Morgan Judith K, Shaw Daniel S, Olino Thomas M, Musselman Samuel C, Kurapati Nikhil T, Forbes Erika E
a Department of Psychiatry , University of Pittsburgh.
b Department of Psychology , University of Pittsburgh.
J Clin Child Adolesc Psychol. 2016;45(1):59-68. doi: 10.1080/15374416.2015.1030753. Epub 2015 Apr 27.
Given that depression in men is associated with risk for seriously adverse consequences, evaluating how putative neural mechanisms of depression-such as reward-related frontostriatal connectivity-may be altered in late adolescent boys with a history of depression is an important research aim. Adolescents and adults with depression have been demonstrated to show blunted striatal response and heightened medial prefrontal cortex (mPFC) activation to winning reward. Function in reward circuits appears to be best understood as coordination of regions within frontostriatal circuitry, and alterations to this circuitry could occur in those with a history of depression. The current study evaluated functional connectivity between the nucleus accumbens and mPFC in a sample of 166 ethnically diverse boys with and without a history of depression. Participants completed an fMRI monetary reward paradigm at age 20. Lifetime history of depression and other psychiatric illnesses was measured prospectively and longitudinally, using structured clinical interviews at 7 time points from ages 8 to 20. Boys with a history of depression showed heightened positive connectivity between the nucleus accumbens and the mPFC relative to boys with no psychiatric history when winning rewards relative to losing rewards. This altered frontostriatal connectivity pattern was also associated with greater number of depressive episodes in the boys' lifetime. History of depression in late adolescent boys may be associated with altered coordination between the nucleus accumbens and mPFC when winning reward. This coordination could reflect oversignaling of the mPFC to dampen typical ventral striatum response or enhance weak ventral striatum response.
鉴于男性抑郁症与严重不良后果的风险相关,评估抑郁症的假定神经机制(如与奖励相关的额纹状体连接)在有抑郁症病史的青少年晚期男孩中可能如何改变是一项重要的研究目标。已有研究表明,患有抑郁症的青少年和成年人在赢得奖励时,纹状体反应迟钝,内侧前额叶皮质(mPFC)激活增强。奖励回路中的功能似乎最好理解为额纹状体回路内各区域的协调,而有抑郁症病史的人可能会出现该回路的改变。本研究评估了166名有或无抑郁症病史、种族多样的男孩样本中伏隔核与mPFC之间的功能连接。参与者在20岁时完成了一项功能磁共振成像金钱奖励范式。使用从8岁到20岁的7个时间点的结构化临床访谈,前瞻性和纵向测量抑郁症和其他精神疾病的终生病史。有抑郁症病史的男孩在赢得奖励相对于输掉奖励时,伏隔核与mPFC之间的正连接性相对于无精神病史的男孩增强。这种改变的额纹状体连接模式也与男孩一生中更多的抑郁发作次数相关。青少年晚期男孩的抑郁症病史可能与赢得奖励时伏隔核与mPFC之间的协调改变有关。这种协调可能反映了mPFC过度发出信号以抑制典型的腹侧纹状体反应或增强微弱的腹侧纹状体反应。