Department of Psychology, York University, Toronto, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
Department of Psychiatry, University of Western Ontario, London, ON, Canada.
Neuropsychologia. 2018 Feb;110:148-158. doi: 10.1016/j.neuropsychologia.2017.07.004. Epub 2017 Jul 8.
Alterations in autobiographical memory (AM) performance have been identified in major depressive disorder (MDD) and in trauma-related disorders, however, the neural and behavioural correlates of AM retrieval in patients with MDD and a co-morbid history of trauma remain unexplored. Here, we used behavioural and neuroimaging techniques to investigate AM in this patient group and in matched healthy comparison subjects (HCs). Twenty patients with MDD and trauma exposure and 20 HCs underwent fMRI scanning while recalling positive, negative, and neutral events. Participants were subsequently administered the Autobiographical Interview (Levine et al., 2002), allowing for separation of episodic and non-episodic details of memories. Key clinical variables, including illness severity, dissociative (e.g., depersonalization, derealization) symptoms, and history of parental bonding, were assessed. Compared to controls, patients showed reduced activation in the left parahippocampus and left anterior insula during retrieval of positive memories. Among patients, greater specificity of positive AM recall on the Autobiographical Interview was related to reduced activation of the left anterior insula during retrieval of positive memories. Moreover, increased left parahippocampal activation during negative memory recall was related to heightened levels of paternal care among the patient group. Taken together, these findings point towards potential alterations in key neural processes (e.g., episodic vividness and embodiment) associated with AM retrieval among MDD patients with a history of co-morbid trauma exposure. These alterations appear unrelated to illness severity, but instead are associated with parental bonding.
自传体记忆 (AM) 表现的改变已在重度抑郁症 (MDD) 和与创伤相关的障碍中得到识别，然而，MDD 患者和伴有创伤史的共病患者的 AM 检索的神经和行为相关性仍未得到探索。在这里，我们使用行为和神经影像学技术来研究该患者组和匹配的健康对照组 (HCs) 的 AM。20 名 MDD 合并创伤暴露患者和 20 名 HCs 接受 fMRI 扫描，同时回忆积极、消极和中性事件。随后，参与者接受了自传体访谈 (Levine 等人，2002 年)，允许对记忆的情节和非情节细节进行分离。关键的临床变量，包括疾病严重程度、分离 (例如，人格解体，现实解体) 症状和父母养育史，都进行了评估。与对照组相比，患者在回忆积极记忆时，左侧海马旁回和左侧前岛叶的激活减少。在患者中，自传体访谈中积极 AM 回忆的特异性越高，与积极记忆检索时左侧前岛叶的激活减少有关。此外，在回忆消极记忆时左海马旁回的激活增加与患者组中父爱水平的升高有关。总之，这些发现表明在伴有共病创伤暴露的 MDD 患者中，与 AM 检索相关的关键神经过程 (例如，情节生动性和体现) 可能存在改变。这些改变似乎与疾病严重程度无关，而是与父母养育有关。
