Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany.
Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Univ., Frankfurt/Main, Germany; Brain Imaging Centre, Goethe Univ., Frankfurt/Main, Germany.
J Affect Disord. 2022 Feb 1;298(Pt A):239-247. doi: 10.1016/j.jad.2021.10.123. Epub 2021 Oct 30.
Disturbed emotion processing underlies depression. We examined the neuronal underpinnings of emotional processing in patients (PAT) with major depressive disorder (MDD) compared to healthy volunteers (HV) using functional magnetic resonance (fMRI) scan.
Thirty-six MDD patients and 30 HV underwent T2-weighted fMRI assessments during the presentation of an implicit affective processing task in three conditions. They differed regarding their affective quality (=valence, high negative, low negative and neutral stimuli) and regarding the arousal based on stimuli from the International Affective Picture System.
Group contrasts showed lower left-sided activation in dorsolateral prefrontal cortex (DLPFC), anterior PFC, precentral and premotor cortex in PAT compared with HV (Cluster-level threshold, 5000 iterations, p<0.01). We found a significant interaction effect of valence and group, a significant effect of emotional valence and a significant effect of group. All effects were shown in brain regions within the emotional network (Cluster-level threshold, 5000 iterations, p<0.01). Higher arousal (rho=-0.33, p<0.01) and higher valence (rho=-0.33, p<0.01) during high negative stimuli presentation as well as more severe depression (Beck Depression Inventory II [BDI II]; r = 0.39, p = 0.01) were significantly negatively associated with left DLFPC activity in patients.
Potential influence of psychopharmacological drugs on functional activation is one of the most discussed source of bias in studies with medicated psychiatric patients.
The results highlight the importance of left DLPFC during the processing of negative emotional stimuli in MDD. The integration of a neurophysiological model of emotional processing in MDD may help to clarify and improve therapeutic options.
抑郁的核心症状为情绪加工障碍。我们采用功能磁共振（fMRI）扫描技术，比较了伴有或不伴有重性抑郁障碍（MDD）的患者（PAT）和健康志愿者（HV）的情绪加工神经基础。
36 例 MDD 患者和 30 例 HV 在呈现内隐情绪加工任务时接受 T2 加权 fMRI 检查，该任务的情绪性质（=效价，高负性、低负性和中性刺激）和基于国际情绪图片系统（International Affective Picture System）的刺激唤醒度不同。
与 HV 相比，PAT 的左侧背外侧前额叶皮质（DLPFC）、额前皮质、中央前回和运动前皮质的激活显著降低（簇水平阈值，5000 次迭代，p<0.01）。我们发现效价和组间的交互作用、情绪效价和组间的主效应均有统计学意义。所有效应均显示在情绪网络内的脑区（簇水平阈值，5000 次迭代，p<0.01）。高负性刺激呈现时的唤醒度（rho=-0.33，p<0.01）和效价（rho=-0.33，p<0.01）以及抑郁严重程度（贝克抑郁自评量表 II [BDI II]；r=0.39，p=0.01）与患者左侧 DLPFC 的活动呈显著负相关。
研究中使用药物治疗的精神科患者，功能激活中潜在的药物影响是最具争议的偏倚来源之一。
结果突出了左侧 DLPFC 在 MDD 负性情绪加工中的重要性。MDD 中情绪加工神经生理模型的整合可能有助于阐明和改善治疗选择。
