Neural responses to sad facial expressions in major depression following cognitive behavioral therapy
Neural responses to sad facial expressions in major depression following cognitive behavioral therapy
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DOI：
10.1016/j.biopsych.2008.04.033
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发表时间：
2008-09-15
影响因子：
10.6
通讯作者：
Murray, Robin M.
中科院分区：
文献类型：
--
作者：
Fu, Cynthia H. Y.;Williams, Steven C. R.;Murray, Robin M.
背景：情感面部处理是人际关系的重要组成部分。在使用抗抑郁药物治疗后对神经基质进行了检查，但未在心理治疗后进行了检查。本研究调查了认知行为疗法（CBT）抑郁症治疗前和治疗后悲伤面部表情内隐加工的神经相关性。方法：患者组由 16 名未接受药物治疗且经 DSM-IV 诊断为急性单相重度抑郁症的受试者（平均年龄 40 岁）组成，对照组为 16 名匹配的健康志愿者。受试者在第 0 周和第 16 周参加了一项功能性磁共振成像 (fMRI) 前瞻性研究。在 fMRI 扫描期间，受试者通过面部刺激进行情感识别任务，以显示不同强度的悲伤。患者接受了 16 次 CBT。分析功能性磁共振成像数据，了解面部情感处理的不同强度（负荷反应）的平均激活和差异反应。结果：在急性抑郁发作期间，患者的杏仁核-海马活动相对于健康个体有所升高。患者的基线背侧前扣带回活动与随后的临床反应显着相关。结论：这些数据为抑郁症患者杏仁核活动升高提供了进一步的支持，并表明前扣带回活动可能是药物治疗和 CBT 治疗反应的预测因子。
Background: Affective facial processing is an important component of interpersonal relationships. The neural substrate has been examined following treatment with antidepressant medication but not with psychological therapies. The present study investigated the neural correlates of implicit processing of sad facial expressions in depression pretreatment and posttreatment with cognitive behavioral therapy (CBT).Methods: The patient group consisted of 16 medication-free subjects (mean age 40 years) with a DSM-IV diagnosis of acute unipolar major depression, and the comparison group were 16 matched healthy volunteers. Subjects participated in a prospective study with functional magnetic resonance imaging (fMRI) at weeks 0 and 16. During the fMRI scans, subjects performed an affect recognition task with facial stimuli morphed to display varying intensities of sadness. Patients received 16 sessions of CBT. Functional magnetic resonance imaging data were analyzed for the mean activation and differential response to variable intensity (load-response) of facial affect processing.Results: During an acute depressive episode, patients showed elevated amygdala-hippocampal activity relative to healthy individuals. Baseline dorsal anterior cingulate activity in patients showed a significant relationship with subsequent clinical response.Conclusions: These data provide further support for elevated amygdala activity in depression and suggest that anterior cingulate activity may be a predictor of treatment response to both pharmacotherapy and CBT.