Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
J Affect Disord. 2013 Oct;151(1):171-7. doi: 10.1016/j.jad.2013.05.073. Epub 2013 Jun 21.
Down-regulation of negative emotions by cognitive strategies relies on prefrontal cortical modulation of limbic brain regions, and impaired frontolimbic functioning during cognitive reappraisal has been observed in affective disorders. However, no study to date has examined cognitive reappraisal in unmedicated euthymic individuals with a history of major depressive disorder relative to symptom-matched controls. Given that a history of depression is a critical risk factor for future depressive episodes, investigating the neural mechanisms of emotion regulation in remitted major depressive disorder (rMDD) may yield novel insights into depression risk.
We assessed 37 individuals (18 rMDD, 19 controls) with functional magnetic resonance imaging (fMRI) during a task requiring cognitive reappraisal of sad images.
Both groups demonstrated decreased self-reported negative affect after cognitive reappraisal and no group differences in the effects of cognitive reappraisal on mood were evident. Functional MRI results indicated greater paracingulate gyrus (rostral anterior cingulate cortex, Brodmann area 32) activation and decreased right midfrontal gyrus (Brodmann area 6) activation during the reappraisal of sad images.
Trial-by-trial ratings of pre-regulation affect were not collected, limiting the interpretation of post-regulation negative affect scores.
Results suggest that activation of rostral anterior cingulate cortex, a region linked to the prediction of antidepressant treatment response, and of the right midfrontal gyrus, a region involved in cognitive control in the context of cognitive reappraisal, may represent endophenotypic markers of future depression risk. Future prospective studies will be needed to validate the predictive utility of these neural markers.
认知策略对负性情绪的下调依赖于前额皮质对边缘脑区的调节，在情感障碍中观察到认知重评时额-边缘功能受损。然而，迄今为止，没有研究在无药物治疗的心境正常且有重性抑郁障碍病史的个体中，相对于症状匹配的对照组，检查认知重评。鉴于抑郁病史是未来抑郁发作的一个关键危险因素，研究缓解期重性抑郁障碍（rMDD）中情绪调节的神经机制可能会为抑郁风险提供新的见解。
我们使用功能磁共振成像（fMRI）在一项需要对悲伤图像进行认知重评的任务中评估了 37 名个体（18 名 rMDD，19 名对照）。
两组在认知重评后自我报告的负性情绪均减少，认知重评对情绪的影响无组间差异。功能磁共振成像结果表明，在重评悲伤图像时，中额上回（前扣带回皮质的额极，Brodmann 区 32）的激活增加，而右侧额中回（Brodmann 区 6）的激活减少。
未采集预调节影响的逐次评定，限制了对重评后负性情绪评分的解释。
结果表明，前扣带皮质的激活（与抗抑郁治疗反应预测相关的区域）和右额中回的激活（认知重评背景下认知控制的一个区域）可能代表未来抑郁风险的表型标记。需要前瞻性研究来验证这些神经标记的预测效用。
