Liu Jin, Liu Bangshan, Wang Mi, Ju Yumeng, Dong Qiangli, Lu Xiaowen, Sun Jinrong, Zhang Liang, Guo Hua, Zhao Futao, Li Weihui, Zhang Li, Li Zexuan, Zhang Yan, Liao Mei, Li Lingjiang
Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.
Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China.
Front Psychiatry. 2021 Feb 16;12:627695. doi: 10.3389/fpsyt.2021.627695. eCollection 2021.
Cognitive deficits have shown progressive feature in major depressive disorder (MDD). However, it remains unknown which component of cognitive function is progressively impaired across episodes of MDD. Here we aim to identify the progressively impaired cognitive components in patients with MDD. A comprehensive neurocognitive test battery was used to assess the cognitive components (executive function, attention, processing speed, memory, working memory, inhibition, shifting, and verbal fluency) in 35 patients with first-episode MDD (FED), 60 patients with recurrent MDD (RD) and 111 matched healthy controls (HCs). After 6 months of treatment with antidepressant, 20 FED and 36 RD patients achieved clinical remission and completed their second-time neurocognitive tests. Statistical analyses were conducted to identify the impaired cognitive components in the FED and RD groups before and after treatment, and to assess the relationship between the cognitive components and the number of episodes and total illness duration in the MDD patient group. At baseline, both the FED and RD groups showed impairments in all of the cognitive components; the FED and RD groups showed no significant difference in all of the components except for shifting. After remission, only shifting in the RD group showed no significant improvement and remained in an impaired status. Furthermore, shifting was the only component negatively correlated with the number of episodes as well as the total illness duration. Shifting may serve as the progressive cognitive deficit across episodes of MDD. Registry name: HPA function and MRI study of trauma-related depression; Registration number: ChiCTR1800014591; URL: http://www.chictr.org.cn/edit.aspx?pid=24669&htm=4.
认知缺陷在重度抑郁症（MDD）中呈现出进行性特征。然而，MDD各发作期认知功能的哪个组成部分会逐渐受损仍不清楚。在此，我们旨在确定MDD患者中逐渐受损的认知组成部分。使用一套全面的神经认知测试组合，对35例首发MDD（FED）患者、60例复发性MDD（RD）患者和111例匹配的健康对照（HCs）的认知组成部分（执行功能、注意力、处理速度、记忆、工作记忆、抑制、转换和语言流畅性）进行评估。在接受抗抑郁药治疗6个月后，20例FED患者和36例RD患者实现临床缓解并完成了第二次神经认知测试。进行统计分析以确定FED组和RD组治疗前后受损的认知组成部分，并评估MDD患者组中认知组成部分与发作次数和总病程之间的关系。在基线时，FED组和RD组在所有认知组成部分均表现出损害；除转换外，FED组和RD组在所有组成部分上均无显著差异。缓解后，仅RD组的转换无显著改善，仍处于受损状态。此外，转换是唯一与发作次数以及总病程呈负相关的组成部分。转换可能是MDD各发作期逐渐出现的认知缺陷。注册名称：创伤相关抑郁症的HPA功能与MRI研究；注册号：ChiCTR1800014591；网址：http://www.chictr.org.cn/edit.aspx?pid=24669&htm=4。
