Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, USA.
Am J Geriatr Psychiatry. 2012 Dec;20(12):1057-69. doi: 10.1097/JGP.0b013e318235b728.
Accumulating evidence implicates a strong association between abnormal frontostriatal-limbic brain circuits, executive dysfunction, and late-life depression (LLD). The stop signal task (SST) was designed by Rubia et al. for use with functional magnetic resonance imaging (fMRI) to identify the neural correlates of motor response inhibition, a well-characterized executive function. In this study, we compared brain activation between a group of unmedicated participants with LLD and an unmedicated healthy cohort during SST performance.
Participants 55-85 years of age were screened, clinically evaluated, and entered into either the LLD (n = 15) or healthy comparison group (n = 13). Both groups underwent neuroimaging while performing the SST under similar conditions. The brain circuitry of successful motor inhibition was evaluated by contrasting the condition of correctly inhibiting responses with the condition of correctly responding to Go signals. Differential areas of brain activation between the LLD and comparison groups were determined with FMRIB Software Library.
Despite comparable SST performance measures, LLD participants demonstrated greater blood oxygen level dependent activation relative to the comparison group in predominantly left-lateralized frontostriatal-limbic circuitry that included the bilateral superior frontal cortices and left-hemispheric orbitofrontal gyri, insular cortex, cingulate cortex, caudate, and putamen. Conversely, the healthy comparison group did not exhibit any areas of greater activation than the LLD group.
Unmedicated participants with LLD activate additional areas within frontostriatal-limbic brain circuitry when performing the SST at a level comparable to a healthy cohort.
越来越多的证据表明,异常的额眶部-边缘脑回路、执行功能障碍与老年期抑郁症(LLD)之间存在强烈关联。Rubia 等人设计了停止信号任务(SST),用于功能磁共振成像(fMRI),以确定运动反应抑制的神经相关性,这是一种特征明确的执行功能。在这项研究中,我们比较了未接受药物治疗的 LLD 患者组和未接受药物治疗的健康对照组在执行 SST 时的大脑激活情况。
筛选出 55-85 岁的参与者,对其进行临床评估,并将其分为 LLD 组(n=15)或健康对照组(n=13)。两组在类似的条件下进行神经影像学检查,同时执行 SST。通过对比正确抑制反应的条件与正确响应 Go 信号的条件,评估成功运动抑制的大脑回路。使用 FMRIB 软件库确定 LLD 组和对照组之间大脑激活的差异区域。
尽管 SST 表现测量结果相似,但与对照组相比,LLD 患者在主要位于左侧额眶部-边缘回路中显示出更高的血氧水平依赖激活,包括双侧额上回和左侧额下回、岛叶、扣带回、尾状核和壳核。相反,健康对照组没有比 LLD 组表现出更多的激活区域。
在执行 SST 时,未接受药物治疗的 LLD 患者比健康对照组激活了额眶部-边缘大脑回路中的额外区域,且表现水平相当。