Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba.
BMC Psychiatry. 2022 Mar 8;22(1):173. doi: 10.1186/s12888-022-03780-y.
Impaired cognitive reappraisal, associated with the social functioning and well-being of patients affected by mood or anxiety disorders, is characterized by distinct neural activation patterns across clinical populations. To date, studies dedicated to identifying common and distinct neural activation profiles need to be clarified. The aim of the present study was to investigate transdiagnostic differences and commonalities in brain activation patterns during reappraisal-mediated downregulation of emotions.
Cognitive reappraisal of negative images was contrasted with maintaining emotions during a control viewing condition. Brain activation in 35 patients with major depressive disorder (MDD), 20 patients with post-traumatic stress disorder (PTSD), and 34 healthy controls (HC) during cognitive reappraisal was compared. Moreover, the neural circuitry of emotion regulation in these clinical populations was examined using seed-to-voxel and voxel-to-voxel functional connectivity analyses.
Whole-brain fMRI analyses showed less right-lateralized activation of the inferior, middle, and superior frontal gyrus during cognitive reappraisal compared to viewing of negative images in MDD and PTSD patients compared to HCs. Right IFG activation was negatively correlated with the severity of anxiety and depressive symptomatology. In addition, increased seed-to-voxel connectivity of the right IFG as well as increased voxel-to-voxel connectivity was observed in PTSD patients compared to HCs and MDD patients.
FMRI results therefore suggested a common deficit of depression and anxiety symptomatology reflected by reduced activation in right IFG during cognitive reappraisal as well as diagnosis specific effects in patients with PTSD based on seed-to-voxel and voxel-to-voxel connectivity showing an overactive and hyperconnected salience network. Findings highlight the role of transdiagnostic research to identify disorder specific brain patterns as well as patterns common across disorders.
认知重评受损与情绪或焦虑障碍患者的社会功能和幸福感相关，其特征是在不同的临床人群中具有不同的神经激活模式。迄今为止，需要阐明旨在确定共同和独特神经激活特征的研究。本研究的目的是调查在情绪重新评估调节过程中，跨诊断差异和大脑激活模式的共性。
将负性图像的认知重评与在控制观察条件下保持情绪进行对比。比较了 35 例重性抑郁障碍（MDD）患者、20 例创伤后应激障碍（PTSD）患者和 34 例健康对照者（HC）在认知重评期间的大脑激活情况。此外，还使用种子到体素和体素到体素功能连接分析来检查这些临床人群中的情绪调节神经回路。
全脑 fMRI 分析显示，与 HC 相比，MDD 和 PTSD 患者在认知重评期间，右侧额下回、中回和上回的激活程度较低。右侧 IFG 的激活与焦虑和抑郁症状的严重程度呈负相关。此外，与 HC 和 MDD 患者相比，PTSD 患者的右侧 IFG 的种子到体素连接和体素到体素连接增加。
因此，FMRI 结果表明，抑郁和焦虑症状的共同缺陷反映在认知重评期间右侧 IFG 的激活减少，以及 PTSD 患者基于种子到体素和体素到体素连接的特定诊断效应，表现出过度活跃和超连接的突显网络。研究结果强调了开展跨诊断研究的重要性，以确定特定障碍的大脑模式以及跨障碍共有的模式。
