Victor Teresa A, Furey Maura L, Fromm Stephen J, Ohman Arne, Drevets Wayne C
National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA.
Arch Gen Psychiatry. 2010 Nov;67(11):1128-38. doi: 10.1001/archgenpsychiatry.2010.144.
Major depressive disorder (MDD) is associated with behavioral and neurophysiological evidence of mood-congruent processing biases toward explicitly presented, emotionally valenced stimuli. However, few studies have investigated such biases toward implicitly presented stimuli.
To investigate differential amygdala responses to sad, happy, and neutral faces presented below the level of explicit conscious awareness using a backward masking task in unmedicated participants with MDD and healthy controls (HCs).
Initial cross-sectional design followed by a longitudinal treatment trial using functional magnetic resonance imaging.
Psychiatric outpatient clinic at the National Institute of Mental Health.
We studied 22 unmedicated, currently depressed people with MDD (dMDD), 16 unmedicated individuals with MDD in full remission (rMDD), and 25 HCs.
Ten dMDD participants underwent 8 weeks of antidepressant treatment with the selective serotonin reuptake inhibitor sertraline hydrochloride.
Amygdala region-of-interest and whole-brain analyses evaluated the hemodynamic response during exposure to masked sad vs masked happy faces, to masked sad vs neutral faces, and to masked happy vs neutral faces.
The dMDD participants showed greater amygdala responses than HCs to masked sad faces, whereas HCs showed greater amygdala responses to masked happy faces. The bias toward sad faces also was evident in rMDD participants relative to HCs and did not differ between dMDD and rMDD participants. This processing bias reversed toward the normative pattern in dMDD participants after sertraline treatment.
Emotional-processing biases occur in amygdala responses to sad faces presented below the level of conscious awareness in dMDD or rMDD individuals and to happy faces in HCs. By influencing the salience of social stimuli, mood-congruent processing biases in the amygdala may contribute to dysfunction in conscious perceptions and social interactions in MDD. Our data suggest, however, that the negative bias resolves and a positive bias develops in patients with MDD during selective serotonin reuptake inhibitor treatment.
重度抑郁症（MDD）与对明确呈现的、具有情绪效价的刺激表现出情绪一致性加工偏差的行为和神经生理学证据相关。然而，很少有研究调查对隐性呈现刺激的此类偏差。
使用反向掩蔽任务，在未接受药物治疗的MDD患者和健康对照（HCs）中，研究杏仁核对低于明确意识水平呈现的悲伤、快乐和中性面孔的不同反应。
最初的横断面设计，随后是使用功能磁共振成像的纵向治疗试验。
国立精神卫生研究所的精神科门诊。
我们研究了22名未接受药物治疗、目前患有MDD的抑郁症患者（dMDD）、16名未接受药物治疗且处于完全缓解期的MDD患者（rMDD）和25名HCs。
10名dMDD参与者接受了为期8周的选择性5-羟色胺再摄取抑制剂盐酸舍曲林的抗抑郁治疗。
杏仁核感兴趣区和全脑分析评估了在暴露于掩蔽悲伤面孔与掩蔽快乐面孔、掩蔽悲伤面孔与中性面孔以及掩蔽快乐面孔与中性面孔期间的血流动力学反应。
dMDD参与者对掩蔽悲伤面孔的杏仁核反应比HCs更大，而HCs对掩蔽快乐面孔的杏仁核反应更大。相对于HCs，rMDD参与者对悲伤面孔的偏差也很明显，并且在dMDD和rMDD参与者之间没有差异。在舍曲林治疗后，dMDD参与者的这种加工偏差向正常模式逆转。
情绪加工偏差出现在dMDD或rMDD个体对低于意识水平呈现的悲伤面孔以及HCs对快乐面孔的杏仁核反应中。通过影响社会刺激的显著性，杏仁核中情绪一致的加工偏差可能导致MDD患者在意识感知和社会互动方面出现功能障碍。然而，我们的数据表明，在选择性5-羟色胺再摄取抑制剂治疗期间，MDD患者的负性偏差得到解决，正性偏差出现。
