Nair Aparna U, Klimes-Dougan Bonnie, Silamongkol Thanharat, Başgöze Zeynep, Roediger Donovan J, Mueller Bryon A, Albott Cristina S, Croarkin Paul E, Lim Kelvin O, Widge Alik S, Nahas Ziad, Eberly Lynn E, Cullen Kathryn R, Thai Michelle E
Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.
Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
J Affect Disord. 2025 Mar 1;372:665-675. doi: 10.1016/j.jad.2024.12.057. Epub 2024 Dec 17.
Affective bias toward negativity is associated with depression and may represent a promising treatment target. Stimulating the dorsolateral prefrontal cortex (dlPFC) with deep Transcranial Magnetic Stimulation (dTMS) could lead to shifts in affective bias. The current study examined behavioral and neural correlates of affective bias in the context of dTMS in adolescents with treatment-resistant depression (TRD).
Adolescents completed a Word-Face Stroop (WFS) task during an fMRI scan before and after 30 sessions of dTMS targeting the left dlPFC. In the task, participants were shown words superimposed on faces in either a "congruent" (both word and face were positive or both negative) or an "incongruent" fashion; in both cases, participants identified whether the words were positive or negative. We examined pre-post intervention neural and behavioral WFS changes and their correlations with clinical improvement.
Usable pre- and post-intervention WFS data were available for 10 adolescents with TRD (Age, years: M = 16.3, SD = 1.09) for behavioral data; 9 for neuroimaging data. After treatment, although changes in behavioral performance did not suggest improved affective bias, amygdala activation decreased during the negative word/happy face condition, which correlated with clinical improvement. Overall, clinical improvement correlated with decreased neural activation during congruent conditions.
Major limitations include the small sample size, lack of a sham control group, and unknown psychometric properties.
Preliminary findings suggesting improving neural efficiency and normalizing affective bias in those with the most clinical improvement highlight the potential importance of targeting affective bias in treating adolescents with TRD.
对消极情绪的情感偏见与抑郁症有关，可能是一个有前景的治疗靶点。用深部经颅磁刺激（dTMS）刺激背外侧前额叶皮层（dlPFC）可能会导致情感偏见的转变。本研究在难治性抑郁症（TRD）青少年中，考察了dTMS背景下情感偏见的行为和神经相关性。
青少年在针对左侧dlPFC进行30次dTMS治疗前后的功能磁共振成像（fMRI）扫描期间完成了单词-面孔斯特鲁普（WFS）任务。在该任务中，向参与者呈现以“一致”（单词和面孔均为积极或均为消极）或“不一致”方式叠加在面孔上的单词；在两种情况下，参与者都要识别单词是积极的还是消极的。我们考察了干预前后WFS的神经和行为变化及其与临床改善的相关性。
有10名患有TRD的青少年（年龄，岁：M = 16.3，SD = 1.09）的行为数据有可用的干预前后WFS数据；9名有神经影像数据。治疗后，虽然行为表现的变化并未表明情感偏见有所改善，但在消极单词/开心面孔条件下杏仁核激活减少，这与临床改善相关。总体而言，临床改善与一致条件下神经激活减少相关。
主要局限性包括样本量小、缺乏假手术对照组以及心理测量特性未知。
初步研究结果表明，在临床改善最明显的患者中提高神经效率并使情感偏见正常化，突出了针对情感偏见治疗TRD青少年的潜在重要性。
