Major depressive disorder is associated with abnormal interoceptive activity and functional connectivity in the insula.
Major depressive disorder is associated with abnormal interoceptive activity and functional connectivity in the insula.
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DOI：
10.1016/j.biopsych.2013.11.027
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发表时间：
2014-08-01
影响因子：
10.6
通讯作者：
Simmons, W. Kyle
中科院分区：
文献类型：
--
作者：
Avery, Jason A.;Drevets, Wayne C.;Moseman, Scott E.;Bodurka, Jerzy;Barcalow, Joel C.;Simmons, W. Kyle
躯体主诉和内感受性意识改变是重性抑郁症（MDD）临床表现的常见特征。近年来，越来越多的神经生物学证据表明，内皮层是内感受性意识的主要皮层结构之一。因此，内感受性的异常表现可能有助于MDD的病理生理学和病理学。我们比较了20名未服药的MDD成人和20名健康对照参与者在一项需要注意内脏内感受性感觉的任务中的fMRI血氧水平依赖性（BOLD）反应，并评估了这种BOLD反应与抑郁严重程度的关系，使用汉密尔顿抑郁评定量表（HDRS）进行评定。此外，我们还研究了静息状态功能连接的组间差异及其与抑郁严重程度HDRS评分的关系。相对于健康对照组，未用药的MDD受试者在内感受过程中双侧背侧中皮层（dmIC）以及先前参与情绪和内脏控制的脑区网络中表现出活动减少。内感受性注意任务中，抑郁症受试者的抑郁严重程度和躯体症状严重程度均与海马内回的活动呈负相关。MDD还与先前参与MDD的DMIC和边缘脑区域（包括杏仁核、膝下前额叶皮层和眶额皮层）之间的静息状态功能连接性增强相关。此外，这些区域和dmIC之间的功能连接与抑郁症的严重程度呈正相关。MDD和抑郁症的躯体症状与脑内异常的内感受性表征有关。
Somatic complaints and altered interoceptive awareness are common features in the clinical presentation of major depressive disorder (MDD). Recently, neurobiological evidence has accumulated demonstrating that the insula is one of the primary cortical structures underlying interoceptive awareness. Abnormal interoceptive representation within the insula may thus contribute to the pathophysiology and symptomatology of MDD. We compared fMRI blood oxygenation level-dependent (BOLD) responses between twenty unmedicated adults with MDD and twenty healthy control participants during a task requiring attention to visceral interoceptive sensations and also assessed the relationship of this BOLD response to depression severity, as rated using the Hamilton Depression Rating Scale (HDRS). Additionally, we examined between-group differences in insula resting-state functional connectivity, and its relationship to HDRS ratings of depression severity. Relative to the healthy controls, unmedicated MDD subjects exhibited decreased activity bilaterally in the dorsal mid-insula cortex (dmIC) during interoception, as well as within a network of brain regions implicated previously in emotion and visceral control. Activity within the insula during the interoceptive attention task was negatively correlated with both depression severity and somatic symptom severity in depressed subjects. MDD also was associated with greater resting-state functional connectivity between the dmIC and limbic brain regions implicated previously in MDD, including the amygdala, subgenual prefrontal cortex, and orbitofrontal cortex. Moreover, functional connectivity between these regions and the dmIC was positively correlated with depression severity. MDD and the somatic symptoms of depression are associated with abnormal interoceptive representation within the insula.
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影响因子：
10.6
作者：
Drevets, WC
通讯作者：
Drevets, WC
影响因子：
10.6
作者：
Greicius, Michael D.;Flores, Benjamin H.;Schatzberg, Alan F.
通讯作者：
Schatzberg, Alan F.
影响因子：
3.3
作者：
Drevets, Wayne C.;Savitz, Jonathan
通讯作者：
Savitz, Jonathan
DOI：
10.1098/rstb.1996.0125
发表时间：
1996-10-29
影响因子：
6.3
作者：
Damasio, AR
通讯作者：
Damasio, AR
影响因子：
4.1
作者：
Dunn, Barnaby D.;Dalgleish, Tim;Lawrence, Andrew D.
通讯作者：
Lawrence, Andrew D.