Disrupted reward circuits is associated with cognitive deficits and depression severity in major depressive disorder
Disrupted reward circuits is associated with cognitive deficits and depression severity in major depressive disorder
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奖励回路中断与重度抑郁症的认知缺陷和抑郁严重程度相关
DOI：
10.1016/j.jpsychires.2016.09.016
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发表时间：
2017-01-01
影响因子：
4.8
通讯作者：
Zhang, Zhijun
中科院分区：
文献类型：
--
作者：
Gong, Liang;Yin, Yingying;Zhang, Zhijun
神经成像研究表明，严重抑郁障碍(MDD)患者对与奖励相关的任务表现出迟钝的活动反应。然而，奖赏回路异常是否会影响MDD患者的认知和抑郁仍不清楚。75名未服药的MDD患者和42名认知正常(CN)的受试者接受了静息状态的功能磁共振成像扫描。选择双侧伏隔核(NAC)作为种子，构建跨越所有受试者的奖赏回路。采用多元线性回归分析研究MDD患者认知功能的神经基础和奖赏回路上的抑郁严重程度。通过联合分析确定了认知缺陷和抑郁的共同途径。与CN受试者相比，MDD患者表现出主要位于前额叶-纹状体区域的奖赏网络连通性降低。重要的是，认知和抑郁背后的不同和共同的神经通路被识别出来，这意味着认知缺陷和抑郁严重程度对奖赏回路的独立和协同作用。这项研究表明，在MDD患者中，奖赏回路内拓扑组织的紊乱与认知缺陷和抑郁严重程度显著相关。这些发现表明，除了抗抑郁药物治疗外，正常化的奖赏回路应该是改善MDD患者抑郁和认知障碍的重点和目标。(C)2016爱思唯尔有限公司。保留所有权利。
Neuroimaging studies have demonstrated that major depressive disorder (MDD) patients show blunted activity responses to reward-related tasks. However, whether abnormal reward circuits affect cognition and depression in MDD patients remains unclear. Seventy-five drug-naive MDD patients and 42 cognitively normal (CN) subjects underwent a resting-state functional magnetic resonance imaging scan. The bilateral nucleus accumbens (NAc) were selected as seeds to construct reward circuits across all subjects. A multivariate linear regression analysis was employed to investigate the neural substrates of cognitive function and depression severity on the reward circuits in MDD patients. The common pathway underlying cognitive deficits and depression was identified with conjunction analysis. Compared with CN subjects, MDD patients showed decreased reward network connectivity that was primarily located in the prefrontal-striatal regions. Importantly, distinct and common neural pathways underlying cognition and depression were identified, implying the independent and synergistic effects of cognitive deficits and depression severity on reward circuits. This study demonstrated that disrupted topological organization within reward circuits was significantly associated with cognitive deficits and depression severity in MDD patients. These findings suggest that in addition to antidepressant treatment, normalized reward circuits should be a focus and a target for improving depression and cognitive deficits in MDD patients. (C) 2016 Elsevier Ltd. All rights reserved.