Belleau Emily L, Kremens Rebecca, Bolton Thomas A W, Bondy Erin, Pisoni Angela, Auerbach Randy P, Pizzagalli Diego A
Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
J Mood Anxiety Disord. 2023 Jun;1. doi: 10.1016/j.xjmad.2023.100001. Epub 2023 May 31.
Major Depressive Disorder (MDD) is associated with alterations within the default mode (DMN) and frontoparietal (FPN) networks. However, it is unclear whether changes in these networks occur prior to onset in youth at high familial risk for MDD or are a consequence of MDD. Moreover, studies examining premorbid MDD vulnerability markers have focused on static rather than dynamic network properties, which could further elucidate DMN-FPN imbalances linked to MDD risk.
Eighty-nine unaffected 12-14-year-old adolescents both with ( = 27) and without ( = 62) a maternal history of MDD completed a resting state functional magnetic resonance imaging scan and self-report assessments of depressive symptoms and perceived stress at baseline and every three months across a two-year span. A coactivation pattern (CAP) analysis was conducted to examine functional network dynamic properties, including time spent in each CAP (total number of volumes), CAP persistence (number of consecutive volumes in each CAP), and number of transitions between posterior DMN-FPN and canonical DMN CAPs. Multilevel models estimated whether DMN-FPN dynamic properties predicted future depressive symptoms and stress sensitivity.
High-risk adolescents spent more time and exhibited a longer persistence in a posterior DMN-FPN CAP. DMN-FPN CAP persistence predicted future perceived stress, but only among high-risk adolescents. High-risk adolescents characterized by high DMN-FPN persistence reported greater future perceived stress, whereas those showing low DMN-FPN persistence had reduced perceived stress over time. Unexpectedly, DMN-FPN dynamics did not predict future depressive symptoms.
Altered DMN-FPN CAP properties among high-risk adolescents mirror alterations among individuals with MDD, suggesting that DMN-FPN dynamics may be a risk marker rather than consequence of MDD. Furthermore, longer DMN-FPN CAP persistence increases vulnerability in high-risk adolescents by predicting greater future stress sensitivity, a well-known catalyst for MDD. Replication in a larger sample is warranted.
重度抑郁症(MDD)与默认模式网络(DMN)和额顶叶网络(FPN)内的改变有关。然而,尚不清楚这些网络的变化是在MDD家族风险高的青少年发病之前就已发生,还是MDD的结果。此外,研究MDD病前易感性标志物时,关注的是静态而非动态网络属性,而动态网络属性可能会进一步阐明与MDD风险相关的DMN - FPN失衡。
89名未受影响的12 - 14岁青少年,其中有(n = 27)和没有(n = 62)母亲患MDD病史的,均完成了静息态功能磁共振成像扫描,并在基线以及两年内每三个月进行一次抑郁症状和感知压力的自我报告评估。进行了共激活模式(CAP)分析,以检查功能网络动态属性,包括在每个CAP中花费的时间(总体积数)、CAP持续性(每个CAP中连续体积数)以及后DMN - FPN与典型DMN CAP之间的转换次数。多水平模型估计DMN - FPN动态属性是否能预测未来的抑郁症状和压力敏感性。
高危青少年在后DMN - FPN CAP中花费更多时间且持续性更长。DMN - FPN CAP持续性可预测未来的感知压力,但仅在高危青少年中如此。以高DMN - FPN持续性为特征的高危青少年报告未来感知压力更大,而那些DMN - FPN持续性低的青少年随着时间推移感知压力降低。出乎意料的是,DMN - FPN动态变化并未预测未来的抑郁症状。
高危青少年中DMN - FPN CAP属性的改变反映了MDD患者的改变,这表明DMN - FPN动态变化可能是MDD的风险标志物而非结果。此外,更长的DMN - FPN CAP持续性通过预测未来更高的压力敏感性增加了高危青少年的易感性,而压力敏感性是MDD的一个众所周知的催化剂。有必要在更大样本中进行重复研究。