Division of Women's Health, Department of Medicine, 75 Francis St., Boston, MA 02120, United States.
Neurosci Lett. 2012 Apr 11;514(1):57-61. doi: 10.1016/j.neulet.2012.02.056. Epub 2012 Feb 25.
The comorbidity of major depressive disorder (MDD) and cardiovascular disease (CVD) is among the 10th leading cause of morbidity and mortality worldwide. Thus, understanding the co-occurrence of these disorders will have major public health significance. MDD is associated with an abnormal stress response, manifested in brain circuitry deficits, gonadal dysfunction, and autonomic nervous system (ANS) dysregulation. Contribution of the relationships between these systems to the pathophysiology of MDD is not well understood. The objective of this preliminary study was to investigate, in parallel, relationships between HPG-axis functioning, stress response circuitry activation, and parasympathetic reactivity in healthy controls and women with MDD. Using fMRI with pulse oximetry [from which we calculated the high frequency (HF) component of R-R interval variability (HF-RRV), a measure of parasympathetic modulation] and hormone data, we studied eight women with recurrent MDD in remission and six controls during a stress response paradigm. We demonstrated that hypoactivations of hypothalamus, amygdala, hippocampus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and subgenual ACC were associated with lower parasympathetic cardiac modulation in MDD women. Estradiol and progesterone attenuated group differences in the effect of HF-RRV on hypoactivation in the amygdala, hippocampus, ACC, and OFC in MDD women. Findings have implications for understanding the relationship between mood, arousal, heart regulation, and gonadal hormones, and may provide insights into MDD and CVD risk comorbidity.
重度抑郁症（MDD）和心血管疾病（CVD）的共病是全球第 10 大导致发病率和死亡率的原因。因此，了解这些疾病的共病将具有重大的公共卫生意义。MDD 与异常的应激反应有关，表现为大脑回路缺陷、性腺功能障碍和自主神经系统（ANS）失调。这些系统之间的关系对 MDD 病理生理学的贡献尚不清楚。本初步研究的目的是平行研究健康对照组和 MDD 女性的 HPG 轴功能、应激反应回路激活和副交感反应之间的关系。使用 fMRI 结合脉搏血氧测定法[从中我们计算了心率间隔变异的高频（HF）成分（HF-RRV），这是副交感神经调节的一种衡量标准]和激素数据，我们研究了 8 名缓解期复发性 MDD 女性和 6 名对照在应激反应范式期间。我们表明，下丘脑、杏仁核、海马体、前扣带皮层（ACC）、眶额皮层（OFC）和扣带回前下部的低激活与 MDD 女性的副交感心脏调节降低有关。雌二醇和孕酮减弱了 HF-RRV 对 MDD 女性杏仁核、海马体、ACC 和 OFC 低激活的影响的组间差异。研究结果对理解情绪、觉醒、心脏调节和性腺激素之间的关系具有重要意义，并可能为理解 MDD 和 CVD 风险共病提供新的视角。
