Mood-linked responses in medial prefrontal cortex predict relapse in patients with recurrent unipolar depression.
Mood-linked responses in medial prefrontal cortex predict relapse in patients with recurrent unipolar depression.
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DOI：
10.1016/j.biopsych.2011.03.009
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发表时间：
2011-08-15
影响因子：
10.6
通讯作者：
Segal ZV
中科院分区：
文献类型：
--
作者：
Farb NA;Anderson AK;Bloch RT;Segal ZV
情绪挑战后认知加工的改变与缓解的单极抑郁症患者复发风险升高有关，但对这种反应性的神经基础及其与抑郁症复发和预防的联系知之甚少。缓解的单极抑郁症参与者（n = 16）和健康对照者（n = 16）在观看悲伤和中性的电影片段时进行了功能磁共振成像（fMRI）。在18个月的随访期间，确定了缓解患者的情绪反应（对悲伤电影和中性电影的神经反应）与随后的复发状态之间的相关性。ROC分析用于确定预测复发的信号截止点。比较两组复发预后区的情绪反应。在缓解组中，内侧前额叶皮层活动（MPFC, ba32）预测复发，视觉皮层活动（ba17）是禁忌。MPFC反应性预测反刍，而视觉皮层反应性预测痛苦耐受（接受）。与对照组相比，持续缓解的抑郁症患者在MPFC和视觉皮层反应性之间表现出更明显的权衡。MPFC和视觉反应性之间的差异评分可以很好地预测抑郁复发。缓解的单极抑郁症患者对情绪刺激的内侧前额叶皮层反应是复发风险的标志，而不是成功的情绪调节。持久缓解的特征是MPFC正常化到健康对照水平。此外，视觉皮层反应性预测抑郁复发的恢复力，表明在消极情绪的处理中，感觉而非反刍认知反应性具有预防作用。
Altered cognitive processing following mood challenge is associated with elevated relapse risk in remitted unipolar depressed patients, but little is known about the neural basis of this reactivity and its link to depressive relapse and prophylaxis. Remitted unipolar depressed participants (n = 16) and healthy controls (n = 16) underwent functional magnetic resonance imaging (fMRI) while viewing sad and neutral film clips. Correlations were determined between emotional reactivity (neural responses to sad vs. neutral films) in remitted patients and subsequent relapse status over an 18 month follow-up period. An ROC analysis was used to determine signal cutoffs for predicting relapse. Emotional reactivity in relapse prognostic areas was compared between groups. Within the remitted group, relapse was predicted by medial prefrontal cortical activity (MPFC, BA 32), and contraindicated by visual cortical activity (BA 17). MPFC reactivity predicted rumination, whereas visual cortical reactivity predicted distress tolerance (acceptance). Compared to control participants, remitted depressed patients who sustained remission demonstrated a more pronounced tradeoff between MPFC and visual cortex reactivity. The difference score between MPFC and visual reactivity yielded excellent prediction of depressive relapse. Medial prefrontal cortical reactivity to mood provocation in remitted unipolar depressed patients serves as a marker of relapse risk rather than successful emotion regulation. Enduring remission is characterized by a normalization of the MPFC to the level of healthy controls. Further, visual cortex reactivity predicts resilience against depressive relapse, indicating a prophylactic role for sensory rather than ruminative cognitive reactivity in the processing of negative emotion.
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影响因子：
4.1
作者：
Lau, MA;Segal, ZV;Williams, JMG
通讯作者：
Williams, JMG
影响因子：
7.6
作者：
NOLENHOEKSEMA, S;MORROW, J
通讯作者：
MORROW, J
影响因子：
6.6
作者：
Keedwell, Paul A.;Drapier, Dominique;Phillips, Mary
通讯作者：
Phillips, Mary
影响因子：
5.9
作者：
Fresco, David M.;Segal, Zindel V.;Kennedy, Sydney
通讯作者：
Kennedy, Sydney
影响因子：
5.7
作者：
Genovese, CR;Lazar, NA;Nichols, T
通讯作者：
Nichols, T