Differential engagement of cognitive control regions and subgenual cingulate based upon presence or absence of comorbid anxiety with depression.
Differential engagement of cognitive control regions and subgenual cingulate based upon presence or absence of comorbid anxiety with depression.
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DOI：
10.1016/j.jad.2018.07.082
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发表时间：
2018-12-01
影响因子：
6.6
通讯作者：
Langenecker SA
中科院分区：
文献类型：
--
作者：
Jenkins LM;Stange JP;Bessette KL;Chang YS;Corwin SD;Skerrett KA;Patrón VG;Zubieta JK;Crane NA;Passarotti AM;Pine DS;Langenecker SA
重度抑郁症（MDD）和焦虑症是高度共病的，共享许多相似的症状，包括认知控制障碍。认知控制缺陷可能是心境障碍患者情绪调节受损的潜在机制。参与者为44名无精神疾病史的个体（健康对照，HC），31名MDD缓解状态（rMDD）的个体，以及18名符合rMDD和缓解期焦虑障碍（共病）的终身DSM-IV-TR标准的个体。参与者在fMRI期间完成了参数Go/No-Go（PGNG）测试。事件相关分析建模活动的认知控制成功（命中目标，拒绝诱惑）和失败（委员会诱惑）的PGNG任务。rMDD组在委员会错误期间，认知控制网络（CCN）内的活动显着减少，包括额中回和顶下小叶（IPL）。共病组在正确的拒绝过程中，CCN内的几个集群的活动显著减少，包括左侧IPL和右侧额下回和大膝下扣带回。值得注意的是，在正确的拒绝过程中，共病组60%的激活在显着性和情感网络（SEN）内，在CCN内为0%。共病亚组的规模是适度的，阻止了不同AD亚型的亚组分析。有证据表明，CCN活性下降rMDD和可能有代偿SEN活动的个人与共病rMDD和焦虑。我们的研究结果支持共病焦虑作为MDD的一个有意义的亚型，可能会掩盖rMDD和HC之间的组间差异的识别。
Major depressive disorder (MDD) and anxiety disorders are highly comorbid, sharing many similar symptoms, including impairments in cognitive control. Deficits in cognitive control could be a potential mechanism underlying impaired emotion regulation in mood disorders. Participants were 44 individuals with no history of mental illness (healthy controls, HC), 31 individuals in the remitted state of MDD (rMDD), and 18 individuals who met lifetime DSM-IV-TR criteria for rMDD and an anxiety disorder in remission (Comorbid). Participants completed a Parametric Go/No-Go (PGNG) test during fMRI. Event-related analyses modeled activity for cognitive control successes (Hits for Targets, Rejections for Lures) and failures (Commissions on Lures) on the PGNG task. The rMDD group showed significantly reduced activity within the cognitive control network (CCN) during Commission errors, including the middle frontal gyrus and inferior parietal lobule (IPL). The Comorbid group showed significantly reduced activity in several clusters within the CCN during correct Rejections, including the left IPL and right inferior frontal gyrus and greater subgenual cingulate. Notably, during correct Rejections, 60% of activation for the Comorbid group was within the Salience and Emotion Network (SEN), with 0% within the CCN. The size of the Comorbid subgroup was modest, preventing subanalysis of the different AD subtypes. There is evidence that CCN activity declines in rMDD and that there may be compensatory SEN activity in individuals with Comorbid rMDD and anxiety. Our findings support the identification of comorbid anxiety as a meaningful subtype of MDD that may obscure group differences between rMDD and HCs.
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影响因子：
5.7
作者：
Jenkinson, M;Bannister, P;Smith, S
通讯作者：
Smith, S
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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