Institute for Translational Psychiatry, University of Münster, Germany.
Institute for Translational Psychiatry, University of Münster, Germany; and Institute for Translational Neuroscience, University of Münster, Germany.
Br J Psychiatry. 2022 Aug;221(2):476-484. doi: 10.1192/bjp.2021.223.
Relapses in major depression are frequent and are associated with a high burden of disease. Although short-term studies suggest a normalisation of depression-associated brain functional alterations directly after treatment, long-term investigations are sparse.
To examine brain function during negative emotion processing in association with course of illness over a 2-year span.
In this prospective case-control study, 72 in-patients with current depression and 42 healthy controls were investigated during a negative emotional face processing paradigm, at baseline and after 2 years. According to their course of illness during the study interval, patients were divided into subgroups ( = 25 no-relapse, = 47 relapse). The differential changes in brain activity were investigated by a group × time analysis of covariance for the amygdala, hippocampus, insula and at whole-brain level.
A significant relapse × time interaction emerged within the amygdala ( = 0.011), insula ( = 0.001) and at the whole-brain level mainly in the temporal and prefrontal cortex ( = 0.027), resulting from activity increases within the no-relapse group, whereas in the relapse group, activity decreased during the study interval. At baseline, the no-relapse group showed amygdala, hippocampus and insula hypoactivity compared with healthy controls and the relapse group.
This study reveals course of illness-associated activity changes in emotion processing areas. Patients in full remission show a normalisation of their baseline hypo-responsiveness to the activation level of healthy controls after 2 years. Brain function during emotion processing could further serve as a potential predictive marker for future relapse.
重度抑郁症反复发作，疾病负担沉重。虽然短期研究表明，治疗后与抑郁相关的大脑功能改变会恢复正常，但长期研究较少。
在 2 年的时间跨度内，检查与疾病过程相关的消极情绪处理期间的大脑功能。
在这项前瞻性病例对照研究中，72 名当前患有抑郁症的住院患者和 42 名健康对照者在基线和 2 年后进行了消极情绪面孔处理范式的研究。根据研究期间的疾病过程，患者被分为亚组（= 25 名无复发，= 47 名复发）。通过对杏仁核、海马体、岛叶和全脑水平的协方差组×时间分析，研究了大脑活动的差异变化。
在杏仁核（= 0.011）、岛叶（= 0.001）和全脑水平（主要在颞叶和前额叶皮层）出现了显著的复发×时间交互作用，这是由于无复发组的活动增加所致，而在复发组中，活动在研究期间减少。在基线时，无复发组与健康对照组和复发组相比，杏仁核、海马体和岛叶的活性降低。
本研究揭示了与疾病过程相关的情绪处理区域的活动变化。完全缓解的患者在 2 年后，其大脑对激活的反应性恢复到健康对照组的基线水平，表现出正常化。情绪处理过程中的大脑功能可以进一步作为未来复发的潜在预测标志物。
