Cognitive function in depression: a distinct pattern of frontal impairment in melancholia?
Cognitive function in depression: a distinct pattern of frontal impairment in melancholia?
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DOI：
10.1017/s0033291798007788
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发表时间：
1999-01-01
影响因子：
6.9
通讯作者：
Hadzi-Pavlovic, D
中科院分区：
文献类型：
--
作者：
Austin, MP;Mitchell, P;Hadzi-Pavlovic, D
背景。尽管抑郁症患者在一系列神经心理学测试中表现出受损的表现，但很少有研究检查额叶认知缺陷或忧郁亚型和非忧郁亚型之间测试表现可能存在的差异。方法。抑郁症受试者接受了广泛的神经心理学治疗。在总体分析中，77 名抑郁症受试者与 28 名对照者进行了比较。在第二组分析中，根据 DSM-III-R、CORE 系统和纽卡斯尔量表，将抑郁样本分为忧郁型和非忧郁型子集。这些抑郁子集与对照组进行对比，并在适当的情况下使用 ANCOVA 控制年龄、智商、简单反应时间和汉密尔顿抑郁评分。结果。总体抑郁样本在大多数助记任务、简单反应时间和轨迹 B 上均受到损害。类似的发现也适用于 DSM-III-R 忧郁和非忧郁受试者。当根据 CORE 和 Newcastle（狭义的忧郁症定义）进行定义时，忧郁症患者在 WCST（持续反应）和（对于 Newcastle）数字符号替换方面也受到损害。相比之下，CORE 和纽卡斯尔定义的非忧郁症患者的认知表现基本上没有受到损害。结论。使用狭义的忧郁症定义，即 CORE 和（特别是）Newcastle，忧郁症患者的记忆任务、选择性注意任务和定势转换受到损害，而非忧郁症受试者的认知表现基本上没有受到损害。这些差异可能是由于狭义的忧郁症患者的特定神经解剖区域受损，特别是前扣带回。
Background. Although depressed patients demonstrate impaired performance on a range of neuropsychological tests, there is little research that examines either frontal cognitive deficits or possible differences in test performance between melancholic and non-melancholic subtypes.Methods. Depressed subjects were administered a broad neuropsychological battery. In an overall analysis, 77 depressed subjects were compared with 28 controls. In a second set of analyses, the depressed sample was divided into melancholic and non-melancholic subsets according to DSM-III-R, the CORE system and the Newcastle scale. These depressed subsets were contrasted to controls and with each other using ANCOVA controlling for age, IQ, simple reaction time and Hamilton Depression scores where appropriate.Results. The total depressed sample was impaird on most mnemonic tasks, simple reaction time and Trails B. Similar findings applied to DSM-III-R melancholic and non-melancholic subjects. When defined by the CORE and Newcastle (narrower definitions of melancholia), melancholic patients were additionally impaired on WCST (perseverative response) and (for Newcastle) digit symbol substitution. In contrast, the cognitive performance of the CORE and Newcastle-defined non-melancholic patients was largely unimpaired.Conclusions. Using narrower definitions of melancholia, i.e. CORE and (in particular) Newcastle, melancholic patients were impaired on mnemonic tasks and tasks of selective attention, and set-shifting while non-melancholic subjects were largely unimpaired in their cognitive performance. These differences may be due to impairment of specific neuroanatomical regions in narrowly defined melancholic patients, in particular the anterior cingulate.