 0.44, P < 0.05) and the right supramarginal gyrus (r = 0.50, P < 0.05). The ReHo value of the right angular gyrus was positively correlated with self-rating depression scale (SDS) score (r = 0.45, P < 0.05) and HAMA score (r = 0.49, P < 0.05). There were significant correlations between the clinical scale scores and the ALFF values and ReHo values of the DMN regions in patients after breast cancer surgery, but no statistical difference in ALFF and ReHo values between patients with and without depression after breast cancer surgery.ConclusionsActivity changes of the DMN in patients were closely related to the attention deficit in depressive disorder and anxiety in patients who had recently undergone breast cancer surgery. Meanwhile, the change of neuronal synchronization in the right angular gyrus may be closely associated with the pathophysiology of anxiety. Rs-fMRI can help to better detect and evaluate depression in patients after breast cancer surgery.