Deuter Christian Eric, Wingenfeld Katja, Otte Christian, Bustami Jasmin, Kaczmarczyk Michael, Kuehl Linn Kristina
Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany.
Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Berlin, Germany.
J Psychiatr Res. 2020 Jun;125:136-143. doi: 10.1016/j.jpsychires.2020.03.017. Epub 2020 Apr 5.
Stress plays a fundamental role in the development and maintenance of major depressive disorder (MDD). Importantly, maladaptive changes in the physiological stress regulation systems have been demonstrated. In the locus coeruleus-noradrenergic (LC-NA) system, up-regulated central alpha2-adrenergic receptors in patients with MDD affect cognitive functions. Although cognitive deficits are core symptoms of MDD, the relationship between the LC-NA system and cognitive processes has rarely been investigated in depressed patients. The aim of our study was to investigate whether noradrenergic stimulation affects cognitive flexibility in MDD. In addition, we aimed to further disentangle the effects of MDD and adverse childhood experiences (ACE), such as physical or sexual abuse on cognitive function. In a double-blind placebo-controlled study, MDD patients with ACE, MDD patients without ACE, healthy participants with ACE and healthy control participants without MDD or ACE were tested with a task switching task (total N = 125). Participants were tested twice after treatment with either 10 mg yohimbine or a placebo. Switch costs (differences between switch and repetition trials) in reaction times and accuracy served as the independent variables. We found higher switch costs in MDD patients as compared with controls, while ACE did not affect task performance. Yohimbine administration had no effect on task switching. The results of this study contribute to a better understanding of the role of the LC-NA system as a neurobiological mechanism of cognitive processes in patients with MDD.
应激在重度抑郁症（MDD）的发生和维持中起着重要作用。重要的是，生理应激调节系统中已证实存在适应不良的变化。在蓝斑-去甲肾上腺素能（LC-NA）系统中，MDD患者中枢α2-肾上腺素能受体上调会影响认知功能。虽然认知缺陷是MDD的核心症状，但在抑郁症患者中，LC-NA系统与认知过程之间的关系很少被研究。我们研究的目的是调查去甲肾上腺素能刺激是否会影响MDD患者的认知灵活性。此外，我们旨在进一步厘清MDD以及童年不良经历（如身体或性虐待）对认知功能的影响。在一项双盲安慰剂对照研究中，使用任务切换任务对有童年不良经历的MDD患者、无童年不良经历的MDD患者、有童年不良经历的健康参与者以及无MDD或童年不良经历的健康对照参与者进行了测试（总N = 125）。参与者在接受10 mg育亨宾或安慰剂治疗后进行了两次测试。反应时间和准确性方面的切换成本（切换试验与重复试验之间的差异）作为自变量。我们发现，与对照组相比，MDD患者的切换成本更高，而童年不良经历并未影响任务表现。给予育亨宾对任务切换没有影响。本研究结果有助于更好地理解LC-NA系统作为MDD患者认知过程神经生物学机制的作用。
