Neural responses to happy facial expressions in major depression following antidepressant treatment.
Neural responses to happy facial expressions in major depression following antidepressant treatment.
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DOI：
10.1176/ajp.2007.164.4.599
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发表时间：
2007-04
期刊：
影响因子：
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通讯作者：
C. Fu;Steven C. R. Williams;M. Brammer;J. Suckling;Jieun Kim;A. Cleare;Nicholas D. Walsh;M. Mitterschif
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文献类型：
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作者：
C. Fu;Steven C. R. Williams;M. Brammer;J. Suckling;Jieun Kim;A. Cleare;Nicholas D. Walsh;M. Mitterschif
目的情感面部表情加工是人际关系的重要组成部分。然而，抑郁症患者在这个系统中表现出障碍。本研究探讨了抑郁症患者快乐面部表情内隐加工的神经相关性，并确定了受抗抑郁治疗影响的区域。方法采用功能磁共振成像技术对两组受试者进行前瞻性研究。患者为19名无药物治疗的受试者（平均年龄43.2岁），患有重度抑郁症、急性抑郁发作、单相亚型。对照组包括19名匹配的健康志愿者（平均年龄42.8岁）。两组均在基线（第0周）和第8周进行fMRI扫描。基线扫描后，患者接受氟西汀治疗，每日20 mg。功能磁共振成像任务是内隐情感识别与标准的面部刺激变形显示不同强度的幸福。分析fMRI数据，以估计参与处理面部情感的脑系统的平均激活（总容量）和对可变强度（动态范围）的差异反应。结果与对照组相比，抑郁症患者的边缘皮层下和纹外视区的反应动态范围明显减弱。抗抑郁药治疗后，基线时减弱的纹外皮质激活增加，症状改善与海马和纹外区整体能力增强相关。结论：抑郁症患者快乐面部表情的神经加工障碍在情感面部加工的核心区域明显，治疗后这些障碍得到逆转。这些数据补充了用消极情感刺激观察到的神经效应。
OBJECTIVE Processing affective facial expressions is an important component of interpersonal relationships. However, depressed patients show impairments in this system. The present study investigated the neural correlates of implicit processing of happy facial expressions in depression and identified regions affected by antidepressant therapy. METHOD Two groups of subjects participated in a prospective study with functional magnetic resonance imaging (fMRI). The patients were 19 medication-free subjects (mean age, 43.2 years) with major depression, acute depressive episode, unipolar subtype. The comparison group contained 19 matched healthy volunteers (mean age, 42.8 years). Both groups underwent fMRI scans at baseline (week 0) and at 8 weeks. Following the baseline scan, the patients received treatment with fluoxetine, 20 mg daily. The fMRI task was implicit affect recognition with standard facial stimuli morphed to display varying intensities of happiness. The fMRI data were analyzed to estimate the average activation (overall capacity) and differential response to variable intensity (dynamic range) in brain systems involved in processing facial affect. RESULTS An attenuated dynamic range of response in limbic-subcortical and extrastriate visual regions was evident in the depressed patients, relative to the comparison subjects. The attenuated extrastriate cortical activation at baseline was increased following antidepressant treatment, and symptomatic improvement was associated with greater overall capacity in the hippocampal and extrastriate regions. CONCLUSIONS Impairments in the neural processing of happy facial expressions in depression were evident in the core regions of affective facial processing, which were reversed following treatment. These data complement the neural effects observed with negative affective stimuli.