Remitted major depression is characterized by reduced prefrontal cortex reactivity to reward loss.
Remitted major depression is characterized by reduced prefrontal cortex reactivity to reward loss.
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DOI：
10.1016/j.jad.2013.06.016
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发表时间：
2013-11
影响因子：
6.6
通讯作者：
Dichter, Gabriel S.
中科院分区：
文献类型：
--
作者：
Schiller, Crystal Edler;Minkel, Jared;Smoski, Moria J.;Dichter, Gabriel S.
重性抑郁症（MDD）的特征是快感缺乏。虽然越来越多的文献将MDD中的快感缺失与奖励获得期间额纹状体活动减少联系起来，但相对较少的研究检查了对损失的神经反应，并且迄今为止还没有研究检查有MDD病史的正常人对损失的神经反应。一个功能磁共振成像货币奖励延迟任务管理19名参与者缓解抑郁症（rMDD）和19从未抑郁的控制。分析研究了在金钱损失预期和结果过程中大脑奖励回路的组激活差异。次要分析检查了rMDD组自我报告的反刍和大脑激活之间的关联。与对照组相比，rMDD组在损失预期期间显示较少的上级额回激活，并且在损失结果期间较少的额下回和上级额回激活（聚类校正p <0.05）。在rMDD组中，在丢失结局期间，反刍反应量表评分与上级额回激活呈负相关（r=-0.68，p= 0.001）。局限性：需要用更大的样本进行复制。有抑郁症病史的正常人在预期损失和结果时表现出前额叶皮质的低激活，并且上级额回低激活的程度与反刍有关。前额叶皮层对损失的异常反应可能反映了对MDD的一种特质样脆弱性，尽管需要未来的研究来评估这种功能性神经内表型作为前瞻性风险标志物的效用。
Major depression (MDD) is characterized by anhedonia. Although a growing body of literature has linked anhedonia in MDD to reduced frontostriatal activity during reward gains, relatively few studies have examined neural responsivity to loss, and no studies to date have examined neural responses to loss in euthymic individuals with a history of MDD. An fMRI monetary incentive delay task was administered to 19 participants with remitted MDD (rMDD) and 19 never depressed controls. Analyses examined group activation differences in brain reward circuitry during monetary loss anticipation and outcomes. Secondary analyses examined the association between self-reported rumination and brain activation in the rMDD group. Compared to controls, the rMDD group showed less superior frontal gyrus activation during loss anticipation and less inferior and superior frontal gyri activation during loss outcomes (cluster corrected p’s<.05). Ruminative Responses Scale scores were negatively correlated with superior frontal gyrus activation (r=−.68, p=.001) during loss outcomes in the rMDD group. Limitations: Replication with a larger sample is needed. Euthymic individuals with a history of MDD showed prefrontal cortex hypoactivation during loss anticipation and outcomes, and the degree of superior frontal gyrus hypoactivation was associated with rumination. Abnormal prefrontal cortex responses to loss may reflect a trait-like vulnerability to MDD, although future research is needed to evaluate the utility of this functional neural endophenotype as a prospective risk marker.
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