Attentional bias in individuals with depression and adverse childhood experiences: influence of the noradrenergic system?
Attentional bias in individuals with depression and adverse childhood experiences: influence of the noradrenergic system?
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DOI：
10.1007/s00213-021-05969-7
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发表时间：
2021-12
影响因子：
3.4
通讯作者：
Otte C
中科院分区：
文献类型：
--
作者：
Kuehl LK;Deuter CE;Nowacki J;Ueberrueck L;Wingenfeld K;Otte C
严重抑郁障碍(MDD)是一种严重的精神障碍，具有情感、认知和躯体症状。情绪一致的认知偏差，包括消极的注意偏差，对于抑郁症状的发展、维持和复发是重要的。MDD与生物应激系统的不良适应变化有关，如蓝斑-去甲肾上腺素系统中中央去甲肾上腺素能α2受体的失调，可影响包括注意力在内的认知过程。有不良童年经历(ACE)的患者，代表着早期生活中的严重压力经历，可能会受到特别大的影响。通过一项实验设计，我们的目标是进一步了解去甲肾上腺素能活动对使用和不使用ACE的MDD患者注意偏向的作用。在安慰剂对照重复测量设计中，我们测试了α2受体阻滞剂育亨宾引起的去甲肾上腺素能活动增加对注意偏向的影响。包括四组：有无血管紧张素转换酶治疗的MDD患者和有无血管紧张素转换酶治疗的健康受试者(总计N = 128人，均未服用抗抑郁药物)。MDD对悲伤面孔图片的注意偏向分数有显著影响(p = .037)，表明MDD患者(与非MDD个体相比)对悲伤面孔图片的注意加工有促进作用。然而，我们没有发现ACE的这种作用。对于笑脸图片的注意偏向，我们发现MDD和ACE没有显著的影响。尽管育亨宾后血压和唾液中α-淀粉酶的升高比安慰剂高，表明去甲肾上腺素能刺激成功，但我们发现育亨宾对快乐或悲伤面孔图片的注意偏差没有显著影响。我们的结果与MDD患者存在负注意偏向的假设是一致的。然而，由于我们没有发现ACE或育亨宾的作用，还需要进一步的研究来了解ACE增加MDD风险的机制，以及了解MDD相关负性注意偏差的生物学基础。
Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of depressive symptoms. MDD is associated with maladaptive changes in the biological stress systems such as dysregulations of central noradrenergic alpha2-receptors in the locus coeruleus-noradrenergic system, which can affect cognitive processes including attention. Patients with adverse childhood experiences (ACE), representing severe stress experiences in early life, might be particularly affected. With an experimental design, we aimed to gain further knowledge about the role of noradrenergic activity for attentional bias in MDD patients with and without ACE. We tested the effect of increased noradrenergic activity induced by the alpha2-receptor blocker yohimbine on attentional bias in a placebo-controlled repeated measures design. Four groups were included as follows: MDD patients with and without ACE, and healthy participants with and without ACE (total N = 128, all without antidepressant medication). A significant effect of MDD on attentional bias scores of sad face pictures (p = .037) indicated a facilitated attentional processing of sad face pictures in MDD patients (compared to non-MDD individuals). However, we found no such effect of ACE. For attentional bias of happy face pictures, we found no significant effects of MDD and ACE. Even though a higher increase of blood pressure and salivary alpha-amylase following yohimbine compared to placebo indicated successful noradrenergic stimulation, we found no significant effects of yohimbine on attentional bias of happy or sad face pictures. Our results are consistent with the hypothesis of a negative attentional bias in MDD patients. However, as we found no effect of ACE or yohimbine, further research is needed to understand the mechanisms by which ACE increases the risk of MDD and to understand the biological basis of the MDD-related negative attentional bias.
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