Neural mechanisms of cognitive reappraisal in remitted major depressive disorder.
Neural mechanisms of cognitive reappraisal in remitted major depressive disorder.
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DOI：
10.1016/j.jad.2013.05.073
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发表时间：
2013-10
影响因子：
6.6
通讯作者：
Dichter, Gabriel S.
中科院分区：
文献类型：
--
作者：
Smoski, Moria J.;Keng, Shian-Ling;Schiller, Crystal Edler;Minkel, Jared;Dichter, Gabriel S.
关键词：
认知策略对负面情绪的下调依赖于前额叶皮质对边缘脑区域的调节，在情感障碍中观察到认知重评价过程中前额叶功能受损。然而，到目前为止，还没有研究检查了与症状匹配的对照组相比，未接受药物治疗的有重度抑郁症病史的健康人的认知重新评估。鉴于抑郁史是未来抑郁发作的关键危险因素，研究缓解型重度抑郁症（rMDD）情绪调节的神经机制可能会对抑郁风险产生新的见解。我们用功能性磁共振成像（fMRI）评估了37名受试者（18名rMDD， 19名对照）在对悲伤图像进行认知重新评估的任务中的表现。两组均表现出认知重评后自我报告的负面情绪减少，认知重评对情绪的影响无明显组间差异。功能性MRI结果显示，在重新评估悲伤图像时，扣带旁回（扣带前皮层吻侧，Brodmann区32）激活增加，右额叶中回（Brodmann区6）激活减少。没有收集前调节影响的逐次评分，限制了后调节负面影响评分的解释。结果表明，与预测抗抑郁药物治疗反应相关的吻侧前扣带皮层和与认知重新评估相关的右额中回的激活可能代表未来抑郁风险的内表型标记。未来的前瞻性研究将需要验证这些神经标记物的预测效用。
Down-regulation of negative emotions by cognitive strategies relies on prefrontal cortical modulation of limbic brain regions, and impaired frontolimbic functioning during cognitive reappraisal has been observed in affective disorders. However, no study to date has examined cognitive reappraisal in unmedicated euthymic individuals with a history of major depressive disorder relative to symptom-matched controls. Given that a history of depression is a critical risk factor for future depressive episodes, investigating the neural mechanisms of emotion regulation in remitted major depressive disorder (rMDD) may yield novel insights into depression risk. We assessed 37 individuals (18 rMDD, 19 controls) with functional magnetic resonance imaging (fMRI) during a task requiring cognitive reappraisal of sad images. Both groups demonstrated decreased self-reported negative affect after cognitive reappraisal and no group differences in the effects of cognitive reappraisal on mood were evident. Functional MRI results indicated greater paracingulate gyrus (rostral anterior cingulate cortex, Brodmann area 32) activation and decreased right midfrontal gyrus (Brodmann area 6) activation during the reappraisal of sad images. Trial-by-trial ratings of pre-regulation affect were not collected, limiting the interpretation of post-regulation negative affect scores. Results suggest that activation of rostral anterior cingulate cortex, a region linked to the prediction of antidepressant treatment response, and of the right midfrontal gyrus, a region involved in cognitive control in the context of cognitive reappraisal, may represent endophenotypic markers of future depression risk. Future prospective studies will be needed to validate the predictive utility of these neural markers.
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