Disentangling cognitive inflexibility in major depressive disorder: A transcranial direct current stimulation study
Disentangling cognitive inflexibility in major depressive disorder: A transcranial direct current stimulation study
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DOI：
10.1111/pcn.13364
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发表时间：
2022-05-14
影响因子：
11.9
通讯作者：
Morishima, Yosuke
中科院分区：
文献类型：
--
作者：
Koshikawa, Yosuke;Nishida, Keiichiro;Morishima, Yosuke
背景
认知功能障碍是重度抑郁症（MDD）中一种持续存在的残留症状，它阻碍了社会和职业康复。认知灵活性缺失是MDD中一种典型的认知功能障碍，指的是在任务转换方面存在困难，这需要两个子成分：忘记旧任务和适应新任务。在此，我们旨在剖析MDD中认知灵活性缺失的子成分，并研究经颅直流电刺激（tDCS）前额叶皮质是否能改善这些成分。
方法
本研究包括20名MDD患者（7名女性）和22名年龄匹配的健康对照者（HCs）（7名女性）。参与者在交叉设计中接受对背内侧前额叶皮质（DMPFC）或背外侧前额叶皮质（DLPFC）的阳极tDCS刺激。在应用tDCS之前和之后，参与者进行改良的威斯康星卡片分类测试，其中任务转换规则有明确描述，并且偶尔会消除先前任务规则的前摄干扰。
结果
我们发现MDD患者的任务转换行为成本增加，但MDD患者和健康对照者之间的前摄干扰行为成本相当。在MDD中，阳极DMPFC tDCS的反应时间比阳极DLPFC tDCS的反应时间减少。
结论
这些发现表明，MDD中的认知灵活性缺失主要是由于难以适应新任务和环境所致，并且DMPFC上的tDCS在需要解决冲突的认知要求较高的任务中改善了行为表现。
Background Cognitive dysfunction is a persistent residual symptom in major depressive disorders (MDDs) that hinders social and occupational recovery. Cognitive inflexibility is a typical cognitive dysfunction in MDD and refers to difficulty in switching tasks, which requires two subcomponents: forgetting an old task and adapting to a new one. Here, we aimed to disentangle the subcomponents of cognitive inflexibility in MDD and investigate whether they can be improved by transcranial direct current stimulation (tDCS) on the prefrontal cortex. Methods The current study included 20 patients with MDD (seven females) and 22 age-matched healthy controls (HCs) (seven females). The participants received anodal tDCS on either the dorsomedial prefrontal cortex (DMPFC) or dorsolateral prefrontal cortex (DLPFC) in a crossover design. Before and after the application of tDCS, the participants performed a modified Wisconsin Card Sorting Test, in which the task-switching rules were explicitly described and proactive interference from a previous task rule was occasionally released. Results We found that the behavioral cost of a task switch was increased in patients with MDD, but that of proactive interference was comparable between patients with MDD and HCs. The response time for anodal DMPFC tDCS was decreased compared with that for anodal tDCS on the DLPFC in MDD. Conclusions These findings suggest that cognitive inflexibility in MDD is primarily explained by the difficulty to adapt to a new task and environment, and that tDCS on the DMPFC improves behavioral performance during cognitively demanding tasks that require conflict resolution.