Prefrontal dysfunction in depressed patients performing a complex planning task: A study using positron emission tomography
Prefrontal dysfunction in depressed patients performing a complex planning task: A study using positron emission tomography
复制标题
DOI：
10.1017/s0033291797005187
复制
发表时间：
1997-07-01
影响因子：
6.9
通讯作者：
Sahakian, BJ
中科院分区：
文献类型：
--
作者：
Elliott, R;Baker, SC;Sahakian, BJ
单极抑郁症患者在伦敦塔规划任务上表现不佳。正电子发射断层扫描（Positron emission tomography）先前已经确定了抑郁症患者静息状态下的血流异常，该技术被用于研究抑郁症患者和正常人在静息状态下的神经活动。研究人员对6名单极抑郁症患者和6名匹配的对照组进行扫描，同时在一触式计算机范式中执行简单和困难的伦敦塔问题，同时执行感知运动控制任务。结果：与正常受试者相比，本研究患者表现出预期的任务相关表现缺陷。在正常受试者中，这项任务涉及前额皮质、前扣带、后皮质区和皮层下结构（包括纹状体、丘脑和小脑）的网络。抑郁症患者扣带体和纹状体未表现出明显的激活；与对照组相比，其他前额叶和后皮层区域的激活明显减弱。至关重要的是，患者也没有表现出与任务难度增加相关的尾状核、前扣带和右前额叶皮层的正常激活增强。结论：这些发现为抑郁症患者任务表现受损与扣带、前额叶和纹状体功能障碍相关提供了证据。目前的结果与扣带功能障碍在抑郁症中的核心作用一致，也表明额纹状体功能受损。
Introduction, Patients with unipolar depression show impaired performance on the Tower of London planning task. Positron emission tomography, which has previously identified resting state blood flow abnormalities in depression, was used to investigate neural activity associated with performance of this task in depressed patients and normal controls.Methods. Six patients with unipolar depression and six matched controls were scanned while performing easy and hard Tower of London problems in a one-touch computerized paradigm and while performing a perceptuomotor control task.Results, The patients in this study showed an expected task-related performance deficit compared with normal subjects. In normal subjects, the task engaged a network of prefrontal cortex, anterior cingulate, posterior cortical areas and subcortical structures including the striatum, thalamus and cerebellum. Depressed patients failed to show significant activation in the cingulate and striatum; activation in the other prefrontal and posterior cortical regions was significantly attenuated relative to controls. Crucially, patients also failed to show the normal augmentation of activation in the caudate nucleus, anterior cingulate and right prefrontal cortex associated with increasing task difficulty.Conclusions, These findings provide evidence for cingulate, prefrontal and striatal dysfunction associated with impaired task performance in depression. The present results are consistent with a central role of cingulate dysfunction in depression as well as suggesting impaired frontostriatal function.