Early changes in neural circuit function engaged by negative emotion and modified by behavioural intervention are associated with depression and problem-solving outcomes: A report from the ENGAGE randomized controlled trial.
Early changes in neural circuit function engaged by negative emotion and modified by behavioural intervention are associated with depression and problem-solving outcomes: A report from the ENGAGE randomized controlled trial.
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DOI：
10.1016/j.ebiom.2021.103387
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发表时间：
2021-05
期刊：
影响因子：
11.1
通讯作者：
Williams LM
中科院分区：
文献类型：
--
作者：
Goldstein-Piekarski AN;Wielgosz J;Xiao L;Stetz P;Correa CG;Chang SE;Lv N;Rosas LG;Lavori PW;Snowden MB;Venditti EM;Simmons JM;Smyth JM;Suppes T;Lewis MA;Ajilore O;Ma J;Williams LM
抑郁症造成的死亡人数惊人，而同时发生的慢性疾病（如肥胖）会使其恶化。开发更有效的抑郁症干预措施，并确定客观和生物学上合理的神经机制，以了解干预结果是势在必行的。目前的研究使用功能性神经成像来确定行为干预是否改变了负影响回路，以及这些改变是否与随后症状和问题解决结果的改善有关。该研究（“ENGAGE”）是随机对照试验“RAINBOW”（ClinicalTrials.gov NCT02246413）的预先计划部分。108例肥胖抑郁症患者随机接受综合协作治疗干预（I-CARE）或常规治疗。参与者在基线和两个月（与前两个月专注于解决问题疗法的干预相一致）时，使用既定的面部情绪任务进行功能性神经成像。杏仁核、脑岛和前扣带皮层的激活使用预先计划的定义和标准化的方法提取。主要健康和行为结果分别是抑郁症状严重程度和问题解决能力，分别在基线、主要6个月结果点和12个月随访时进行评估。中介分析采用意向治疗方法。与常规护理相比，PST在两个月时减少了威胁刺激引起的杏仁核激活。这种减少以干预依赖的方式介导了随后抑郁严重程度的改善。两个月后，PST并没有改变脑岛的激活，但确实缓和了脑岛激活与解决问题能力改善之间的关系。负性情绪回路可能是肥胖症患者PST的重要神经靶点和潜在介质。美国国立卫生研究院/国家心肺和血液研究所R01 HL119453和UH2/UH3 HL132368
Depression exerts a staggering toll that is worsened with co-occurring chronic conditions such as obesity. It is imperative to develop more effective interventions for depression and to identify objective and biological plausible neural mechanisms to understand intervention outcomes. The current study uses functional neuroimaging to determine whether a behavioural intervention changes the negative affect circuit and whether these changes relate to subsequent improvements in both symptom and problem-solving outcomes in depressed patients with co-occurring obesity. This study (‘ENGAGE’) was a pre-planned element of the randomized controlled trial, ‘RAINBOW’ (ClinicalTrials.gov NCT02246413). 108 depressed patients with obesity were randomized to receive an integrated collaborative care intervention (I-CARE) or usual care. Participants underwent functional neuroimaging using an established facial emotion task at baseline and two months (coinciding with the first two months of intervention focused on problem-solving therapy (‘PST’)). Amygdala, insula and anterior cingulate cortex activation was extracted using pre-planned definitions and standardized methods. The primary health and behavioural outcomes were depression symptom severity and problem-solving ability respectively, assessed at baseline, the main 6-month outcome point and at 12-month follow up. Mediation analyses used an intent-to-treat approach. PST, relative to usual care, reduced amygdala activation engaged by threat stimuli at two months. This reduction mediated subsequent improvements in depression severity in an intervention-dependent manner. PST did not change insula activation at two months but did temper the strength of the relationship between insula activation and improvements in problem-solving ability. The negative affect circuit may be an important neural target and potential mediator of PST in patients with comorbid obesity. US National Institutes of Health/National Heart Lung and Blood Institute R01 HL119453 and UH2/UH3 HL132368
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影响因子：
4.1
作者：
Nielsen L;Riddle M;King JW;NIH Science of Behavior Change Implementation Team;Aklin WM;Chen W;Clark D;Collier E;Czajkowski S;Esposito L;Ferrer R;Green P;Hunter C;Kehl K;King R;Onken L;Simmons JM;Stoeckel L;Stoney C;Tully L;Weber W
通讯作者：
Weber W
影响因子：
7.6
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Phan, K. Luan
影响因子：
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作者：
Milaneschi, Yuri;Simmons, W Kyle;Penninx, Brenda Wjh
通讯作者：
Penninx, Brenda Wjh
影响因子：
2.2
作者：
Ma, Jun;Yank, Veronica;Blonstein, Andrea C.
通讯作者：
Blonstein, Andrea C.
影响因子：
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作者：
Fu, Cynthia H. Y.;Steiner, Herbert;Costafreda, Sergi G.
通讯作者：
Costafreda, Sergi G.