Laureate Institute for Brain Research, Tulsa, OK, United States.
Laureate Institute for Brain Research, Tulsa, OK, United States.
Biol Psychol. 2022 Mar;169:108286. doi: 10.1016/j.biopsycho.2022.108286. Epub 2022 Feb 8.
Unmedicated individuals with major depressive disorder (MDD) show abnormal interoception, but it is unclear whether antidepressant treatment via serotonergic medication alters this relationship. The current cross-sectional study examined associations between neural and behavioral indices of interoceptive processing and chronic serotonergic medication administration in MDD. 47 selective serotonin reuptake inhibitor (SSRI)-medicated MDD (MDD-SSRI) individuals were propensity-matched with 48 unmedicated current MDD (MDD-UnMed) and 41 healthy comparison (HC) participants on demographics including age, sex, body mass index, education, as well as on dimensional scales of symptom severity including depression and anxiety. All participants completed an interoceptive attention task during functional magnetic resonance imaging, and a behavioral heartbeat tapping task under three conditions: Guessing, No Guessing, and Breath Hold. Relative to HC, both MDD groups: (1) exhibited lower mid-insula, amygdala, putamen, and caudate activation during interoceptive versus exteroceptive attention; and (2) showed poorer heartbeat tapping performance during the Breath Hold condition. However, the MDD-SSRI group reported higher intensity ratings of heartbeat and stomach sensations than MDD-UnMed and HC during the interoceptive attention task. These findings suggest that the attenuated patterns of neural activation observed in depressed individuals during interoceptive attention are not ameliorated by the chronic administration of serotonergic medications. However, amplified interoceptive sensation ratings suggest a potential impact of chronic serotonergic medication on conscious experiences of internal body states. Future investigations will need to determine the extent to which serotonergic medications acutely influence interoceptive processing, and whether such changes play a role in therapeutic responses during treatment initiation.
未接受药物治疗的重度抑郁症（MDD）患者表现出异常的内脏感知，但尚不清楚通过血清素能药物治疗抗抑郁是否会改变这种关系。本横断面研究探讨了 MDD 患者中内脏感知处理的神经和行为指标与慢性血清素能药物治疗之间的关联。将 47 名接受选择性 5-羟色胺再摄取抑制剂（SSRI）药物治疗的 MDD（MDD-SSRI）患者与 48 名未接受药物治疗的当前 MDD（MDD-UnMed）和 41 名健康对照（HC）参与者在年龄、性别、体重指数、教育程度等人口统计学方面进行倾向评分匹配，以及在抑郁和焦虑等维度量表上的症状严重程度。所有参与者在功能磁共振成像期间完成了内脏感知注意任务，在三种条件下完成了行为心跳敲击任务：猜测、不猜测和屏住呼吸。与 HC 相比，两组 MDD 患者：（1）在内脏感知与外感知注意力期间，中脑岛、杏仁核、壳核和尾状核的激活水平较低；（2）在屏住呼吸条件下的心跳敲击表现较差。然而，与 MDD-UnMed 和 HC 相比，MDD-SSRI 组在内脏感知注意任务中报告的心跳和胃部感觉强度评分更高。这些发现表明，在接受慢性血清素能药物治疗后，抑郁个体在内脏感知注意力期间观察到的神经激活减弱模式并未得到改善。然而，增强的内脏感知感觉评分表明慢性血清素能药物治疗对内部身体状态的意识体验可能有潜在影响。未来的研究需要确定血清素能药物治疗在多大程度上急性影响内脏感知处理，以及这些变化是否在治疗开始时的治疗反应中起作用。
