Keller Micha, Zweerings Jana, Klasen Martin, Zvyagintsev Mikhail, Iglesias Jorge, Mendoza Quiñones Raul, Mathiak Klaus
Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.
Interdisciplinary Training Centre for Medical Education and Patient Safety-AIXTRA, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Front Psychiatry. 2021 Aug 23;12:715898. doi: 10.3389/fpsyt.2021.715898. eCollection 2021.
Affective disorders are associated with maladaptive emotion regulation strategies. In particular, the left more than the right ventrolateral prefrontal cortex (vlPFC) may insufficiently regulate emotion processing, e.g., in the amygdala. A double-blind cross-over study investigated NF-supported cognitive reappraisal training in major depression ( = 42) and age- and gender-matched controls ( = 39). In a randomized order, participants trained to upregulate either the left or the right vlPFC during cognitive reappraisal of negative images on two separate days. We wanted to confirm regional specific NF effects with improved learning for left compared to right vlPFC (ClinicalTrials.gov NCT03183947). Brain responses and connectivity were studied with respect to training progress, gender, and clinical outcomes in a 4-week follow-up. Increase of vlPFC activity was stronger after NF training from the left- than the right-hemispheric ROI. This regional-specific NF effect during cognitive reappraisal was present across patients with depression and controls and supports a central role of the left vlPFC for cognitive reappraisal. Further, the activity in the left target region was associated with increased use of cognitive reappraisal strategies ( = 0.48). In the 4-week follow-up, 75% of patients with depression reported a successful application of learned strategies in everyday life and 55% a clinically meaningful symptom improvement suggesting clinical usability.
情感障碍与适应不良的情绪调节策略有关。特别是，左侧腹外侧前额叶皮质（vlPFC）比右侧更可能无法充分调节情绪处理，例如在杏仁核中。一项双盲交叉研究调查了针对重度抑郁症患者（n = 42）以及年龄和性别匹配的对照组（n = 39）的经颅直流电刺激（NF）支持的认知重评训练。参与者以随机顺序在两天内对负面图像进行认知重评时接受训练，以增强左侧或右侧vlPFC的活动。我们希望确认与右侧vlPFC相比，左侧vlPFC在学习改善方面具有区域特异性的NF效应（ClinicalTrials.gov NCT03183947）。在4周的随访中，研究了大脑反应和连接性与训练进展、性别和临床结果的关系。与右侧半球感兴趣区域相比，经颅直流电刺激（NF）训练后左侧vlPFC的活动增加更为明显。这种认知重评过程中的区域特异性经颅直流电刺激（NF）效应在抑郁症患者和对照组中均存在，支持左侧vlPFC在认知重评中的核心作用。此外，左侧目标区域的活动与认知重评策略使用的增加有关（r = 0.48）。在4周的随访中，75%的抑郁症患者报告在日常生活中成功应用了所学策略，55%的患者症状有临床意义的改善，表明该方法具有临床实用性。
