COGNITION-CHILDHOOD MALTREATMENT INTERACTIONS IN THE PREDICTION OF ANTIDEPRESSANT OUTCOMES IN MAJOR DEPRESSIVE DISORDER PATIENTS: RESULTS FROM THE iSPOT-D TRIAL.
COGNITION-CHILDHOOD MALTREATMENT INTERACTIONS IN THE PREDICTION OF ANTIDEPRESSANT OUTCOMES IN MAJOR DEPRESSIVE DISORDER PATIENTS: RESULTS FROM THE iSPOT-D TRIAL.
复制标题
认知-童年虐待治疗相互作用在预测重度抑郁症患者抗抑郁药效果中的作用：iSPOT-D 试验的结果。
DOI：
10.1002/da.22368
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发表时间：
2015
影响因子：
7.4
通讯作者：
Etkin,Amit
中科院分区：
文献类型：
--
作者：
Miller,Shefali;McTeague,LisaM;Gyurak,Anett;Patenaude,Brian;Williams,LeanneM;Grieve,StuartM;Korgaonkar,MayureshS;Etkin,Amit
背景童年期虐待（CM）史与重度抑郁症（MDD）的不良治疗反应有关，但这种关系的机制尚不清楚。执行认知的神经回路功能障碍是CM的神经生物学后果，可能对不良临床结局有重要影响。我们使用行为和神经影像学措施的执行功能，以评估他们的贡献之间的关系CM和抗抑郁药反应在MDD patients. MethodsNine-8无药物的MDD门诊患者参与国际研究预测抑郁症的最佳治疗进行了评估，在基线上的行为神经认知措施和功能磁共振成像任务探测工作记忆（连续执行任务，CPT）和抑制（Go/No-go）。77例患者完成了8周的抗抑郁治疗。基线行为和神经影像学措施进行了评估CM（历史的儿童身体，性，和/或情感虐待）和治疗后抑郁outcomes.ResultsPatients with maltreatment showed decreased modulation of right dorsolateral prefrontal cortex（DLPFC）activity during working memory updating on the CPT，and a corresponding impairment in CPT behavior performance outside the scanner.在抑制的Go/No-go测试中，未发现成像或行为的组间差异。更大的DLPFC活动在CPT显着预测治疗后症状改善的患者没有虐待，而DLPFC活动和症状变化之间的关系是不显着的，在相反的方向，在patients with maltreatment.ConclusionsThe影响CM对前额叶电路参与执行功能是一个潜在的预测抗抑郁药的结果。
BackgroundChildhood maltreatment (CM) history has been associated with poor treatment response in major depressive disorder (MDD), but the mechanisms underlying this relationship remain opaque. Dysfunction in the neural circuits for executive cognition is a putative neurobiological consequence of CM that may contribute importantly to adverse clinical outcomes. We used behavioral and neuroimaging measures of executive functioning to assess their contribution to the relationship between CM and antidepressant response in MDD patients.MethodsNinety eight medication‐free MDD outpatients participating in the International Study to Predict Optimized Treatment in Depression were assessed at baseline on behavioral neurocognitive measures and functional magnetic resonance imaging during tasks probing working memory (continuous performance task, CPT) and inhibition (Go/No‐go). Seventy seven patients completed 8 weeks of antidepressant treatment. Baseline behavioral and neuroimaging measures were assessed in relation to CM (history of childhood physical, sexual, and/or emotional abuse) and posttreatment depression outcomes.ResultsPatients with maltreatment exhibited decreased modulation of right dorsolateral prefrontal cortex (DLPFC) activity during working memory updating on the CPT, and a corresponding impairment in CPT behavioral performance outside the scanner. No between‐group differences were found for imaging or behavior on the Go/No‐go test of inhibition. Greater DLPFC activity during CPT significantly predicted posttreatment symptom improvement in patients without maltreatment, whereas the relationship between DLPFC activity and symptom change was nonsignificant, and in the opposite direction, in patients with maltreatment.ConclusionsThe effect of CM on prefrontal circuitry involved in executive function is a potential predictor of antidepressant outcomes.