Kerestes Rebecca, Segreti Anna Maria, Pan Lisa A, Phillips Mary L, Birmaher Boris, Brent David A, Ladouceur Cecile D
Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia.
Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
J Affect Disord. 2016 Mar 1;192:143-52. doi: 10.1016/j.jad.2015.12.013. Epub 2015 Dec 21.
There is accumulating evidence of alterations in neural circuitry underlying the processing of social-affective information in adolescent Major Depressive Disorder (MDD). However the extent to which such alterations are present in youth at risk for mood disorders remains unclear.
Whole-brain blood oxygenation level-dependent task responses and functional connectivity using generalized psychophysiological interaction (gPPI) analyses to mild and intense happy face stimuli was examined in 29 adolescents with MDD (MDD; M age, 16.0, S.D. 1.2 years), 38 healthy adolescents at risk of a mood disorder, by virtue of having a parent diagnosed with either Bipolar Disorder (BD) or MDD (Mood-risk; M age 13.4, S.D. 2.5 years) and 43 healthy control adolescents, having parents with no psychiatric disorder (HC; M age 14.6, S.D. 2.2 years).
Relative to HC adolescents, Mood-risk adolescents showed elevated right dorsolateral prefrontal cortex (DLPFC) activation to 100% intensity happy (vs. neutral) faces and concomitant lowered ventral putamen activity to 50% intensity happy (vs. neutral) faces. gPPI analyses revealed that MDD adolescents showed significantly lower right DLPFC functional connectivity with the ventrolateral PFC (VLPFC) compared to HC to all happy faces.
The current study is limited by the smaller number of healthy offspring at risk for MDD compared to BD.
Because Mood-risk adolescents were healthy at the time of the scan, elevated DLPFC and lowered ventral striatal activity in Mood-risk adolescents may be associated with risk or resiliency. In contrast, altered DLPFC-VLPFC functional connectivity in MDD adolescents may be associated with depressed mood state. Such alterations may affect social-affective development and progression to a mood disorder in Mood-risk adolescents. Future longitudinal follow-up studies are needed to directly answer this research question.
越来越多的证据表明，青少年重度抑郁症（MDD）患者在处理社会情感信息时神经回路存在改变。然而，情绪障碍高危青少年中这种改变的程度尚不清楚。
对29名患有MDD的青少年（MDD组；平均年龄16.0岁，标准差1.2岁）、38名因父母被诊断为双相情感障碍（BD）或MDD而有情绪障碍风险的健康青少年（情绪风险组；平均年龄13.4岁，标准差2.5岁）和43名父母无精神疾病的健康对照青少年（HC组；平均年龄14.6岁，标准差2.2岁），使用广义心理生理交互作用（gPPI）分析，研究他们对轻度和强烈的快乐面孔刺激的全脑血氧水平依赖任务反应和功能连接。
与HC组青少年相比，情绪风险组青少年对100%强度的快乐（相对于中性）面孔显示右侧背外侧前额叶皮质（DLPFC）激活增强，而对50%强度的快乐（相对于中性）面孔，腹侧壳核活动降低。gPPI分析显示，与HC组相比，MDD组青少年对所有快乐面孔的右侧DLPFC与腹外侧前额叶皮质（VLPFC）的功能连接显著降低。
与BD组相比，本研究中MDD风险的健康后代数量较少，存在局限性。
由于情绪风险组青少年在扫描时是健康的，其DLPFC激活增强和腹侧纹状体活动降低可能与风险或恢复力有关。相比之下，MDD组青少年DLPFC-VLPFC功能连接改变可能与抑郁情绪状态有关。这种改变可能影响情绪风险组青少年的社会情感发展以及向情绪障碍的进展。未来需要进行纵向随访研究以直接回答这个研究问题。
