The goal of this study was to observe the differences in brain activation under negative emotional picture stimuli in drug-naïve female patients with a first major depressive episode, comparing patients with and without stressful life experiences prior to the onset of depression. Using a 3.0 T magnetic resonance imaging (MRI) system, 18 patients who experienced stressful life events (SLEs) and 15 patients who did not experience SLEs were scanned under a task-fMRI paradigm designed to distinguish between negative and neutral neural responses to visual stimuli. SPM 8.0 software was used to process the fMRI data; the significantly activated brain regions were recorded and organized in the Montreal Neurological Institute (MNI) standard space. Upon stimulation with negative emotional pictures, depressed patients who had experienced SLEs showed significantly increased activation of the bilateral superior temporal gyrus, left middle temporal gyrus, left middle occipital gyrus, left medial frontal gyrus, right inferior frontal gyrus, bilateral precentral gyrus, bilateral postcentral gyrus, bilateral middle frontal gyrus, right precuneus, left paracentral lobule, bilateral thalamus, bilateral hippocampus, and left cerebellum when compared with depressed patients who did not experience SLEs.The brain regions that showed increased activation in depressed patients who experienced SLEs were primarily located in the neural circuits of the emotion processing system; this result likely indicates that these patients may have an increased negative cognitive bias in the perception, experience, and memory of negative emotional events, as well as their response to those events.

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Many previous studies have reported that regional cerebral blood flow (rCBF) aberrations may be one of the pathological characteristics of depression and rCBF has demonstrated a certain degree of asymmetry. However, studies investigating the cerebral blood perfusion asymmetry changes of drug-naïve patients experiencing their first episode of major depression using pseudo-continuous arterial spin labeling (pCASL) are rare. Ten drug-naïve patients experiencing their first major depression episode and 15 healthy volunteers were enrolled in the current study. A novel pCASL method was applied to whole brain MRI scans of all of the samples. The Statistics Parameter Mapping and Relative Expression Software Tool software packages were used for the pre-processing and statistical analysis of the two sets of images, and the differences in the cerebral blood perfusion at the whole brain level were compared between the two groups. Compared with the healthy control group, the cerebral perfusion of the depression patients showed an asymmetric pattern. Decreased cerebral blood perfusion regions were primarily located in the left hemisphere, specifically in the left temporal lobe, frontal lobe and cingulate cortex [P<0.05 and cluster size ≥30 with false discovery rate (FDR) correction]. Simultaneously, increased perfusion regions were predominantly located in the right hemisphere, specifically in the right cerebellum, thalamus, frontal lobe and anterior cingulate cortex (P<0.05 and cluster size ≥30, with FDR correction). Thus, pCASL may characterize the alterations in cerebral blood perfusion of patients with depression.

Objective To investigate the effects of adjunct ketamine treatment on chronic treatment‐resistant schizophrenia patients with treatment‐resistant depressive symptoms (CTRS‐TRD patients), including alterations in brain function. Methods Intravenous ketamine (0.5 mg/kg body weight) was administered to CTRS‐TRD patients over a 1‐hr period on days 1, 4, 7, 10, 13, 16, 19, 22, and 25 of our initial pilot study. This treatment method was subsequently repeated 58 days after the start of the pilot study for a secondary follow‐up study. Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), and regional homogeneity (ReHo) results were used to assess treatment effects and alterations in brain function throughout the entire duration of our studies. Results Between day 7 and day 14 of the first treatment, CDSS scores were reduced by 63.8% and PANSS scores were reduced by 30.04%. In addition, ReHo values increased in the frontal, temporal, and parietal lobes. However, by day 21, depressive symptoms relapsed. During the second treatment period, CDSS and PANSS scores exhibited no significant differences compared to baseline between day 58 and day 86. On day 65, ReHo values were higher in the temporal, frontal, and parietal lobes. However, on day 79, the increase in ReHo values completely disappeared. Conclusions Depressive symptoms in CTRS‐TRD patients were alleviated with adjunct ketamine treatment for only 1 week during the first treatment period. Moreover, after 1 month, the antidepressant effects of ketamine on CTRS‐TRD patients completely disappeared. Correspondingly, ReHo alterations induced by ketamine in the CTRS‐TRD patients were not maintained for more than 3 weeks. These pilot findings indicate that adjunct ketamine treatment is not satisfactory for CTRS‐TRD patients.