Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, United States.
Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, United States.
J Affect Disord. 2013 Nov;151(2):756-762. doi: 10.1016/j.jad.2013.06.016. Epub 2013 Jul 5.
Major depression (MDD) is characterized by anhedonia. Although a growing body of literature has linked anhedonia in MDD to reduced frontostriatal activity during reward gains, relatively few studies have examined neural responsivity to loss, and no studies to date have examined neural responses to loss in euthymic individuals with a history of MDD.
An fMRI monetary incentive delay task was administered to 19 participants with remitted MDD (rMDD) and 19 never depressed controls. Analyses examined group activation differences in brain reward circuitry during monetary loss anticipation and outcomes. Secondary analyses examined the association between self-reported rumination and brain activation in the rMDD group.
Compared to controls, the rMDD group showed less superior frontal gyrus activation during loss anticipation and less inferior and superior frontal gyri activation during loss outcomes (cluster corrected p's<.05). Ruminative Responses Scale scores were negatively correlated with superior frontal gyrus activation (r=-.68, p=.001) during loss outcomes in the rMDD group.
Replication with a larger sample is needed.
Euthymic individuals with a history of MDD showed prefrontal cortex hypoactivation during loss anticipation and outcomes, and the degree of superior frontal gyrus hypoactivation was associated with rumination. Abnormal prefrontal cortex responses to loss may reflect a trait-like vulnerability to MDD, although future research is needed to evaluate the utility of this functional neural endophenotype as a prospective risk marker.
重度抑郁症（MDD）的特征是快感缺失。尽管越来越多的文献将 MDD 中的快感缺失与奖励获得期间额-纹状体活动减少联系起来，但相对较少的研究检查了对损失的神经反应，并且迄今为止没有研究检查了有 MDD 病史的心境正常个体对损失的神经反应。
对 19 名缓解期 MDD（rMDD）患者和 19 名从未抑郁的对照者进行了 fMRI 货币奖励延迟任务。分析检查了在货币损失预期和结果期间大脑奖励回路中的组激活差异。二次分析检查了 rMDD 组中自我报告的反刍与大脑激活之间的关联。
与对照组相比，rMDD 组在损失预期期间的额上回激活减少，在损失结果期间的额下回和额上回激活减少（簇校正 p<.05）。在 rMDD 组中，反刍反应量表得分与损失结果期间额上回激活呈负相关（r=-.68，p=.001）。
需要更大的样本进行复制。
有 MDD 病史的心境正常个体在损失预期和结果期间表现出前额叶皮层激活不足，额上回激活不足的程度与反刍有关。对损失的异常前额叶皮层反应可能反映了对 MDD 的特质易感性，尽管需要进一步研究来评估这种功能性神经内表型作为前瞻性风险标志物的效用。
