Ionescu Dawn F, Nugent Allison C, Luckenbaugh David A, Niciu Mark J, Richards Erica M, Zarate Carlos A, Furey Maura L
1Department of Psychiatry,Massachusetts General Hospital,Boston,MA,USA.
3Experimental Therapeutics & Pathophysiology Branch,Intramural Research Program,National Institute of Mental Health,National Institutes of Health,Bethesda,MD,USA.
Acta Neuropsychiatr. 2015 Jun;27(3):143-52. doi: 10.1017/neu.2014.46. Epub 2015 Jan 20.
Anxiety often co-occurs with major depressive disorder (MDD). This preliminary study sought to ascertain the extent to which anxious depression drives group neurobiological differences between patients with MDD and healthy volunteers (HVs).
Magnetoencephalography beta-band frequency was used to compare differences in brain response during the N-back working memory task between 30 medication-free patients with treatment-resistant MDD (anxious depression=18; nonanxious depression=12) and 28 HVs.
Compared to HVs, patients with anxious depression had significantly reduced desynchronisation (less activation) in the left precuneus, right cuneus, and left insula extending into the inferior and middle frontal cortex during the 2-back condition compared with the 1-back condition of the N-back working memory task--indicating less activation of these neural networks in patients with anxious depression during the condition with the highest level of task demands. No other significant group differences were found during the working memory conditions.
This preliminary study suggests that a subset of patients--those with anxious depression--may be driving observed group differences between patients with MDD and HVs. Further neurobiological studies and replication experiments are necessary to determine the extent to which this subgroup has preferentially influenced our understanding of the underlying neurobiology of depression.
焦虑常与重度抑郁症(MDD)并发。这项初步研究旨在确定焦虑性抑郁在多大程度上导致了MDD患者与健康志愿者(HV)之间的群体神经生物学差异。
采用脑磁图β波段频率,比较30例未服药的难治性MDD患者(焦虑性抑郁=18例;非焦虑性抑郁=12例)与28例HV在N-back工作记忆任务期间脑反应的差异。
与HV相比,在N-back工作记忆任务的2-back条件下,与1-back条件相比,焦虑性抑郁患者在左楔前叶、右楔叶和延伸至额下和额中皮质的左岛叶的去同步化(激活减少)显著降低——这表明在任务需求最高的条件下,焦虑性抑郁患者的这些神经网络激活较少。在工作记忆条件下未发现其他显著的组间差异。
这项初步研究表明,一部分患者——即焦虑性抑郁患者——可能导致了观察到的MDD患者与HV之间的群体差异。需要进一步的神经生物学研究和重复实验来确定该亚组在多大程度上优先影响了我们对抑郁症潜在神经生物学的理解。