Altered ability to access a clinically relevant control network in patients remitted from major depressive disorder
Altered ability to access a clinically relevant control network in patients remitted from major depressive disorder
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DOI：
10.1002/hbm.24559
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发表时间：
2019-06-15
影响因子：
4.8
通讯作者：
Ruhe, Henricus G.
中科院分区：
文献类型：
--
作者：
Figueroa, Caroline A.;Cabral, Joana;Ruhe, Henricus G.
神经生物学模型来解释抑郁症（MDD）的脆弱性是稀缺的，以前的功能磁共振成像研究主要是检查“静态”的功能连接（FC）。了解到FC随着时间的推移不断演变，评估FC在易受新抑郁发作影响的缓解MDD患者中的动态差异变得非常重要。使用最近开发的方法来检查动态FC，我们在51例无抗抑郁药的MDD患者（复发风险高（≥ 2次既往发作））和35例健康对照者中描述了静息时再次出现的FC状态。我们研究了中性和悲伤情绪诱导后FC状态的发生、持续时间和转换特征的差异。缓解的MDD患者表现出FC状态的概率降低（p < 0.005），FC状态由连接额叶区（对认知控制很重要）与默认模式网络、纹状体和显著区（涉及情绪和自我参照处理）的广泛网络组成。即使在患者中观察到这种FC状态，其持续时间也较短（p < 0.005），并且不太可能转换为较小的前额叶-纹状体网络（p < 0.005）。悲伤情绪诱导后，患者和对照组之间的差异减少。此外，缓解患者在悲伤情绪诱导后FC状态的持续时间增加，而对照组则没有（p < 0.05）。我们的研究结果表明，缓解MDD患者，在中性情绪，访问一个临床相关的控制网络参与外部和内部导向的注意力之间的相互作用的能力降低。当从悲伤情绪中恢复时，缓解的复发性MDD似乎采用了一种补偿机制来进入这种FC状态。这项研究提供了一个新的MDD脆弱性的神经生物学概况。
Neurobiological models to explain vulnerability of major depressive disorder (MDD) are scarce and previous functional magnetic resonance imaging studies mostly examined "static" functional connectivity (FC). Knowing that FC constantly evolves over time, it becomes important to assess how FC dynamically differs in remitted-MDD patients vulnerable for new depressive episodes. Using a recently developed method to examine dynamic FC, we characterized re-emerging FC states during rest in 51 antidepressant-free MDD patients at high risk of recurrence (>= 2 previous episodes), and 35 healthy controls. We examined differences in occurrence, duration, and switching profiles of FC states after neutral and sad mood induction. Remitted MDD patients showed a decreased probability of an FC state (p < 0.005) consisting of an extensive network connecting frontal areas-important for cognitive control-with default mode network, striatum, and salience areas, involved in emotional and self-referential processing. Even when this FC state was observed in patients, it lasted shorter (p < 0.005) and was less likely to switch to a smaller prefrontal-striatum network (p < 0.005). Differences between patients and controls decreased after sad mood induction. Further, the duration of this FC state increased in remitted patients after sad mood induction but not in controls (p < 0.05). Our findings suggest reduced ability of remitted-MDD patients, in neutral mood, to access a clinically relevant control network involved in the interplay between externally and internally oriented attention. When recovering from sad mood, remitted recurrent MDD appears to employ a compensatory mechanism to access this FC state. This study provides a novel neurobiological profile of MDD vulnerability.