From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra).
J Psychiatry Neurosci. 2021 Apr 12;46(2):E303-E312. doi: 10.1503/jpn.200074.
Major depressive disorder (MDD) is characterized by impaired cortical-subcortical functional connectivity. Apathy adds to functional impairment, but its cerebral basis in MDD remains unknown. Our objective was to describe impairments in functional connectivity during emotional processing in MDD (with varying levels of congruency and attention), and to determine their correlation with apathy.
We used the Variable Attention Affective Task during functional MRI, followed by diffusion-weighted MRI, to assess 55 right-handed women (30 with MDD and 25 healthy controls) between September 2012 and February 2015. We estimated functional connectivity using generalized psychophysiologic interaction and anatomic connectivity with tract-based spatial statistics. We measured apathy using the Apathy Evaluation Scale.
We found decreased functional connectivity between the left amygdala and the left anterior cingulate cortex (ACC) during negative stimuli in participants with MDD (t54 = 4.2; p = 0.035, family-wise error [FWE]-corrected). During high-attention stimuli, participants with MDD showed reduced functional connectivity between the right dorsolateral prefrontal cortex (dlPFC) and the right ACC (t54 = 4.06, pFWE = 0.02), but greater functional connectivity between the right dlPFC and the right amygdala (t54 = 3.35, p = 0.048). Apathy was associated with increased functional connectivity between the right dlPFC and the right ACC during high-attention stimuli (t28 = 5.2, p = 0.01) and increased fractional anisotropy in the right posterior cerebellum, the anterior and posterior cingulum and the bilateral internal capsule (all pFWE < 0.05).
Limitations included a moderate sample size, concomitant antidepressant therapy and no directed connectivity.
We found that MDD was associated with impairments in cortical-subcortical functional connectivity during negative stimuli that might alter the recruitment of networks engaged in attention. Apathy-related features suggested networks similar to those observed in degenerative disorders, but possible different mechanisms.
重度抑郁症（MDD）的特征是皮质-皮质下功能连接受损。淡漠增加了功能障碍，但在 MDD 中的大脑基础仍然未知。我们的目的是描述 MDD 患者在情绪处理过程中（具有不同程度的一致性和注意力）的功能连接损伤，并确定其与淡漠的相关性。
我们在 2012 年 9 月至 2015 年 2 月期间使用功能磁共振成像的可变注意情感任务，随后使用弥散加权磁共振成像，评估了 55 名右利手女性（30 名 MDD 患者和 25 名健康对照组）。我们使用广义心理生理相互作用和基于束的空间统计学来估计功能连接。我们使用淡漠评估量表测量淡漠。
我们发现 MDD 患者在负性刺激期间左杏仁核和左前扣带回之间的功能连接减少（t54=4.2;p=0.035，经家族错误校正[FWE]）。在高注意力刺激期间，MDD 患者的右背外侧前额叶皮层（dlPFC）和右 ACC 之间的功能连接减少（t54=4.06，pFWE=0.02），但右 dlPFC 和右杏仁核之间的功能连接增加（t54=3.35，p=0.048）。淡漠与高注意力刺激时右 dlPFC 和右 ACC 之间的功能连接增加有关（t28=5.2，p=0.01），以及右小脑后叶、前扣带回和后扣带回以及双侧内囊的分数各向异性增加（所有 pFWE<0.05）。
局限性包括样本量适中、同时进行抗抑郁治疗和无定向连接。
我们发现 MDD 与负性刺激期间皮质-皮质下功能连接受损有关，这可能会改变参与注意力的网络的招募。与淡漠相关的特征表明与退行性疾病中观察到的网络相似，但可能有不同的机制。
