Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Transl Psychiatry. 2024 Jul 23;14(1):303. doi: 10.1038/s41398-024-03020-9.
Poor inhibitory control contributes to deficits in emotion regulation, which are often targeted by treatments for major depressive disorder (MDD), including cognitive behavioral therapy (CBT). Brain regions that contribute to inhibitory control and emotion regulation overlap; thus, inhibitory control might relate to response to CBT. In this study, we examined whether baseline inhibitory control and resting state functional connectivity (rsFC) within overlapping emotion regulation-inhibitory control regions predicted treatment response to internet-based CBT (iCBT). Participants with MDD were randomly assigned to iCBT (N = 30) or a monitored attention control (MAC) condition (N = 30). Elastic net regression was used to predict post-treatment Patient Health Questionnaire-9 (PHQ-9) scores from baseline variables, including demographic variables, PHQ-9 scores, Flanker effects (interference, sequential dependency, post-error slowing), and rsFC between the dorsal anterior cingulate cortex, bilateral anterior insula (AI), and right temporoparietal junction (TPJ). Essential prognostic predictor variables retained in the elastic net regression included treatment group, gender, Flanker interference response time (RT), right AI-TPJ rsFC, and left AI-right AI rsFC. Prescriptive predictor variables retained included interactions between treatment group and baseline PHQ-9 scores, age, gender, Flanker RT, sequential dependency effects on accuracy, post-error accuracy, right AI-TPJ rsFC, and left AI-right AI rsFC. Inhibitory control and rsFC within inhibitory control-emotion regulation regions predicted reduced symptom severity following iCBT, and these effects were stronger in the iCBT group than in the MAC group. These findings contribute to a growing literature indicating that stronger inhibitory control at baseline predicts better outcomes to psychotherapy, including iCBT.
较差的抑制控制能力会导致情绪调节缺陷，这是治疗重度抑郁症（MDD）的主要目标，包括认知行为疗法（CBT）。有助于抑制控制和情绪调节的大脑区域重叠；因此，抑制控制可能与 CBT 的反应有关。在这项研究中，我们研究了基线抑制控制和重叠的情绪调节-抑制控制区域内的静息态功能连接（rsFC）是否可以预测基于互联网的认知行为疗法（iCBT）的治疗反应。MDD 患者被随机分配到 iCBT（N=30）或监测注意对照组（MAC）（N=30）。弹性网络回归用于从基线变量预测治疗后 PHQ-9 评分，包括人口统计学变量、PHQ-9 评分、Flanker 效应（干扰、序列依赖、错误后减速）和背侧前扣带皮层、双侧前岛叶（AI）和右侧颞顶交界处（TPJ）之间的 rsFC。保留在弹性网络回归中的基本预后预测变量包括治疗组、性别、Flanker 干扰反应时间（RT）、右 AI-TPJ rsFC 和左 AI-右 AI rsFC。保留的预测性预测变量包括治疗组和基线 PHQ-9 评分、年龄、性别、Flanker RT、准确性的序列依赖性效应、错误后准确性、右 AI-TPJ rsFC 和左 AI-右 AI rsFC 之间的相互作用。抑制控制和抑制控制-情绪调节区域内的 rsFC 预测 iCBT 后症状严重程度降低，在 iCBT 组中的效果强于 MAC 组。这些发现有助于越来越多的文献表明，基线时更强的抑制控制能力预测心理治疗，包括 iCBT 的效果更好。
