Department of Radiology, Department of Psychology, Hatch Research Center, Columbia University, Neurological Institute, New York, New York, United States of America.
PLoS One. 2011;6(12):e27253. doi: 10.1371/journal.pone.0027253. Epub 2011 Dec 13.
Objective measurement of depression remains elusive. Depression has been associated with insecure attachment, and both have been associated with changes in brain reactivity in response to viewing standard emotional and neutral faces. In this study, we developed a method to calculate predicted scores for the Beck Depression Inventory II (BDI-II) using personalized stimuli: fMRI imaging of subjects viewing pictures of their own mothers.
28 female subjects ages 18-30 (14 healthy controls and 14 unipolar depressed diagnosed by MINI psychiatric interview) were scored on the Beck Depression Inventory II (BDI-II) and the Adult Attachment Interview (AAI) coherence of mind scale of global attachment security. Subjects viewed pictures of Mother (M), Friend (F) and Stranger (S), during functional magnetic resonance imaging (fMRI). Using a principal component regression method (PCR), a predicted Beck Depression Inventory II (BDI-II) score was obtained from activity patterns in the paracingulate gyrus (Brodmann area 32) and compared to clinical diagnosis and the measured BDI-II score. The same procedure was performed for AAI coherence of mind scores.
Activity patterns in BA-32 identified depressed subjects. The categorical agreement between the derived BDI-II score (using the standard clinical cut-score of 14 on the BDI-II) and depression diagnosis by MINI psychiatric interview was 89%, with sensitivity 85.7% and specificity 92.8%. Predicted and measured BDI-II scores had a correlation of 0.55. Prediction of attachment security was not statistically significant.
Brain activity in response to viewing one's mother may be diagnostic of depression. Functional magnetic resonance imaging using personalized paradigms has the potential to provide objective assessments, even when behavioral measures are not informative. Further, fMRI based diagnostic algorithms may enhance our understanding of the neural mechanisms of depression by identifying distinctive neural features of the illness.
目前仍难以对抑郁症进行客观测量。抑郁症与不安全型依恋有关，而两者均与大脑对观看标准情绪和中性面孔的反应能力变化有关。在这项研究中，我们开发了一种使用个性化刺激物（即被试观看自己母亲的图片的 fMRI 成像）来计算贝克抑郁量表第二版（BDI-II）预测分数的方法。
28 名年龄在 18-30 岁之间的女性受试者（14 名健康对照者和 14 名经 MINI 精神病学访谈诊断为单相抑郁的患者）接受贝克抑郁量表第二版（BDI-II）和成人依恋访谈（AAI）的心智连贯整体依恋安全性量表评分。在功能磁共振成像（fMRI）期间，受试者观看母亲（M）、朋友（F）和陌生人（S）的图片。使用主成分回归方法（PCR），从旁中央回（Brodmann 区域 32）的活动模式中获得预测贝克抑郁量表第二版（BDI-II）的分数，并将其与临床诊断和测量的 BDI-II 分数进行比较。对于 AAI 心智连贯的分数，也进行了相同的程序。
BA-32 的活动模式可识别出抑郁的受试者。使用 BDI-II 的标准临床分界值（14）得出的 BDI-II 评分（使用 BDI-II 的标准临床分界值为 14）与 MINI 精神病学访谈得出的抑郁诊断之间的分类一致性为 89%，敏感性为 85.7%，特异性为 92.8%。预测和测量的 BDI-II 分数之间的相关性为 0.55。对依恋安全性的预测没有统计学意义。
观看自己母亲的大脑活动可能是抑郁症的诊断依据。使用个性化范式的功能磁共振成像有可能提供客观评估，即使行为测量没有提供信息也是如此。此外，基于 fMRI 的诊断算法可以通过识别疾病的独特神经特征，增强我们对抑郁症神经机制的理解。
