背景:对恐惧过程失调的威胁的敏感性被认为有助于焦虑症和重度抑郁症(MDD)的发展。然而,研究MDD中的恐惧处理的研究少于焦虑症。ThecurrentstudyusedpropensitymatchingtoexaminedthehypothesisthatcoordbidMDDandanxety(AnxMDD)showsgreaterneuralcorrelatesoffearprocessingthanMDD,这表明AnxMDD的共同出现是通过夸大的防御相关过程来举例说明的。
方法:从社区招募了195名MDD(N=65)或AnxMDD(N=130)患者,并完成了多层次评估,包括功能成像期间的巴甫洛夫恐惧学习任务。将与威胁配对的视觉图像(条件刺激:CS)与未与威胁配对的刺激(CS-)进行比较。
结果:MDD和AnxMDD在背侧前岛/下额回中显示CS与CS-的激活模式显着不同(部分eta平方;ηp2=0.02),背外侧前额叶皮质(ηp2=0.01)和背侧前/中扣带皮质(ηp2=0.01)。这些差异是由AnxMDD与MDD中CS+的更大激活驱动的。
结论:限制包括横截面设计,作为AnxMDD参与者,美国尖叫而不是震惊,MDD人数的一半。
结论:AnxMDD在确定为恐惧加工的区域显示出激活增加的模式。效果一直是由威胁驱动的,进一步建议恐惧信号作为紧急目标过程。与显著性处理相关的区域出现了差异,注意力取向/冲突,焦虑和抑郁并存的自我相关处理和执行功能,从而突出了这一流行和治疗耐药组的潜在治疗目标。
BACKGROUND: Dysregulation of fear processing through altered sensitivity to
threat is thought to contribute to the development of anxiety disorders and major depressive disorder (MDD). However, fewer studies have examined fear processing in MDD than in anxiety disorders. The current study used propensity matching to examine the hypothesis that comorbid MDD and anxiety (AnxMDD) shows greater neural correlates of fear processing than MDD, suggesting that the co-occurrence of AnxMDD is exemplified by exaggerated defense related processes.
METHODS: 195 individuals with MDD (N = 65) or AnxMDD (N = 130) were recruited from the community and completed multi-level assessments, including a Pavlovian fear learning task during functional imaging. Visual images paired with
threat (conditioned stimuli: CS+) were compared to stimuli not paired with
threat (CS-).
RESULTS: MDD and AnxMDD showed significantly different patterns of activation for CS+ vs CS- in the dorsal anterior insula/inferior frontal gyrus (partial eta squared; ηp2 = 0.02), dorsolateral prefrontal cortex (ηp2 = 0.01) and dorsal anterior/mid cingulate cortex (ηp2 = 0.01). These differences were driven by greater activation to the CS+ in AnxMDD versus MDD.
CONCLUSIONS: Limitations include the cross-sectional design, a scream US rather than shock and half the number of MDD as AnxMDD participants.
CONCLUSIONS: AnxMDD showed a pattern of increased activation in regions identified with fear processing. Effects were consistently driven by
threat, further suggesting fear signaling as the emergent target process. Differences emerged in regions associated with salience processing, attentional orienting/conflict, self-relevant processing and executive functioning in comorbid anxiety and depression, thereby highlighting potential treatment targets for this prevalent and treatment resistant group.