Acute neural effects of fluoxetine on emotional regulation in depressed adolescents.
Acute neural effects of fluoxetine on emotional regulation in depressed adolescents.
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DOI：
10.1017/s0033291722001805
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发表时间：
2023-07
影响因子：
6.9
通讯作者：
Harmer, Catherine J.
中科院分区：
文献类型：
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作者：
Capitao, Liliana P.;Chapman, Robert;Filippini, Nicola;Wright, Lucy;Murphy, Susannah E.;James, Anthony;Cowen, Philip J.;Harmer, Catherine J.
青少年重度抑郁症（MDD）与情绪刺激处理中断和认知重新评估困难有关。然而，目前的药物疗法如何调节这些关键过程背后的神经机制，人们知之甚少。因此，本研究调查了氟西汀对青少年抑郁症情绪反应和认知重新评估的神经影响。 31 名患有 MDD 的青少年被随机分配接受急性氟西汀（10 毫克）或安慰剂治疗。还招募了 17 名健康青少年，但出于道德原因没有接受任何治疗。在功能性磁共振成像（fMRI）过程中，参与者观看令人厌恶的图像，并被要求自然地体验所引发的情绪状态（“维持”）或重新解释图片的内容以减少负面影响（“重新评估”）。使用全脑分析确定了显着的激活。比较重新评估和维护条件时，没有发现显着的组间差异。然而，与健康对照组相比，服用安慰剂的抑郁青少年无论病情如何，对厌恶图片的视觉激活都会减少。与服用安慰剂的抑郁青少年相比，服用氟西汀的抑郁青少年组表现出相反的模式，即对厌恶图片的视觉小脑活动增加。这些数据表明，青春期的抑郁症可能与厌恶意象的视觉处理减少有关，而氟西汀可能会减少对此类线索的回避。这可能反映了抑郁青少年与以前避免的负面暗示进行接触的关键机制。尽管如此，未来的研究仍需要将功能磁共振成像与眼动追踪相结合来进一步阐明这些影响。
Adolescent major depressive disorder (MDD) is associated with disrupted processing of emotional stimuli and difficulties in cognitive reappraisal. Little is known however about how current pharmacotherapies act to modulate the neural mechanisms underlying these key processes. The current study therefore investigated the neural effects of fluoxetine on emotional reactivity and cognitive reappraisal in adolescent depression. Thirty-one adolescents with MDD were randomised to acute fluoxetine (10 mg) or placebo. Seventeen healthy adolescents were also recruited but did not receive any treatment for ethical reasons. During functional magnetic resonance imaging (fMRI), participants viewed aversive images and were asked to either experience naturally the emotional state elicited (‘Maintain’) or to reinterpret the content of the pictures to reduce negative affect (‘Reappraise’). Significant activations were identified using whole-brain analysis. No significant group differences were seen when comparing Reappraise and Maintain conditions. However, when compared to healthy controls, depressed adolescents on placebo showed reduced visual activation to aversive pictures irrespective of the condition. The depressed adolescent group on fluoxetine showed the opposite pattern, i.e. increased visuo-cerebellar activity in response to aversive pictures, when compared to depressed adolescents on placebo. These data suggest that depression in adolescence may be associated with reduced visual processing of aversive imagery and that fluoxetine may act to reduce avoidance of such cues. This could reflect a key mechanism whereby depressed adolescents engage with negative cues previously avoided. Future research combining fMRI with eye-tracking is nonetheless needed to further clarify these effects.