Reward-circuit biomarkers of risk and resilience in adolescent depression
Reward-circuit biomarkers of risk and resilience in adolescent depression
复制标题
DOI：
10.1016/j.jad.2018.12.104
复制
发表时间：
2019-03-01
影响因子：
6.6
通讯作者：
Gotlib, Ian H.
中科院分区：
文献类型：
--
作者：
Fischer, Adina S.;Ellwood-Lowe, Monica E.;Gotlib, Ian H.
背景：奖励加工功能障碍是重性抑郁障碍的核心特征。虽然青少年抑郁症的奖励处理知识越来越多，但研究人员忽视了抑郁症恢复力的神经机制。在这里，我们研究了奖励处理的神经相关性，这些神经相关性表征了青少年抑郁症风险的弹性和风险，促进了有效干预方法的发展，这些干预方法加强了高危青少年对精神病理学的弹性。（缓解抑郁; n = 15）或没有（弹性; n = 17）经历抑郁发作，和18个低风险的健康对照。参与者每隔18个月完成一次临床评估，并在青春期后期完成一项fMRI奖励处理任务。我们进行了预测建模与先验奖励感兴趣区域（ROI）。结果：在风险弹性和缓解抑郁的青少年表现出较少的纹状体激活比控制在预期的奖励。弹性青少年表现出更大的激活比缓解抑郁的青少年在额中回在奖励预期，和较少的激活在上级额上回和楔叶在奖励结果的加工。使用预测模型，腹侧前扣带皮层和壳核激活在奖励过程中区分从缓解抑郁青少年的弹性与83%accuracy.Limitations：相对较小的样本量，只有女性和事实，即功能磁共振成像数据获得在一个时间点在青春期后期的局限性。结论：奖励回路中神经激活的独特模式似乎是风险和弹性的标志，可能是旨在加强高危青少年自适应奖励处理的预防和治疗方法的目标。
Background: Dysfunctional reward processing is a core feature of major depressive disorder. While there is growing knowledge of reward processing in adolescent depression, researchers have ignored neural mechanisms of resilience to depression. Here, we examine neural correlates of reward processing that characterize resilience and risk in adolescents at risk for depression, facilitating the development of effective intervention approaches that strengthen resilience to psychopathology in at-risk youth.Methods: 50 adolescent females were followed through age 18: 32 at-risk adolescents who either did (remitted-depressed; n = 15) or did not (resilient; n = 17) experience a depressive episode, and 18 low-risk healthy controls. Participants completed clinical assessments at 18-month intervals and an fMRI reward-processing task in late adolescence. We conducted predictive modeling with a priori reward regions of interest (ROIs).Results: At-risk resilient and remitted-depressed adolescents exhibited less striatal activation than did controls during anticipation of reward. Resilient adolescents exhibited greater activation than did remitted-depressed adolescents in the middle frontal gyrus during reward anticipation, and less activation in the superior frontal gyrus and cuneus during processing of reward outcome. Using predictive modeling, ventral anterior cingulate cortex and putamen activation during reward processing distinguished resilient from remitted-depressed adolescents with 83% accuracy.Limitations: The relatively small sample size of only females and the fact that fMRI data were obtained at one time point in late adolescence are limitations.Conclusions: Distinct patterns of neural activation in reward circuitry appear to be markers of risk and resilience that may be targets for prevention and treatment approaches aimed at strengthening adaptive reward processing in at-risk adolescents.