Winograd-Gurvich C, Georgiou-Karistianis N, Fitzgerald P B, Millist L, White O B
Experimental Neuropsychology Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne 3800, Australia.
J Affect Disord. 2006 Jul;93(1-3):193-203. doi: 10.1016/j.jad.2006.03.018. Epub 2006 May 6.
Major depressive disorder may be a heterogeneous disorder, yet melancholic depression is the most consistently described subtype, regarded as qualitatively different to non-melancholic depression in terms of cognitive and motor impairments. Eye movement studies in depression are infrequent and findings are inconclusive.
This study employed a battery of saccadic eye movement tasks to explore reflexive saccades, as well as higher order cognitive aspects of saccades including inhibitory control and spatial working memory. Nineteen patients with major depressive disorder (9 melancholic; 10 non-melancholic) and 15 healthy controls participated.
Differences were revealed between melancholic and non-melancholic patients. Melancholia was associated with longer latencies, difficulty increasing peak velocities as target amplitudes increased, and hypometric primary saccades during the predictable protocol. In contrast, the non-melancholic depression group performed similarly to controls on most tasks, but saccadic peak velocity was increased for reflexive saccades at larger amplitudes.
Most patients were taking antidepressant medication.
The latency increases, reduced peak velocity and primary saccade hypometria with more severe melancholia may be explained by functional changes in the fronto-striatal-collicular networks, related to dopamine dysfunction. In contrast, the serotonergic system plays a greater role in non-melancholic symptoms and this may underpin the observed increases in saccadic peak velocity. These findings provide neurophysiological support for functional differences between depression subgroups that are consistent with previous motor and cognitive findings.
重度抑郁症可能是一种异质性疾病，然而忧郁症性抑郁症是最常被描述的亚型，在认知和运动障碍方面被认为与非忧郁症性抑郁症在性质上有所不同。关于抑郁症的眼动研究较少，且结果尚无定论。
本研究采用了一系列扫视眼动任务，以探索反射性扫视以及扫视的高阶认知方面，包括抑制控制和空间工作记忆。19名重度抑郁症患者（9名忧郁症性；10名非忧郁症性）和15名健康对照者参与了研究。
忧郁症性和非忧郁症性患者之间存在差异。忧郁症与更长的潜伏期、随着目标幅度增加而难以提高峰值速度以及在可预测方案中初级扫视幅度不足有关。相比之下，非忧郁症性抑郁症组在大多数任务上的表现与对照组相似，但在较大幅度的反射性扫视中，扫视峰值速度增加。
大多数患者正在服用抗抑郁药物。
更严重的忧郁症所导致的潜伏期增加、峰值速度降低和初级扫视幅度不足，可能是由额叶 - 纹状体 - 丘系网络的功能变化所解释的，这与多巴胺功能障碍有关。相比之下，血清素能系统在非忧郁症症状中起更大作用，这可能是观察到的扫视峰值速度增加的基础。这些发现为抑郁症亚组之间的功能差异提供了神经生理学支持，这与先前的运动和认知研究结果一致。
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