PDF(Pubmed)
Abstract：
Abnormalities within the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system have been implicated in depression. Studies have reported glucocorticoid insensitivity and reduced heart rate variability (HRV) in depressive disorders. However, little is known about the effects of cortisol on HRV and resting-state functional connectivity (rsFC) of the central autonomic network (CAN) in depression. We collected resting-state fMRI and cardiac data for women with different depression histories (n = 61) after administration of cortisol and placebo using a double-blind crossover design. We computed rsFC for R-amygdala and L-amygdala seeds and assessed the change in HRV after cortisol (cortisol-placebo). Analyses examined the effects of acute cortisol administration on HRV and rsFC of the R-amygdala and L-amygdala. There was a significant interaction between HRV and treatment for rsFC between the amygdala and CAN regions. We found lower rsFC between the L-amygdala and putamen for those with a greater decrease in HRV after cortisol. There was also reduced rsFC between the R-amygdala and dorsomedial prefrontal cortex, putamen, middle cingulate cortex, insula, and cerebellum in those with lower HRV after cortisol. These results remained significant after adjusting for depression symptoms, age, and race. Our findings suggest that the effect of cortisol on CAN connectivity is related to its effects on HRV. Overall, these results could inform transdiagnostic interventions targeting HRV and the stress response systems across clinical and non-clinical populations.
摘要：
下丘脑-垂体-肾上腺（HPA）轴和自主神经系统内的异常与抑郁症有关。研究报道了糖皮质激素不敏感和抑郁症患者心率变异性（HRV）降低。然而,关于皮质醇对抑郁症患者的HRV和中枢自主神经网络（CAN）的静息状态功能连通性（rsFC）的影响知之甚少。我们使用双盲交叉设计，在给予皮质醇和安慰剂后，收集了具有不同抑郁史的女性（n=61）的静息状态fMRI和心脏数据。我们计算了R-杏仁核和L-杏仁核种子的rsFC，并评估了皮质醇（皮质醇安慰剂）后HRV的变化。分析了急性皮质醇给药对R-杏仁核和L-杏仁核的HRV和rsFC的影响。杏仁核和CAN区域之间的HRV和rsFC治疗之间存在显着的相互作用。我们发现，皮质醇后HRV下降幅度较大的人，L-杏仁核和壳核之间的rsFC较低。R-杏仁核和背内侧前额叶皮层之间的rsFC也降低，壳核,中扣带皮质，脑岛,皮质醇后HRV较低的患者和小脑。在调整了抑郁症状之后，这些结果仍然很重要，年龄,和种族。我们的发现表明，皮质醇对CAN连接的影响与其对HRV的影响有关。总的来说,这些结果可以为临床和非临床人群提供针对HRV和应激反应系统的跨诊断干预措施.
