Mood and Anxiety Disorders Program, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA.
Neurobiol Learn Mem. 2011 Nov;96(4):553-63. doi: 10.1016/j.nlm.2011.06.006. Epub 2011 Jun 16.
Major depressive disorder (MDD) is a disabling medical condition associated with significant morbidity, mortality and public health costs. However, neurocircuitry abnormalities underlying depression remain incompletely understood and consequently current treatment options are unfortunately limited in efficacy. Recent research has begun to focus specifically on cognitive aspects of depression and potential neurobiological correlates. Two fundamental types of cognitive dysfunction observed in MDD are cognitive biases, which include distorted information processing or attentional allocation toward negative stimuli, and cognitive deficits, which include impairments in attention, short-term memory and executive functioning. In this article, we present a selective review of current research findings in these domains and examine neuroimaging research that is beginning to characterize the neurocircuitry underlying these biases and deficits. We propose that deficient cognitive functioning, attention biases and the sustained negative affect characteristic of MDD can be understood as arising in part from dysfunctional prefrontal-subcortical circuitry and related disturbances in the cognitive control of emotion. Finally, we highlight potential new pharmacological and non-pharmacological therapeutic strategies for MDD based on an evolving mechanistic understanding of the disorder.
重度抑郁症（MDD）是一种致残性疾病，与重大发病率、死亡率和公共卫生成本相关。然而，抑郁症的神经回路异常仍不完全了解，因此目前的治疗选择效果不佳。最近的研究开始特别关注抑郁症的认知方面及其潜在的神经生物学相关性。在 MDD 中观察到两种基本类型的认知功能障碍，即认知偏差，包括对负面刺激的信息处理或注意力分配的扭曲，以及认知缺陷，包括注意力、短期记忆和执行功能的损害。在本文中，我们对这些领域的当前研究结果进行了选择性回顾，并检查了开始描述这些偏差和缺陷背后的神经回路的神经影像学研究。我们提出，认知功能障碍、注意力偏差以及 MDD 特征性的持续负面情绪，可以部分理解为由前额叶-皮质下回路功能障碍以及情绪认知控制相关的紊乱引起。最后，我们根据对该疾病的不断发展的机制理解，强调了基于潜在的新的药理学和非药理学治疗策略。
