Platt Belinda, Campbell Catherine A, James Anthony C, Murphy Susannah E, Cooper Myra J, Lau Jennifer Y F
Department of Experimental Psychology, University of Oxford, South Parks Road, OX1 3UD, UK; Department of Child and Adolescent Psychiatry, Ludwig-Maximilians University of Munich, Waltherstraße 23, 80337, Munich, Germany.
Oxford Institute of Clinical Psychology Training, The Isis Education Centre, Roosevelt Drive, Warnford Hospital, Oxford, OX3 7JX, UK; Institute of Psychiatry, Kings College London, 16 De Crespigny Park, London, SE5 8AF, UK.
J Psychiatr Res. 2015 Feb;61:73-80. doi: 10.1016/j.jpsychires.2014.11.016. Epub 2014 Dec 6.
Depression is the most common psychiatric disorder in adolescence, and is characterised by an inability to down-regulate negative emotional responses to stress. Adult studies suggest this may be associated with reduced functional connectivity between prefrontal and subcortical regions, yet the neurological mechanisms in adolescence remain unclear.
We developed a novel, age-appropriate, reappraisal paradigm to investigate functional connectivity during reappraisal of a real-life source of stress in 15 depressed and 15 non-depressed adolescents. During fMRI, participants i) attended to, and ii) implemented reappraisal techniques (learnt prior to fMRI) in response to, rejection.
Reappraisal reduced negative mood and belief in negative thoughts in both groups alike, however during reappraisal (versus attend) trials, depressed adolescents showed greater connectivity between the right frontal pole and numerous subcortical and cortical regions than non-depressed adolescents.
These findings tentatively suggest that, when instructed, depressed adolescents do have the ability to engage neural networks involved in emotion regulation, possibly because adolescence reflects a period of heightened plasticity. These data support the value of cognitive reappraisal as a treatment tool, identify neural markers that could be used to optimise current therapies, and lay the foundations for developing novel neuroscientific techniques for the treatment of adolescent depression.
抑郁症是青少年期最常见的精神障碍，其特征是无法下调对压力的负面情绪反应。成人研究表明，这可能与前额叶和皮质下区域之间功能连接性降低有关，但青少年期的神经机制仍不清楚。
我们开发了一种新颖的、适合年龄的重新评估范式，以研究15名抑郁青少年和15名非抑郁青少年在重新评估现实生活中的压力源时的功能连接性。在功能磁共振成像（fMRI）期间，参与者：i）关注并ii）针对拒绝情况采用（在fMRI之前学到的）重新评估技术。
重新评估在两组中均降低了负面情绪和对负面想法的相信程度，然而在重新评估（相对于关注）试验期间，抑郁青少年比非抑郁青少年在右侧额极与众多皮质下和皮质区域之间表现出更强的连接性。
这些发现初步表明，在得到指导时，抑郁青少年确实有能力激活参与情绪调节的神经网络，这可能是因为青少年期反映了一个可塑性增强的时期。这些数据支持认知重新评估作为一种治疗工具的价值，确定了可用于优化当前疗法的神经标志物，并为开发治疗青少年抑郁症的新型神经科学技术奠定了基础。
