Lin Jingyuan, Yang Xuemei, Li Hong, Lin Wuji, Zhang Jie, Lei Yi
The Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China.
College Students Mental Health Education Service Center, Sichuan Normal University, Chengdu, China.
Depress Anxiety. 2024 Jun 27;2024:3135532. doi: 10.1155/2024/3135532. eCollection 2024.
Agency, a sense of control over one's actions and outcomes, is crucial for recovery from depressive symptoms. However, the mechanisms that enhance agency in individuals with depressive symptoms remain poorly understood. This study endeavors to elucidate these fundamental processes.
We recruited 52 participants exhibiting depressive symptoms to participate in a novel Judgment of Agency (JoA) task. This task was structured with a 3 (effort: high load, medium load, low load) × 2 (outcome: win, miss) within-subject design to assess the impact of effort and outcome valence on agency. Throughout the task, we utilized functional near-infrared spectroscopy (fNIRS) to explore the neural mechanisms underlying agency. Furthermore, we conducted a randomized, sham-controlled, pre-post-test trial involving intermittent theta-burst stimulation (iTBS) targeted at the left dorsolateral prefrontal cortex (DLPFC) to investigate its potential to enhance agency. Participants were randomly allocated to either an active iTBS group or a sham group, with each receiving a single session of stimulation (600 pulses). The JoA task was conducted both before and after the stimulation.
Effort significantly influenced agency in individuals with depressive symptoms, with this effect being moderated by the outcomes' valences. Agency was positively correlated with self-efficacy ( = 0.28, < 0.05) when goals were achieved with effort, and with anxiety severity ( = 0.29, < 0.05) when goals were not achieved. Additionally, it was associated with the activation of several frontal brain regions (all values < 0.01), including the left DLPFC, right premotor and supplementary motor areas, and the left inferior frontal gyrus (IFG). Application of iTBS over the left DLPFC significantly enhanced self-attributed agency, particularly when the outcomes were achieved under conditions of low-load effort.
Our study highlights the critical role of effort in enhancing agency for individuals with depressive symptoms, with iTBS applied to the left DLPFC showing potential to enhance agency postgoal achievement. Moreover, the activation of the left IFG and the presence of anxiety are associated with maladaptive self-attributed agency, offering potential targets for therapeutic intervention.
能动性，即对自身行为和结果的控制感，对于从抑郁症状中恢复至关重要。然而，增强抑郁症状个体能动性的机制仍知之甚少。本研究旨在阐明这些基本过程。
我们招募了52名表现出抑郁症状的参与者，让他们参与一项新颖的能动性判断（JoA）任务。该任务采用3（努力程度：高负荷、中等负荷、低负荷）×2（结果：成功、失败）的被试内设计，以评估努力程度和结果效价对能动性的影响。在整个任务过程中，我们利用功能近红外光谱（fNIRS）来探究能动性背后的神经机制。此外，我们进行了一项随机、假刺激对照、前后测试试验，对左侧背外侧前额叶皮质（DLPFC）进行间歇性theta波爆发刺激（iTBS），以研究其增强能动性的潜力。参与者被随机分配到主动iTBS组或假刺激组，每组接受一次刺激（600个脉冲）。在刺激前后均进行JoA任务。
努力程度对抑郁症状个体的能动性有显著影响，这种影响受结果效价的调节。当通过努力实现目标时，能动性与自我效能感呈正相关（r = 0.28，p < 0.05），而当目标未实现时，能动性与焦虑严重程度呈正相关（r = 0.29，p < 0.05）。此外，它与几个额叶脑区的激活有关（所有p值< 0.01），包括左侧DLPFC、右侧运动前区和辅助运动区，以及左侧额下回（IFG）。对左侧DLPFC施加iTBS显著增强了自我归因的能动性，尤其是在低负荷努力条件下实现结果时。
我们的研究强调了努力在增强抑郁症状个体能动性方面的关键作用，对左侧DLPFC施加iTBS显示出在目标实现后增强能动性的潜力。此外，左侧IFG的激活和焦虑的存在与适应不良的自我归因能动性有关，为治疗干预提供了潜在靶点。
