Department of Psychology, Temple University, USA.
Department of Psychology, Temple University, USA.
Brain Behav Immun. 2021 May;94:369-380. doi: 10.1016/j.bbi.2020.08.030. Epub 2020 Sep 2.
Cognitive functioning is disrupted during a depressive episode and cognitive dysfunction persists when depression is in remission. A subtype of depressed individuals who exhibit elevated inflammatory biomarkers may be at particular risk for cognitive dysfunction. We examined whether an elevated inflammatory biomarker (C-reactive protein: CRP) in acute and/or remitted depression was associated with specific deficits in executive functioning, episodic memory, and verbal fluency. Data were drawn from a population-based sample of Dutch adolescents (N = 1066; 46% male) recruited at the age of 11 and followed over the course of eight years. We tested whether adolescents with either, (i) a history of depression (Wave 1-3) or (ii) current depression (Wave 4), and elevated levels of C-reactive protein measured in blood at Wave 3 performed worse on cognitive assessments at Wave 4. Eight measures of cognitive functioning were hypothesized to load on to one of three dimensions of cognitive functioning (executive functioning, episodic memory, and verbal fluency) within a structural equation model framework. Higher levels of CRP were associated with worse future executive functioning in adolescents with and without current/prior depression. A current depression diagnosis also was associated with worse executive functioning. There was consistent evidence linking low socioeconomic status and health-related covariates (high body mass index/sedentary behavior) with worse performance across multiple measures of cognitive functioning and, importantly, the association of depression/CRP and executive functioning was no longer significant when controlling for these covariates. Future studies may benefit from investigating whether specific depressogenic behaviors (e.g., sedentary behavior/substance use) mediate a relationship between depression and worse executive functioning, potentially via a prospective pathway through elevated inflammation.
认知功能在抑郁发作期间受到干扰，而抑郁缓解后认知功能仍会持续受损。表现出炎症生物标志物升高的抑郁个体亚类可能特别容易出现认知功能障碍。我们研究了在急性和/或缓解期抑郁症中升高的炎症生物标志物（C 反应蛋白：CRP）是否与执行功能、情景记忆和言语流畅性的特定缺陷有关。数据来自荷兰青少年的一项基于人群的样本（N=1066；46%为男性），他们在 11 岁时被招募，并在 8 年内进行了随访。我们测试了在第 3 波时患有以下疾病的青少年是否存在认知功能障碍：（i）有抑郁史（第 1 波至第 3 波）或（ii）当前抑郁（第 4 波），并且第 3 波时血液中的 C 反应蛋白水平升高。在结构方程模型框架内，我们假设 8 种认知功能测量结果可以加载到认知功能的三个维度之一（执行功能、情景记忆和言语流畅性）上。在有或没有当前/先前抑郁的青少年中，CRP 水平较高与未来执行功能下降有关。当前的抑郁诊断也与执行功能下降有关。有充分的证据表明，低社会经济地位和与健康相关的协变量（高身体质量指数/久坐行为）与多项认知功能测量结果较差有关，重要的是，当控制这些协变量时，抑郁/CRP 与执行功能之间的关联不再显著。未来的研究可能受益于研究特定的致郁行为（例如久坐行为/物质使用）是否通过升高的炎症来调节抑郁与执行功能下降之间的关系，可能通过前瞻性途径。
