Washington University, School of Medicine, Department of Psychiatry, St. Louis, MO 63110, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Jul;52(7):737-46. doi: 10.1016/j.jaac.2013.04.009. Epub 2013 May 22.
Disrupted amygdala activity in depressed adolescents and adults while viewing facial expressions of emotion has been reported. However, few data are available to inform the developmental nature of this phenomenon, an issue that studies of the earliest known forms of depression might elucidate. The current study addressed this question by examining functional brain activity and its relationships to emotion regulation in depressed 4- to 6-year-old children and their healthy peers.
A total of 54 medication-naive 4- to 6-year-olds (23 depressed and 31 healthy) participated in a case-control study using functional magnetic resonance imaging (fMRI). Imaging data were used to compare functional brain activity in children with and without depression during emotion face processing.
A right-lateralized pattern of elevated amygdala, thalamus, inferior frontal gyrus, and angular gyrus activity during face processing was found in depressed 4- to 6-year-olds. In addition, relationships between increased amygdala activity during face processing and disruptions in parent-reported emotion regulation and negative affect were found. No between-group differences specific to emotion face type were identified.
To our knowledge, this is the earliest evidence of alterations in functional brain activity in depression using fMRI. Results suggest that, similar to findings in older depressed groups, depression at this age is associated with disrupted amygdala functioning during face processing. The findings also raise the intriguing possibility that disrupted amygdala function is a depression-related biomarker that spans development. Additional studies will be needed to clarify whether the current findings are a precursor to or a consequence of very early childhood depression.
在观看情绪面部表情时,抑郁青少年和成年人的杏仁核活动受到干扰,这一点已有报道。然而,关于这种现象的发展本质,目前数据有限,这是一个可以通过研究最早已知形式的抑郁症来阐明的问题。本研究通过检查抑郁的 4 至 6 岁儿童及其健康同龄人的大脑功能活动及其与情绪调节的关系,来解决这个问题。
共有 54 名未经药物治疗的 4 至 6 岁儿童(23 名抑郁,31 名健康)参与了一项病例对照研究,使用功能磁共振成像(fMRI)。通过 fMRI 比较了有和没有抑郁症的儿童在情绪面孔处理过程中的大脑功能活动。
在抑郁的 4 至 6 岁儿童中,发现了在处理面部表情时右外侧化的杏仁核、丘脑、下额回和角回活动增强的模式。此外,还发现了在处理面部表情时杏仁核活动增加与父母报告的情绪调节和负性情绪中断之间的关系。未发现特定于情绪面孔类型的组间差异。
据我们所知,这是使用 fMRI 研究在抑郁症中发现的最早的大脑功能活动改变的证据。结果表明,与年龄较大的抑郁组的发现相似,在这个年龄,抑郁与在处理面部表情时杏仁核功能障碍有关。这些发现还提出了一个有趣的可能性,即杏仁核功能障碍是一种与抑郁症相关的生物标志物,跨越了发育过程。需要进一步的研究来澄清当前的发现是儿童早期抑郁症的前兆还是后果。