Department of Psychiatry, the First Affiliated Hospital, Zhejjiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China.
Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health.
J Affect Disord. 2020 Dec 1;277:204-211. doi: 10.1016/j.jad.2020.08.024. Epub 2020 Aug 14.
Cognitive impairment has long challenged the patients with major depressive disorder (MDD), hypocretins and inflammation have recently been implicated in cognitive function. However, limited studies have compressively assessed their associations with cognitive impairment in MDD.
A total of 100 MDD patients and 100 healthy controls (HC) were recruited for this study. They were tested with HAMD, HAMA, and MCCB scales. The plasma level of selected inflammatory factors (IL-1β, IL-6, and TNF-α) and hypocretin-1 were determined using enzyme-linked immunosorbent assay (ELISA). Correlation analysis was performed to explore the relationship between the plasma level of the factors and clinical performances.
Patients with MDD showed cognitive impairment in each MCCB subdomain except working memory compared with HC. The levels of IL-6, IL-1β and hypocretin-1 in MDD patients were higher than HC. Besides, IL-1β levels was negatively correlated with overall cognitive function in the combined group. Hypocretin-1 was positively correlated with socially cognitive impairment in MDD patients. A negative correlation between plasma hypocretin-1 levels and HAMA scales was also observed in MDD patients.
The study was cross-sectional, thereby limiting causal inference, and had a relatively small sample size. There are no subcategories for MDD based on characteristics.
IL-1β, IL-6 and Hypocretin-1 were reported as potential factors involved in MDD pathology. Hypocretin-1 could contribute to the biological mechanisms of anxiety relief. Hypocretin-1, therefore, may be important in exploring the pathological mechanisms of social cognitive impairment in MDD patients. Conclusively, this study provides new insights for exploring cognitive impairment in depression.
认知障碍长期以来一直困扰着重度抑郁症（MDD）患者，最近发现下丘脑泌素和炎症与认知功能有关。然而，有限的研究综合评估了它们与 MDD 认知障碍的相关性。
本研究共纳入 100 例 MDD 患者和 100 例健康对照者（HC）。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和认知成套测验（MCCB）进行评估。采用酶联免疫吸附试验（ELISA）测定所选炎症因子（IL-1β、IL-6 和 TNF-α）和下丘脑泌素-1 的血浆水平。进行相关性分析以探讨这些因素的血浆水平与临床表现之间的关系。
与 HC 相比，MDD 患者在 MCCB 的每个子领域均表现出认知障碍，除了工作记忆。MDD 患者的 IL-6、IL-1β 和下丘脑泌素-1 水平高于 HC。此外，在联合组中，IL-1β 水平与整体认知功能呈负相关。在 MDD 患者中，下丘脑泌素-1 与社会认知障碍呈正相关。在 MDD 患者中还观察到血浆下丘脑泌素-1 水平与 HAMA 量表呈负相关。
该研究为横断面研究，因此限制了因果推断，且样本量相对较小。MDD 没有基于特征的亚类。
IL-1β、IL-6 和下丘脑泌素-1 被报道为可能参与 MDD 发病机制的因素。下丘脑泌素-1 可能有助于缓解焦虑的生物学机制。因此，下丘脑泌素-1 可能对探索 MDD 患者社会认知障碍的病理机制很重要。总之，本研究为探索抑郁症认知障碍提供了新的见解。
