Blunted amygdala activity is associated with depression severity in treatment-resistant depression.
Blunted amygdala activity is associated with depression severity in treatment-resistant depression.
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DOI：
10.3758/s13415-017-0544-6
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Mathalon DH
中科院分区：
文献类型：
--
作者：
Ferri J;Eisendrath SJ;Fryer SL;Gillung E;Roach BJ;Mathalon DH
高达50%的重度抑郁症（MDD）患者在两次抗抑郁药物试验后没有恢复，因此符合难治性抑郁症（TRD）的标准。基于正念的认知疗法（MBCT）是一种很有前途的治疗方法，但MBCT相对于基线神经激活对临床结果的影响程度仍然未知。本研究调查了TRD患者和健康对照（HC）之间杏仁核激活的基线差异，将杏仁核激活与抑郁症状相关，并检查了MBCT和杏仁核激活对纵向抑郁结局的影响。在基线时，TRD患者（n = 80）和HC（n = 37）参与了功能性磁共振成像任务，其中他们识别面孔的情感（情感标签）、面孔的性别（性别标签）或被动观看的面孔（观察）。然后，TRD参与者完成了为期8周的MBCT或健康增强计划（HEP）。相对于HC，TRD患者在情感标签期间表现出较少的杏仁核激活，在性别标签期间也略少。TRD患者在情感标记过程中杏仁核激活迟钝与抑郁严重程度相关。MBCT与治疗后直接进行HEP相比，抑郁症的减少程度更大，然而，在52周时，治疗效果并不显著，两组中任务条件下的基线杏仁核激活可预测抑郁症的严重程度。TRD患者在情感标记过程中杏仁核反应迟钝，这与更大的并发抑郁症有关。此外，虽然MBCT产生更大的短期改善抑郁症比HEP，总的基线杏仁核反应是预测长期的临床结果在两组。
Up to 50% of individuals with major depressive disorder (MDD) do not recover after two antidepressant medication trials and therefore meet criteria for treatment-resistant depression (TRD). Mindfulness based cognitive therapy (MBCT) is one promising treatment, however the extent to which MBCT influences clinical outcomes relative to baseline neural activation remains unknown. The current study investigated baseline differences in amygdala activation between TRD patients and healthy controls (HCs), related amygdala activation to depression symptoms, and examined the impact of MBCT and amygdala activation on longitudinal depression outcomes. At baseline, TRD patients (n = 80) and HCs (n = 37) participated in a functional magnetic resonance imaging task where they identified the emotion of faces (affect labeling), gender of faces (gender labeling), or passively viewed faces (observing). TRD participants then completed 8 weeks of MBCT or a Health Enhancement Program (HEP). Relative to HCs, TRD patients demonstrated less amygdala activation during affect labeling, and marginally less during gender labeling. Blunted amygdala activation in TRD patients during affect labeling was associated with greater depression severity. MBCT was associated with greater depression reductions than HEP directly following treatment, however, at 52 weeks, the treatment effect was not significant and baseline amygdala activation across task conditions predicted depression severity in both groups. TRD patients have blunted amygdala responses during affect labeling that are associated with greater concurrent depression. Furthermore, while MBCT produced greater short term improvements in depression than HEP, overall baseline amygdala reactivity was predictive of long term clinical outcomes in both groups.
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影响因子：
6.6
作者：
Delaveau, Pauline;Jabourian, Maritza;Fossati, Philippe
通讯作者：
Fossati, Philippe
影响因子：
1.7
作者：
Beauregard, Mario;Paquette, Vincent;Levesque, Johanne
通讯作者：
Levesque, Johanne
DOI：
10.1176/appi.ajp.2009.09010043
发表时间：
2010-01
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Brotman MA;Rich BA;Guyer AE;Lunsford JR;Horsey SE;Reising MM;Thomas LA;Fromm SJ;Towbin K;Pine DS;Leibenluft E
通讯作者：
Leibenluft E
影响因子：
34.7
作者：
DeRubeis, Robert J.;Siegle, Greg J.;Hollon, Steven D.
通讯作者：
Hollon, Steven D.
影响因子：
2.6
作者：
Habel, Ute;Windischberger, Christian;Moser, Ewald
通讯作者：
Moser, Ewald