Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osaka-sayama, Osaka 589-8511, Japan.
Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osaka-sayama, Osaka 589-8511, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jun 8;108:110085. doi: 10.1016/j.pnpbp.2020.110085. Epub 2020 Sep 2.
Patients with remitted major depressive disorder (rMDD) generally rely on maladaptive coping strategies for stressful situations. These maladaptive copings are associated with an elevated relapse risk of rMDD; however, their neural basis remains poorly understood.
We enrolled (1) 45 patients with rMDD (17-item Hamilton Depression Rating Scale [HRSD] total score ≤ 3) and (2) 56 healthy controls (HCs). Coping styles were measured using the Coping Inventory for Stressful Situations (CISS) according to three coping dimensions: avoidance-, emotion-, and task-oriented copings. The cognitive strategic processes of the prefrontal cortex were measured using a verbal fluency task (VFT). Furthermore, regional frontotemporal hemodynamic responses were monitored by near-infrared spectroscopy (NIRS).
Patients with rMDD had significantly lower task-oriented coping scores and significantly higher avoidance- and emotion-oriented coping scores than HCs. Predominantly in the left frontotemporal region, patients with rMDD had lower frontotemporal hemodynamic responses during a VFT than HCs. Hemodynamic responses in the right inferior frontal gyrus of patients with rMDD were significantly and negatively associated with avoidance-oriented coping scores, but not of HCs. Conversely, those responses of HCs were significantly and positively associated with task-oriented coping scores, but not of patients with rMDD.
Alteration in the right inferior frontal cortex plays an important role in dysfunction to stress response in patients with rMDD. Differential functioning patterns of the right inferior frontal cortex associated with coping strategies may link to MDD recurrence vulnerability.
缓解期的重度抑郁症（rMDD）患者通常依赖于适应不良的应对策略来应对压力。这些应对方式与 rMDD 的复发风险增加有关；然而，它们的神经基础仍不清楚。
我们纳入了（1）45 例 rMDD 患者（17 项汉密尔顿抑郁量表[HRSD]总分≤3）和（2）56 例健康对照者（HCs）。使用应激应对量表（CISS）根据三个应对维度：回避型、情绪型和任务型来测量应对方式。使用言语流畅性任务（VFT）测量前额叶的认知策略过程。此外，通过近红外光谱（NIRS）监测额颞区的局部血流动力学反应。
rMDD 患者的任务型应对得分明显低于 HCs，回避型和情绪型应对得分明显高于 HCs。rMDD 患者在 VFT 中左侧额颞区的额颞区血流动力学反应明显低于 HCs。rMDD 患者右侧额下回的血流动力学反应与回避型应对得分显著负相关，但 HCs 无此相关性。相反，HCs 的这些反应与任务型应对得分显著正相关，但 rMDD 患者无此相关性。
右侧额下回的改变在 rMDD 患者的应激反应功能障碍中起着重要作用。与应对策略相关的右侧额下回的功能差异模式可能与 MDD 的复发易感性有关。
