Luking Katherine R, Gilbert Kirsten, Kelly Danielle, Kappenman Emily S, Hajcak Greg, Luby Joan L, Barch Deanna M
Department of Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, Missouri.
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2021 May;6(5):527-535. doi: 10.1016/j.bpsc.2020.11.001. Epub 2020 Nov 11.
Blunted neural reward responsiveness (RR) is observed in youth depression. However, it is unclear whether symptoms of depression experienced early in development relate to adolescent RR beyond current symptoms and, further, whether such relationships with RR differ during two key components of reward processing: anticipation and outcome.
Within a prospective longitudinal study oversampled for early depression, children and caregivers completed semiannual diagnostic assessments beginning in preschool. In later adolescence, mean age = 16.49 years (SD = 0.94), youths' (N = 100) neurophysiological responses to cues signaling likely win and loss and these outcomes were assessed. Longitudinally assessed dimensional depression and externalizing symptoms (often comorbid with depression as well as associated with RR) experienced at different developmental periods (preschool [age 3-5.11 years], school age [6-9.11 years], early adolescence [10-14.11 years], current) were used as simultaneous predictors of event-related potentials indexing anticipatory cue processing (cue-P3) and outcome processing (reward positivity/feedback negativity and feedback-P3).
Blunted motivated attention to cues signaling likely win (cue-P3) was specifically predicted by early-adolescent depression symptoms. Blunted initial response to win (reward positivity) and loss (feedback negativity) outcomes was specifically predicted by preschool depression symptoms. Blunted motivational salience of win and loss outcomes (feedback-P3) was predicted by cumulative depression, not specific to any developmental stage.
Although blunted anticipation and outcome RR is a common finding in depression, specific deficits related to motivated attention to cues and initial outcome processing may map onto the developmental course of these symptoms.
在青少年抑郁症中观察到神经奖赏反应性（RR）减弱。然而，尚不清楚发育早期经历的抑郁症状是否与青少年RR相关，这种相关性是否超出当前症状，此外，在奖赏处理的两个关键组成部分（预期和结果）中，与RR的这种关系是否存在差异。
在一项针对早期抑郁症进行过度抽样的前瞻性纵向研究中，儿童及其照料者从学龄前开始每半年完成一次诊断评估。在青少年后期，平均年龄为16.49岁（标准差=0.94），评估了青少年（N=100）对预示可能赢或输的线索的神经生理反应以及这些结果。纵向评估在不同发育阶段（学龄前[3-5.11岁]、学龄期[6-9.11岁]、青少年早期[10-14.11岁]、当前）经历的维度抑郁和外化症状（通常与抑郁症共病且与RR相关），将其作为事件相关电位的同时预测因素，这些电位指标分别用于预期线索处理（线索P3）和结果处理（奖赏正性/反馈负性和反馈P3）。
青少年早期的抑郁症状特别能预测对预示可能赢的线索的动机性注意力减弱（线索P3）。学龄前抑郁症状特别能预测对赢（奖赏正性）和输（反馈负性）结果的初始反应减弱。赢和输结果的动机显著性减弱（反馈P3）由累积抑郁预测，而非特定于任何发育阶段。
尽管预期和结果RR减弱是抑郁症中的常见发现，但与线索的动机性注意力和初始结果处理相关的特定缺陷可能与这些症状的发展过程相关。
