中文摘要：

目的通过静息态功能连接探讨认知行为治疗（cognitivebehaviortherapy，CBT）早期对首次发病轻中度抑郁症患者膝下前扣带回（subgenualanteriorcingulatedcodex，sgACC）功能连接的影响，初步探讨CBT对抑郁症患者的神经作用机制。方法对18例首次发病未服药轻中度抑郁症患者（抑郁症组）及相匹配的20名健康对照者（对照组）进行静息态功能磁共振扫描。抑郁症组接受6周CBT后进行第2次扫描。采用DPARSF和REST软件以sgACC为种子点进行基于感兴趣区的全脑功能连接分析并比较差异。结果治疗前，抑郁症组sgACC与左侧额上回（t=-5．50）、左侧额中回（t=-3．78）、左侧角回（t=-3．38）功能连接低于对照组（均P〈0．05）。治疗后，抑郁症组sgACC与右侧额下回（蒙特利尔神经科学研究所坐标：x=42，y=33，z=6；t=3．61）、右侧小脑（蒙特利尔神经科学研究所坐标：x=36，y=-42，z=-48；t=4．08）功能连接较对照组增高（均P〈O．05），与右侧额上回（t=-4．02）、左侧额上回（t=-3．67）、左侧内侧额上回（t=-4．38）、右侧楔前叶（t=-4．59）、左侧角回（t=-4．71）功能连接低于对照组（均P〈0．05）。治疗后，抑郁症组sgACC与左侧额下回（声6．22）、右侧额下回（t：4．66）、左侧颞中回（t=4．76）、右侧颞中回（t=4．43）、左侧颞下回（t=5．33）、右侧缘上回（t=5．51）、左侧中央前回（t=4．68）和右侧小脑（t=3．88）功能连接较治疗前增加（均P〈0．05）。结论CBT早期可能通过直接调节sgACC与额下回、默认网络内节点的功能连接而改善抑郁症患者反应抑制功能、降低自我参照性加工和反刍。

英文摘要：

Objective To explore the neurobiological mechanism of cognitive behavior therapy （CBT） by detecting alterations of resting state functional connectivitiy of subgenual anterior cingulate cortex （sgACC） of CBT for first episode patients with mild to moderate depression. Methods Resting state fMRI data were collected from 18 first-episode treatment nafve patients who suffered from major depressive disorder from mild to moderate degree and 20 matched healthy control subjects. Afterward, depressed patients were scanned again after 6 weeks CBT. Functional connectivity maps from the sgACC were computed for each subject by DPARSF and REST software. The difference of functional connectivity of sgACC was explored. Results Before treatment, compared with health controls, depressed patients have significantly decreased （all P〈0.05） sgACC connectivity to the left superior frontal gyrus（t=-5.50）,left middle frontal gyms（t=-3.78） and left angular gyms（t=-3.38）. After treatment, compared with health controls, depressed patients have significantly increased（both P〈0.05） sgACC connectivity to right inferior frontal gyms（Montreal Neurological Institute coordinate： x=42, y=33, z=6; t=3.61） and right cerebellum（MontrealNeurological Institute coordinate： x=36, y=-42,z=-48; t=4.08）, and decreased sgACC connectivity to right superior frontal gyrus（t=-4.02）, left superior frontal gyrus（t=-3.67）, left medial frontal gyrus（t=-4.38）, right preeuneus（t=-4.59） and left angular gurus（t=-4.71, all P〈0.05）. From pre- to post-treatment, patients exhibited increased sgACC connectivity with left inferior frontal gyrus（t=4.11）, right inferior frontal gyrus （ t= 4.66）,left middle temporal gyrus（t=4.76）, right middle temporal gyrus（ t=4.43）,left inferior temporal gyrus（t= 5.33）, right supramarginal gyrus（t=5.51）, left precentral cortex（t=4.68） and right cerebellum（t=3.88, all P〈 0.05）. Conclusion The early stage of CBT may modulate functional connectivi