情绪调节障碍与重度抑郁症（MD）精神病理学中的认知控制功能障碍：来自背外侧前额叶皮层（DLPFC）经颅脑刺激的证据。
Cognitive control dysfunction in emotion dysregulation and psychopathology of major depression (MD): Evidence from transcranial brain stimulation of the dorsolateral prefrontal cortex (DLPFC).
作者信息
Salehinejad Mohammad Ali, Ghanavai Elham, Rostami Reza, Nejati Vahid
机构信息
Department of Psychology, University of Tehran, Tehran, Iran; Department of Psychology, University of Kansas, Lawrence, KS, USA.
Department of Psychology, Islamic Azad University, Science & Research Branch, Tehran, Iran.
出版信息
J Affect Disord. 2017 Mar 1;210:241-248. doi: 10.1016/j.jad.2016.12.036. Epub 2016 Dec 31.
BACKGROUND
Previous studies showed that MD is associated with a variety of cognitive deficits and executive dysfunctions which can persist even in remitted states. However, the role of cognitive impairments in MD psychopathology and treatment is not fully understood. This article aims to discuss how executive functions central components (e.g., Working memory and attention) mediate MD psychopathology considering the role of dorsolateral prefrontal cortex (dLPFC) and present findings of a brain stimulation experiment to support this notion.
METHODS
The effect of transcranial direct current stimulation (tDCS) of the dLPFC on enhancing cognitive control functions was investigated. Twenty-four patients with MD (Experimental group=12, Control group=12) received 10 sessions of tDCS (2mA for 30min) over 10 consecutive days. The experimental group received active stimulation and the control group received sham stimulation. Participant's performance on cognitive functions (PAL, SRM, RVP and CRT from CANTAB) and their depression scores were assessed before and after tDCS.
RESULTS
Results showed that brain stimulation of the dLPFC improved executive dysfunction in patients and a significant improvement on depression scores was also observed suggesting that cognitive control dysfunction may be a mediator in emotional dysregulation and psychopathology of MD.
LIMITATIONS
No follow-up investigation was done in this study which does not allow to infer long-term effect of tDCS. Low-focality of tDCS might have stimulated adjacent areas too.
CONCLUSION
Cognitive components, namely cognitive control dysfunction, play role in MD psychopathology as they are involved in emotion dysregulation in MD. The amount of contribution of cognitive components in MD psychopathology is however, an open question. tDCS can be used as an intervention to improve cognitive dysfunction in MD.
背景
先前的研究表明，双相情感障碍（MD）与多种认知缺陷和执行功能障碍有关，这些障碍即使在缓解状态下也可能持续存在。然而，认知障碍在双相情感障碍的精神病理学和治疗中的作用尚未完全明确。本文旨在探讨执行功能的核心组成部分（如工作记忆和注意力）如何通过背外侧前额叶皮质（dLPFC）的作用介导双相情感障碍的精神病理学，并展示一项脑刺激实验的结果以支持这一观点。
方法
研究了经颅直流电刺激（tDCS）dLPFC对增强认知控制功能的效果。24名双相情感障碍患者（实验组 = 12名，对照组 = 12名）连续10天接受10次tDCS（2毫安，持续30分钟）。实验组接受主动刺激，对照组接受假刺激。在tDCS前后评估参与者的认知功能（来自剑桥神经心理测试自动化成套系统的PAL、SRM、RVP和CRT）表现及其抑郁评分。
结果
结果表明，对dLPFC进行脑刺激改善了患者的执行功能障碍，并且抑郁评分也有显著改善，这表明认知控制功能障碍可能是双相情感障碍情绪失调和精神病理学的一个中介因素。
局限性
本研究未进行随访调查，因此无法推断tDCS的长期效果。tDCS的低聚焦性可能也刺激了相邻区域。
结论
认知成分，即认知控制功能障碍，在双相情感障碍的精神病理学中起作用，因为它们参与了双相情感障碍的情绪失调。然而，认知成分在双相情感障碍精神病理学中的贡献程度仍是一个悬而未决的问题。tDCS可作为一种干预措施来改善双相情感障碍中的认知功能障碍。
Zotero 插件