Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
Eur J Neurosci. 2024 Apr;59(7):1819-1832. doi: 10.1111/ejn.16249. Epub 2024 Jan 13.
The brain's default mode network (DMN) and the executive control network (ECN) switch engagement are influenced by the ventral attention network (VAN). Alterations in resting-state functional connectivity (RSFC) within this so-called triple network have been demonstrated in patients with major depressive disorder (MDD) or anxiety disorders (ADs). This study investigated alterations in the RSFC in patients with comorbid MDD and ADs to better understand the pathophysiology of this prevalent group of patients. Sixty-eight participants (52.9% male, mean age 35.3 years), consisting of 25 patients with comorbid MDD and ADs (MDD + AD), 20 patients with MDD only (MDD) and 23 healthy controls (HCs) were investigated clinically and with 3T resting-state fMRI. RSFC utilizing a seed-based approach within the three networks belonging to the triple network was compared between the groups. Compared with HC, MDD + AD showed significantly reduced RSFC between the ECN and the VAN, the DMN and the VAN and within the ECN. No differences could be found for the MDD group compared with both other groups. Furthermore, symptom severity and medication status did not affect RSFC values. The results of this study show a distinct set of alterations of RSFC for patients with comorbid MDD and AD compared with HCs. This set of dysfunctions might be related to less adequate switching between the DMN and the ECN as well as poorer functioning of the ECN. This might contribute to additional difficulties in engaging and utilizing consciously controlled emotional regulation strategies.
大脑的默认模式网络 (DMN) 和执行控制网络 (ECN) 的切换参与受腹侧注意网络 (VAN) 的影响。在患有重度抑郁症 (MDD) 或焦虑症 (AD) 的患者中,已经证明了这种所谓的三网络中静息态功能连接 (RSFC) 的改变。本研究调查了患有 MDD 和 AD 共病患者的 RSFC 改变,以更好地了解这一常见患者群体的病理生理学。68 名参与者(52.9%为男性,平均年龄 35.3 岁),包括 25 名患有 MDD 和 AD 共病的患者(MDD+AD)、20 名仅患有 MDD 的患者(MDD)和 23 名健康对照者(HCs),进行了临床和 3T 静息态 fMRI 检查。在三网络中属于三重网络的三个网络内利用基于种子的方法比较了组间的 RSFC。与 HC 相比,MDD+AD 显示 ECN 与 VAN、DMN 与 VAN 之间以及 ECN 内的 RSFC 显著降低。与其他两组相比,MDD 组没有差异。此外,症状严重程度和药物状态不影响 RSFC 值。本研究的结果显示,与 HCs 相比,患有 MDD 和 AD 共病的患者的 RSFC 存在明显的改变。这组功能障碍可能与 DMN 和 ECN 之间的切换不足以及 ECN 的功能较差有关。这可能导致在参与和利用有意识控制的情绪调节策略方面出现额外的困难。