Wang Yuchen, Zhang Aixia, Yang Chunxia, Li Gaizhi, Sun Ning, Liu Penghong, Wang Yanfang, Zhang Kerang
Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
Department of Medical Psychology, College of Humanities and Social Science, Shanxi Medical University, Taiyuan, China.
Front Psychiatry. 2021 Jan 28;11:538333. doi: 10.3389/fpsyt.2020.538333. eCollection 2020.
Impaired executive function (EF) is associated with a range of typical clinical characteristics and psychosocial dysfunction in major depressive disorder (MDD). However, because of the lack of objective cognitive tests, inconsistencies in research results, and improvement in patients' subjective experience, few clinicians are concerned with the persistent impairment of EF in euthymia. The study makes a further investigation for EF in remitted and partially remitted MDD patients multiple EF tests and fMRI, so as to explore the executive function of patients in euthymia. We recruited 19 MDD patients and 17 age-, gender-, and education-matched healthy controls (HCs). All participants completed EF tests and fMRI scanning. Bilateral dorsolateral prefrontal cortex (dlPFC) regions were selected as the region of interests (ROIs) to conduct seed-based functional connectivity (FC). We conducted fractional amplitude of low-frequency fluctuations (fALFF) analysis for all ROIs and whole brain. All MDD patients were in remission or partial remission, and they were comparable with HCs on all the EF tests. MDD group showed increased positive FC between left dlPFC and cerebellar Crus I, right dlPFC and supramarginal gyrus after 8-weeks treatment, even taking residual depressive symptoms into account. We did not find group difference of fALFF value. MDD patients persisted with EF impairment despite the remission or partially remission of depressive symptoms. Clinicians should focus on residual cognitive symptoms, which may contribute to maximize the efficacy of routine therapy.
执行功能受损(EF)与重度抑郁症(MDD)的一系列典型临床特征及心理社会功能障碍相关。然而,由于缺乏客观的认知测试、研究结果不一致以及患者主观体验的改善,很少有临床医生关注缓解期MDD患者EF的持续受损情况。本研究通过多项EF测试和功能磁共振成像(fMRI)对缓解期和部分缓解期的MDD患者的EF进行了进一步调查,以探讨患者在缓解期的执行功能。我们招募了19名MDD患者和17名年龄、性别和教育程度相匹配的健康对照者(HCs)。所有参与者均完成了EF测试和fMRI扫描。选择双侧背外侧前额叶皮质(dlPFC)区域作为感兴趣区(ROIs),进行基于种子点的功能连接(FC)分析。我们对所有ROIs和全脑进行了低频振幅分数(fALFF)分析。所有MDD患者均处于缓解期或部分缓解期,且在所有EF测试中与HCs具有可比性。即使考虑到残留的抑郁症状,MDD组在治疗8周后左dlPFC与小脑脚I、右dlPFC与缘上回之间的正性FC增加。我们未发现fALFF值存在组间差异。尽管抑郁症状已缓解或部分缓解,但MDD患者的EF仍持续受损。临床医生应关注残留的认知症状,这可能有助于使常规治疗的疗效最大化。