Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States.
Soc Cogn Affect Neurosci. 2024 Mar 1;19(1). doi: 10.1093/scan/nsae009.
Anxiety and depression co-occur; the neural substrates of shared and unique components of these symptoms are not understood. Given emotional alterations in internalizing disorders, we hypothesized that function of regions associated with emotion processing/regulation, including the anterior cingulate cortex (ACC), amygdala and fusiform gyrus (FG), would differentiate these symptoms. Forty-three adults with depression completed an emotional functional magnetic resonance imaging task and the Hamilton Depression and Anxiety Scales. We transformed these scales to examine two orthogonal components, one representing internalizing symptom severity and the other the type of internalizing symptoms (anxiety vs depression). We extracted blood oxygen level dependent signal from FG subregions, ACC, and amygdala and performed generalized psychophysiological interaction analyses to assess relationships between symptoms and brain function. Type of internalizing symptoms was associated with FG3-FG1 coupling (F = 8.14, P = 0.007). More coupling was associated with a higher concentration of depression, demonstrating that intra-fusiform coupling is differentially associated with internalizing symptom type (anxiety vs depression). We found an interaction between task condition and internalizing symptoms and dorsal (F = 4.51, P = 0.014) and rostral ACC activity (F = 4.27, P = 0.012). Post hoc comparisons revealed that less activity was associated with greater symptom severity during emotional regulation. Functional coupling differences during emotional processing are associated with depressive relative to anxiety symptoms and internalizing symptom severity. These findings could inform future treatments for depression.
焦虑和抑郁共病；这些症状的共同和独特成分的神经基础尚不清楚。鉴于内感障碍中的情绪改变，我们假设与情绪处理/调节相关的区域的功能，包括前扣带皮层（ACC）、杏仁核和梭状回（FG），将区分这些症状。43 名抑郁症成年人完成了情绪功能磁共振成像任务和汉密尔顿抑郁和焦虑量表。我们将这些量表转化为检查两个正交成分，一个代表内感症状的严重程度，另一个代表内感症状的类型（焦虑与抑郁）。我们从 FG 亚区、ACC 和杏仁核中提取血氧水平依赖信号，并进行广义心理生理相互作用分析，以评估症状与大脑功能之间的关系。内感症状的类型与 FG3-FG1 耦合有关（F=8.14，P=0.007）。更多的耦合与更高浓度的抑郁相关，表明内梭状回耦合与内感症状类型（焦虑与抑郁）存在差异。我们发现任务条件与内感症状之间存在交互作用，背侧（F=4.51，P=0.014）和前侧 ACC 活动（F=4.27，P=0.012）。事后比较表明，在情绪调节期间，活动越少与症状严重程度越大相关。情绪处理过程中的功能耦合差异与抑郁相关，而不是与焦虑症状和内感症状严重程度相关。这些发现可以为未来的抑郁症治疗提供信息。
