Fan Huanhuan, Li Qing, Du Yue, Yan Yushun, Ni Rongjun, Wei Jinxue, Zhao Liansheng, Yang Xiao, Ma Xiaohong
Mental Health Center and Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, China.
Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Psychiatry. 2024 Sep 19;15:1428425. doi: 10.3389/fpsyt.2024.1428425. eCollection 2024.
Major depressive disorder (MDD) is associated with deficits in cognitive function, thought to be related to underlying decreased hedonic experiences. Further research is needed to fully elucidate the role of functional brain activity in this relationship. In this study, we investigated the neurofunctional correlate of the interplay between cognitive function and hedonic experiences in medication-free MDD using functional near-infrared spectroscopy (fNIRS).
We examine differences of brain activation corresponding to the verbal fluency test (VFT) between MDD patients and healthy controls (HCs). Fifty-six MDD patients and 35 HCs underwent fMRI scanning while performing the VFT. In exploratory analyses, cognitive performance, as assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB), four dimensions of hedonic processing (desire, motivation, effort, and consummatory pleasure) measured by the Dimensional Anhedonia Rating Scale (DARS), and relative changes in oxygenated hemoglobin concentration during the VFT were compared across groups.
Patients with MDD demonstrated impairments in sustained attention and working memory, accompanied by lower total and subscale scores on the DARS. Compared to healthy controls, MDD patients exhibited reduced activation in the prefrontal cortex (PFC) during the VFT task (t = 2.32 to 4.77, < 0.001 to 0.02, FDR corrected). DARS motivation, desire, and total scores as well as sustained attention, were positively correlated with activation in the dorsolateral PFC and Broca's area ( < 0.05, FDR corrected).
These findings indicate that changes in prefrontal lobe oxygenated hemoglobin levels, a region implicated in hedonic motivation and cognitive function, may serve as potential biomarkers for interventions targeting individuals with MDD. Our results corroborate the clinical consensus that the prefrontal cortex is a primary target for non-invasive neuromodulatory treatments for depression.
重度抑郁症（MDD）与认知功能缺陷有关，这被认为与潜在的享乐体验减少有关。需要进一步研究以充分阐明大脑功能活动在这种关系中的作用。在本研究中，我们使用功能近红外光谱（fNIRS）研究了未服药的MDD患者认知功能与享乐体验之间相互作用的神经功能相关性。
我们检查了MDD患者与健康对照（HCs）在言语流畅性测试（VFT）中大脑激活的差异。56名MDD患者和35名HCs在进行VFT时接受了功能磁共振成像扫描。在探索性分析中，比较了通过剑桥神经心理测试自动成套系统（CANTAB）评估的认知表现、通过维度快感缺乏评定量表（DARS）测量的享乐加工的四个维度（欲望、动机、努力和满足性愉悦）以及VFT期间氧合血红蛋白浓度的相对变化。
MDD患者表现出持续注意力和工作记忆受损，同时DARS的总分和子量表得分较低。与健康对照相比，MDD患者在VFT任务期间前额叶皮层（PFC）的激活减少（t = 2.32至4.77，P < 0.001至0.02，经FDR校正）。DARS动机、欲望和总分以及持续注意力与背外侧PFC和布洛卡区的激活呈正相关（P < 0.05，经FDR校正）。
这些发现表明，前额叶叶氧合血红蛋白水平的变化，该区域与享乐动机和认知功能有关，可能作为针对MDD个体干预的潜在生物标志物。我们的结果证实了临床共识，即前额叶皮层是抑郁症非侵入性神经调节治疗的主要靶点。
