Delaveau Pauline, Arruda Sanchez Tiago, Steffen Ricardo, Deschet Karine, Jabourian Maritza, Perlbarg Vincent, Gasparetto Emerson Leandro, Dubal Stéphanie, Costa E Silva Jorge, Fossati Philippe
Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, APHP, Institut du cerveau et de la moelle (ICM)-Hôpital Pitié Salpêtrière, Boulevard de l'hôpital, Paris, France.
Department of Radiology, Universidade Federal do Rio de Janeiro, Medical School, Rio de Janeiro, Brazil.
Hum Brain Mapp. 2017 Jul;38(7):3491-3501. doi: 10.1002/hbm.23603. Epub 2017 Apr 8.
Clinical remission of depression may be associated with emotional residual symptoms. We studied the association of emotional blunting, rumination with neural networks dynamics in remitted depressed patients and cognitive performance during an N-Back task. Twenty-six outpatients in remission of depression (Hamilton Depressive rating scale score <7) performed an N-Back task during fMRI assessment. All patients had been treated by paroxetine for a minimum of 4 months. Two subgroups of patients [Nonemotionally blunted (NEB) = 14 and emotionally blunted (EB) = 12] were determined. To identify functional network maps across participants, the Network Detection using Independent Component Analysis approach was employed. Within and between Task Positive Network (TPN) and Default Mode Network (DMN) connectivity were assessed and related to variability of performance on the N-Back task and rumination. EB and NEB patients were not different for the level of accurate responses at the N-Back. However over the entire working memory task, the negative correlation between DMN and TPN was significantly lower in the EB than NEB group and was differently related to cognitive performance and rumination. The stronger the negative correlation between DMN and TPN was, the less variable the reaction time during 3-Back task in NEB patients. Moreover the greater the negative correlation between DMN and TPN was, the lower the rumination score in EB patients. Emotional blunting may be associated with compromised monitoring of rumination and cognitive functioning in remitted depressed patients through altered cooperation between DMN and TPN. The study suggests clinical remission in depression is associated with biological heterogeneity. Hum Brain Mapp 38:3491-3501, 2017. © 2017 Wiley Periodicals, Inc.
抑郁症的临床缓解可能与情绪残留症状有关。我们研究了缓解期抑郁症患者的情感迟钝、沉思与神经网络动力学以及N-回溯任务期间认知表现之间的关联。26名抑郁症缓解期门诊患者(汉密尔顿抑郁量表评分<7)在功能磁共振成像评估期间执行N-回溯任务。所有患者均接受帕罗西汀治疗至少4个月。确定了两个患者亚组[非情感迟钝(NEB)=14例和情感迟钝(EB)=12例]。为了识别参与者之间的功能网络图谱,采用了使用独立成分分析方法的网络检测。评估了任务积极网络(TPN)和默认模式网络(DMN)内部及之间的连通性,并将其与N-回溯任务表现和沉思的变异性相关联。EB组和NEB组患者在N-回溯任务中的准确反应水平没有差异。然而,在整个工作记忆任务中,EB组中DMN与TPN之间的负相关性显著低于NEB组,并且与认知表现和沉思的相关性不同。DMN与TPN之间的负相关性越强,NEB组患者在3-回溯任务期间的反应时间变异性越小。此外,DMN与TPN之间的负相关性越大,EB组患者的沉思得分越低。情感迟钝可能与缓解期抑郁症患者通过DMN与TPN之间改变的协作对沉思和认知功能的监测受损有关。该研究表明抑郁症的临床缓解与生物学异质性有关。《人类大脑图谱》38:3491-3501,2017年。©2017威利期刊公司。