额侧不对称性作为重度抑郁症的核心特征：一项功能近红外光谱研究。
Frontal asymmetry as a core feature of major depression: a functional near-infrared spectroscopy study.
机构信息
From the Department of Psychiatry (Tseng, Jeng, Cheng, Chu, Chen, Bai, Tsai, Su, Li), Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Biomedical Imaging and Radiological Sciences (Lu), National Yang Ming University, Taipei, Taiwan; the Division of Psychiatry (Cheng, Chen, Bai, Tsai, Su, Li), School of Medicine, National Yang-Ming University, Taipei, Taiwan; the Department of Psychiatry (Su), Cheng Hsin General Hospital, Taipei, Taiwan.
From the Department of Psychiatry (Tseng, Jeng, Cheng, Chu, Chen, Bai, Tsai, Su, Li), Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Biomedical Imaging and Radiological Sciences (Lu), National Yang Ming University, Taipei, Taiwan; the Division of Psychiatry (Cheng, Chen, Bai, Tsai, Su, Li), School of Medicine, National Yang-Ming University, Taipei, Taiwan; the Department of Psychiatry (Su), Cheng Hsin General Hospital, Taipei, Taiwan
出版信息
J Psychiatry Neurosci. 2022 May 4;47(3):E186-E193. doi: 10.1503/jpn.210131. Print 2022 May-Jun.
BACKGROUND
Frontal asymmetry plays a major role in depression. However, patients with treatment-resistant depression (TRD) have widespread hypofrontality. We investigated whether patients with TRD have a characteristic frontal activation pattern in functional near-infrared spectroscopy (fNIRS) findings and how the frontal cortex responds to different levels of cognitive tasks.
METHODS
We enrolled 27 right-handed patients with TRD, 27 patients without TRD and 27 healthy controls. We used multichannel fNIRS to evaluate activation of the bilateral dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC) and left motor area in response to 3 tasks: finger tapping, a low cognitive-load motor task; verbal fluency, a moderate cognitive-load task; and a dual task involving simultaneous finger tapping and verbal fluency, a high cognitive-load task.
RESULTS
We found significant between-group differences in left DLPFC activation for all 3 tasks. The healthy controls had cortical activation in the left motor area during finger tapping and the bilateral frontal cortex during the dual task. However, patients without TRD had right VLPFC activation during finger tapping and left DLPFC activation during the dual task. Patients with TRD had bilateral DLPFC activation during finger tapping but exhibited increased bilateral VLPFC and left motor area activation during verbal fluency and increased left motor area activation during the dual task. In healthy controls and patients without TRD, we found that the right VLPFC was positively correlated with depression severity.
LIMITATIONS
Our cohort included only patients with late-onset depression.
CONCLUSION
We found different patterns of abnormal frontal activation between patients with and without TRD. In patients without TRD, the right prefrontal cortex (PFC) was recruited during simple motor tasks. However, in patients with TRD, the bilateral PFC was recruited during simple tasks and motor cortical resources were used compensatorily during PFC-demanding complex cognitive tasks.
背景
额不对称在抑郁症中起着重要作用。然而，治疗抵抗性抑郁症（TRD）患者存在广泛的额皮质下功能低下。我们研究了 TRD 患者在功能近红外光谱（fNIRS）研究中是否具有特征性的额激活模式，以及额皮质如何对不同水平的认知任务做出反应。
方法
我们纳入了 27 名右手 TRD 患者、27 名无 TRD 患者和 27 名健康对照者。我们使用多通道 fNIRS 评估双侧背外侧前额叶皮质（DLPFC）、腹外侧前额叶皮质（VLPFC）和左侧运动区在 3 种任务下的激活情况：手指敲击，低认知负荷运动任务；言语流畅性，中认知负荷任务；以及同时进行手指敲击和言语流畅性的双重任务，高认知负荷任务。
结果
我们发现所有 3 种任务中，左 DLPFC 的激活在组间存在显著差异。健康对照组在手指敲击时，左侧运动区和双侧额皮质在双重任务时均有皮质激活。然而，无 TRD 患者在手指敲击时右侧 VLPFC 激活，在双重任务时左侧 DLPFC 激活。TRD 患者在手指敲击时双侧 DLPFC 激活，但在言语流畅性测试时双侧 VLPFC 和左侧运动区激活增加，在双重任务时左侧运动区激活增加。在健康对照组和无 TRD 患者中，我们发现右侧 VLPFC 与抑郁严重程度呈正相关。
局限性
我们的队列仅包括晚发性抑郁症患者。
结论
我们发现 TRD 患者和无 TRD 患者之间存在不同的额异常激活模式。在无 TRD 患者中，右侧前额皮质（PFC）在简单运动任务中被募集。然而，在 TRD 患者中，双侧 PFC 在简单任务中被募集，而在需要 PFC 的复杂认知任务中，运动皮质资源则被代偿性地使用。
Zotero 插件