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Abstract：
Despite tremendous advances in characterizing human neural circuits that govern emotional and cognitive functions impaired in depression and anxiety, we lack a circuit-based taxonomy for depression and anxiety that captures transdiagnostic heterogeneity and informs clinical decision making.
We developed and tested a novel system for quantifying 6 brain circuits reproducibly and at the individual patient level. We implemented standardized circuit definitions relative to a healthy reference sample and algorithms to generate circuit clinical scores for the overall circuit and its constituent regions.
In new data from primary and generalizability samples of depression and anxiety (N = 250), we demonstrated that overall disconnections within task-free salience and default mode circuits map onto symptoms of anxious avoidance, loss of pleasure, threat dysregulation, and negative emotional biases-core characteristics that transcend diagnoses-and poorer daily function. Regional dysfunctions within task-evoked cognitive control and affective circuits may implicate symptoms of cognitive and valence-congruent emotional functions. Circuit dysfunction scores also distinguished response to antidepressant and behavioral intervention treatments in an independent sample (n = 205).
Our findings articulate circuit dimensions that relate to transdiagnostic symptoms across mood and anxiety disorders. Our novel system offers a foundation for deploying standardized circuit assessments across research groups, trials, and clinics to advance more precise classifications and treatment targets for psychiatry.
We developed and tested a novel system for quantifying 6 brain circuits reproducibly and at the individual patient level. We implemented standardized circuit definitions relative to a healthy reference sample and algorithms to generate circuit clinical scores for the overall circuit and its constituent regions.
In new data from primary and generalizability samples of depression and anxiety (N = 250), we demonstrated that overall disconnections within task-free salience and default mode circuits map onto symptoms of anxious avoidance, loss of pleasure, threat dysregulation, and negative emotional biases-core characteristics that transcend diagnoses-and poorer daily function. Regional dysfunctions within task-evoked cognitive control and affective circuits may implicate symptoms of cognitive and valence-congruent emotional functions. Circuit dysfunction scores also distinguished response to antidepressant and behavioral intervention treatments in an independent sample (n = 205).
Our findings articulate circuit dimensions that relate to transdiagnostic symptoms across mood and anxiety disorders. Our novel system offers a foundation for deploying standardized circuit assessments across research groups, trials, and clinics to advance more precise classifications and treatment targets for psychiatry.
摘要：
尽管在表征控制抑郁和焦虑受损的情绪和认知功能的人类神经回路方面取得了巨大进展，我们缺乏一种基于回路的抑郁和焦虑分类法,该分类法能够捕获诊断异质性并为临床决策提供信息.
我们开发并测试了一种新颖的系统，用于可重复地和在个体患者水平上量化6个大脑回路。我们实施了相对于健康参考样本和算法的标准化电路定义,以生成整个电路及其组成区域的电路临床评分。
在来自抑郁和焦虑的主要和可推广性样本的新数据中（N=250），我们证明了无任务显著性和默认模式电路中的整体断开映射到焦虑回避的症状，失去快乐，威胁失调,和负面情绪偏差-超越诊断的核心特征-以及较差的日常功能。任务诱发的认知控制和情感回路中的区域功能障碍可能暗示认知和效价一致的情绪功能的症状。回路功能障碍评分还在独立样本中区分对抗抑郁药和行为干预治疗的反应(n=205)。
我们的发现阐明了与情绪和焦虑症的综合诊断症状有关的回路尺寸。我们新颖的系统为跨研究小组部署标准化电路评估提供了基础，试验,和诊所推进更精确的精神病学分类和治疗目标。
我们开发并测试了一种新颖的系统，用于可重复地和在个体患者水平上量化6个大脑回路。我们实施了相对于健康参考样本和算法的标准化电路定义,以生成整个电路及其组成区域的电路临床评分。
在来自抑郁和焦虑的主要和可推广性样本的新数据中（N=250），我们证明了无任务显著性和默认模式电路中的整体断开映射到焦虑回避的症状，失去快乐，威胁失调,和负面情绪偏差-超越诊断的核心特征-以及较差的日常功能。任务诱发的认知控制和情感回路中的区域功能障碍可能暗示认知和效价一致的情绪功能的症状。回路功能障碍评分还在独立样本中区分对抗抑郁药和行为干预治疗的反应(n=205)。
我们的发现阐明了与情绪和焦虑症的综合诊断症状有关的回路尺寸。我们新颖的系统为跨研究小组部署标准化电路评估提供了基础，试验,和诊所推进更精确的精神病学分类和治疗目标。
