Hoch Megan M, Doucet Gaelle E, Moser Dominik A, Hee Lee Won, Collins Katherine A, Huryk Kathryn M, DeWilde Kaitlin E, Fleysher Lazar, Iosifescu Dan V, Murrough James W, Charney Dennis S, Frangou Sophia, Iacoviello Brian M
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Chronic Stress (Thousand Oaks). 2019 Sep 18;3:2470547019877880. doi: 10.1177/2470547019877880. eCollection 2019 Jan-Dec.
Digital therapeutics such as cognitive-emotional training have begun to show promise for the treatment of major depressive disorder. Available clinical trial data suggest that monotherapy with cognitive-emotional training using the Emotional Faces Memory Task is beneficial in reducing depressive symptoms in patients with major depressive disorder. The aim of this study was to investigate whether Emotional Faces Memory Task training for major depressive disorder is associated with changes in brain connectivity and whether changes in connectivity parameters are related to symptomatic improvement.
Fourteen major depressive disorder patients received Emotional Faces Memory Task training as monotherapy over a six-week period. Patients were scanned at baseline and posttreatment to identify changes in resting-state functional connectivity and effective connectivity during emotional working memory processing.
Compared to baseline, patients showed posttreatment reduced connectivity within resting-state networks involved in self-referential and salience processing and greater integration across the functional connectome at rest. Moreover, we observed a posttreatment increase in the Emotional Faces Memory Task-induced modulation of connectivity between cortical control and limbic brain regions, which was associated with clinical improvement.
These findings provide initial evidence that cognitive-emotional training may be associated with changes in short-term plasticity of brain networks implicated in major depressive disorder.
Our findings pave the way for the principled design of large clinical and neuroimaging studies.
诸如认知-情感训练等数字疗法已开始显示出治疗重度抑郁症的潜力。现有的临床试验数据表明，使用情绪面孔记忆任务进行认知-情感训练的单一疗法有助于减轻重度抑郁症患者的抑郁症状。本研究的目的是调查针对重度抑郁症的情绪面孔记忆任务训练是否与大脑连通性的变化相关，以及连通性参数的变化是否与症状改善有关。
14名重度抑郁症患者在六周内接受了作为单一疗法的情绪面孔记忆任务训练。在基线期和治疗后对患者进行扫描，以确定在情绪工作记忆处理过程中静息态功能连通性和有效连通性的变化。
与基线相比，患者在治疗后显示出参与自我参照和显著性处理的静息态网络内连通性降低，以及静息时整个功能连接组的整合增强。此外，我们观察到治疗后情绪面孔记忆任务诱导的皮质控制和边缘脑区之间连通性调制增加，这与临床改善相关。
这些发现提供了初步证据，表明认知-情感训练可能与重度抑郁症相关脑网络的短期可塑性变化有关。
我们的发现为大型临床和神经影像学研究的原则性设计铺平了道路。
