Sicorello M, Herzog J, Wager T D, Ende G, Müller-Engelmann M, Herpertz S C, Bohus M, Schmahl C, Paret C, Niedtfeld I
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
Neuroimage Rep. 2021 May 29;1(2):100019. doi: 10.1016/j.ynirp.2021.100019. eCollection 2021 Jun.
Pathophysiological models are urgently needed for personalized treatments of mental disorders. However, most potential neural markers for psychopathology are limited by low interpretability, prohibiting reverse inference from brain measures to clinical symptoms and traits. Neural signatures-i.e. multivariate brain-patterns trained to be both sensitive specific to a construct of interest-might alleviate this problem, but are rarely applied to mental disorders. We tested whether previously developed neural signatures for negative affect and discrete emotions distinguish between healthy individuals and those with mental disorders characterized by emotion dysregulation, i.e. Borderline Personality Disorder (BPD) and complex Post-traumatic Stress Disorder (cPTSD). In three different fMRI studies, a total sample of 192 women (49 BPD, 62 cPTSD, 81 healthy controls) were shown pictures of scenes with negative or neutral content. Based on pathophysiological models, we hypothesized higher negative and lower positive reactivity of neural emotion signatures in participants with emotion dysregulation. The expression of neural signatures differed strongly between neutral and negative pictures (average Cohen's = 1.17). Nevertheless, a mega-analysis on individual participant data showed no differences in the reactivity of neural signatures between participants with and without emotion dysregulation. Confidence intervals ruled out even small effect sizes in the hypothesized direction and were further supported by Bayes factors. Overall, these results support the validity of neural signatures for emotional states during fMRI tasks, but raise important questions concerning their link to individual differences in emotion dysregulation.
精神障碍的个性化治疗迫切需要病理生理模型。然而,大多数潜在的精神病理学神经标志物因可解释性低而受到限制,无法从脑测量反向推断临床症状和特征。神经特征——即针对感兴趣的结构进行训练以兼具敏感性和特异性的多变量脑模式——可能会缓解这一问题,但很少应用于精神障碍。我们测试了先前开发的用于消极情绪和离散情绪的神经特征是否能够区分健康个体与那些患有以情绪调节障碍为特征的精神障碍的个体,即边缘型人格障碍(BPD)和复杂性创伤后应激障碍(cPTSD)。在三项不同的功能磁共振成像(fMRI)研究中,向总共192名女性(49名BPD患者、62名cPTSD患者、81名健康对照)展示了带有消极或中性内容的场景图片。基于病理生理模型,我们假设情绪调节障碍参与者的神经情绪特征具有更高的消极反应性和更低的积极反应性。中性图片和消极图片之间神经特征的表达差异很大(平均科恩d值 = 1.17)。然而,对个体参与者数据的元分析表明,有和没有情绪调节障碍的参与者之间神经特征的反应性没有差异。置信区间排除了假设方向上即使很小的效应量,并且贝叶斯因子进一步支持了这一点。总体而言,这些结果支持了fMRI任务期间神经特征对情绪状态的有效性,但也提出了关于它们与情绪调节障碍个体差异之间联系的重要问题。