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缓解期成年重性抑郁障碍患者奖赏加工中的瞳孔反应。

Pupillary response in reward processing in adults with major depressive disorder in remission.

机构信息

Uppsala University, Uppsala, Sweden.

Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.

出版信息

J Int Neuropsychol Soc. 2023 Mar;29(3):306-315. doi: 10.1017/S1355617722000224. Epub 2022 May 12.

Abstract

OBJECTIVE

Major depressive disorder (MDD) is associated with impaired reward processing and reward learning. The literature is inconclusive regarding whether these impairments persist after remission. The current study examined reward processing during a probabilistic learning task in individuals in remission from MDD ( 19) and never depressed healthy controls ( 31) matched for age and sex. The outcome measures were pupil dilation (an indirect index of noradrenergic activity and arousal) and computational modeling parameters.

METHOD

Participants completed two versions (facial/nonfacial feedback) of probabilistic reward learning task with changing contingencies. Pupil dilation was measured with a corneal reflection eye tracker. The hypotheses and analysis plan were preregistered.

RESULT

Healthy controls had larger pupil dilation following losses than gains ( <.001), whereas no significant difference between outcomes was found in individuals with a history of MDD, resulting in an interaction between group and outcome ( = 0.81, = 0.34, = 2.37, = .018). The rMDD group also achieved lower mean score at the last trial ([46.77] = 2.12, = .040) as well as a smaller proportion of correct choices ([46.70] = 2.09, = .041) compared with healthy controls.

CONCLUSION

Impaired reward processing may persist after remission from MDD and could constitute a latent risk factor for relapse. Measuring pupil dilation in a reward learning task is a promising method for identifying reward processing abnormalities linked to MDD. The task is simple and noninvasive, which makes it feasible for clinical research.

摘要

目的

重度抑郁症(MDD)与奖赏加工和奖赏学习受损有关。关于这些损伤在缓解后是否持续存在,文献尚无定论。本研究在缓解期 MDD 患者(19 例)和年龄、性别相匹配的从未抑郁的健康对照组(31 例)中,检查了奖赏加工。结局指标为瞳孔扩张(去甲肾上腺素能活动和觉醒的间接指标)和计算模型参数。

方法

参与者完成了两种版本(面部/非面部反馈)的具有变化关联的概率奖赏学习任务。瞳孔扩张通过角膜反射眼动追踪仪进行测量。假设和分析计划已预先注册。

结果

健康对照组在损失后瞳孔扩张较大(<0.001),而有 MDD 病史的个体在结果之间没有发现显著差异,从而导致组间和结果间的相互作用(=0.81,=0.34,=2.37,=0.018)。rMDD 组在最后一次试验中的平均得分也较低([46.77]=2.12,=0.040),正确选择的比例也较小([46.70]=2.09,=0.041)。

结论

MDD 缓解后奖赏加工受损可能持续存在,可能构成复发的潜在风险因素。在奖赏学习任务中测量瞳孔扩张是识别与 MDD 相关的奖赏加工异常的一种很有前途的方法。该任务简单、无创,使其在临床研究中可行。

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