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缓解期重度抑郁症中支持热认知和冷认知的网络连接中断。

Disrupted engagement of networks supporting hot and cold cognition in remitted major depressive disorder.

机构信息

University of Illinois at Chicago, Chicago, IL, USA.

University of Michigan Medical Center, Ann Arbor, MI, USA.

出版信息

J Affect Disord. 2018 Feb;227:183-191. doi: 10.1016/j.jad.2017.10.018. Epub 2017 Oct 9.

Abstract

BACKGROUND

Major depressive disorder (MDD) is characterized by dysfunction in cognitive and emotional systems. However, the neural network correlates of cognitive control (cold cognition) and emotion processing (hot cognition) during the remitted state of MDD (rMDD) remain unclear and not fully probed, which has important implications for identifying intermediate phenotypes of depression risk.

METHODS

43 young adults with rMDD and 33 healthy controls (HCs) underwent fMRI while completing separate tasks of cold cognition (Parametric Go/No-Go test) and hot cognition (Facial Emotion Processing Test). Two 2 group (rMDD, HC) × 2 event (sad/fearful faces, correct rejections) factorial models of activation were calculated in SPM8. Functional activation was evaluated in the salience and emotional network (SEN) and the cognitive control network (CCN), including hypothesized interaction between group and task within the CCN.

RESULTS

Individuals with rMDD demonstrated greater spatial extent of suprathreshold activation within the SEN during sad faces relative to HCs. There were several regions within the CCN in which HCs showed greater activation than rMDD during correct rejections of lures, whereas individuals with rMDD showed greater activation than HCs during sad or fearful faces.

LIMITATIONS

Results were not directly compared with active MDD.

CONCLUSIONS

These results provide evidence of deficient CCN engagement during cognitive control in rMDD (dysfunctional cold cognition). Elevated SEN activation during sad faces could represent heightened salience of negative emotional faces in rMDD; elevated CCN activation during emotional faces in rMDD could represent compensatory regulatory control. These group differences may represent vulnerability factors, scars of prior depressive episodes, or processes maintaining wellness.

摘要

背景

重度抑郁症(MDD)的特征是认知和情感系统功能障碍。然而,MDD 缓解期(rMDD)认知控制(冷认知)和情绪处理(热认知)的神经网络相关性仍不清楚,也未得到充分探讨,这对识别抑郁风险的中间表型具有重要意义。

方法

43 名 rMDD 年轻患者和 33 名健康对照(HC)在完成冷认知(参数 Go/No-Go 测试)和热认知(面部情绪处理测试)任务时接受 fMRI 检查。在 SPM8 中计算了 2 组(rMDD,HC)×2 事件(悲伤/恐惧面孔,正确拒绝)的激活因子模型。在突显和情绪网络(SEN)和认知控制网络(CCN)中评估功能激活,包括 CCN 内组间和任务间的假设交互。

结果

与 HC 相比,rMDD 患者在悲伤面孔时 SEN 内的超阈值激活具有更大的空间范围。在 rMDD 对诱饵进行正确拒绝时,CCN 内有几个区域的激活强度大于 rMDD,而在 rMDD 对悲伤或恐惧面孔时,激活强度大于 HC。

局限性

结果未与活跃的 MDD 直接比较。

结论

这些结果提供了 rMDD 认知控制期间 CCN 参与不足(冷认知功能障碍)的证据。在悲伤面孔时 SEN 激活增加可能代表 rMDD 中负性情绪面孔的突显增加;在 rMDD 中情绪面孔时 CCN 激活增加可能代表代偿性调节控制。这些组间差异可能代表易感性因素、先前抑郁发作的痕迹或维持健康的过程。

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