Biological Psychiatry-Cognitive Neuroscience and Neuroimaging最新文献

Associations of Child Amygdala Development With Borderline Personality Symptoms During Adolescence 儿童杏仁核发育与青春期边缘性人格症状的关系

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.01.010

Anna Constantino-Pettit , Kirsten Gilbert , Kiran Boone , Katherine Luking , Benjamin Geselowitz , Rebecca Tillman , Diana Whalen , Joan Luby , Deanna M. Barch , Alecia Vogel

Background

The current understanding of the neural correlates of borderline personality disorder (BPD) is limited, but some evidence suggests that alterations in limbic structures play a role in adult BPD. The developmental course of structural neural differences in BPD is unknown. Whether there is specificity for structural alterations in BPD compared to other psychiatric presentations, such as major depressive disorder (MDD), remains unexplored. In the current study, we examined childhood trajectories of 2 limbic regions that have been implicated in BPD, hippocampal and amygdala volume, as they relate to adolescent BPD symptoms compared to MDD symptoms.

Methods

Participants (n = 175; 85 [48.6%] female) were from a 17-year longitudinal study of preschool depression. Participants completed up to 5 magnetic resonance imaging scans from late childhood through adolescence. General linear models were used to examine the relationship between gray matter volume intercepts/slopes and BPD symptoms to understand the influence of the developmental trajectory of brain regions on BPD. Separate models were used to examine the relationship between MDD symptoms and volume intercepts to assess diagnostic specificity.

Results

Lower childhood amygdala volume (intercept; age 13 centered) across scans was associated with higher adolescent BPD symptoms (β = −0.25, adjusted p = .015). There was no relationship between the slope of amygdala volume and BPD symptoms. There was no relationship between hippocampal volume and BPD or any relationship between amygdala or hippocampal volume and MDD symptoms during adolescence.

Conclusions

Our findings add evidence that supports the role of alterations in amygdala structure in BPD development. Decreased amygdala volume as early as age 13 may be an early indicator of the development of BPD during adolescence.

背景：人们对边缘型人格障碍（BPD）的神经相关性了解有限，但边缘结构的改变在成人 BPD 中起着一定的作用。BPD 神经结构差异的发展过程尚不清楚。与重度抑郁障碍（MDD）等其他精神疾病相比，BPD 的结构改变是否具有特异性，目前仍未探明。本研究考察了与 BPD 有关的两个边缘区域--海马和杏仁核体积--的童年轨迹，因为与 MDD 症状相比，它们与青少年 BPD 症状有关：参与者（人数=175；85 [48.6%]为女性）来自一项为期17年的学龄前抑郁症纵向研究。参与者从童年晚期到青春期完成了多达 5 次磁共振成像扫描。一般线性模型评估了灰质体积截距/斜率与 BPD 症状之间的关系，以了解大脑区域的发育轨迹对 BPD 的影响。不同的模型评估了 MDD 症状与体积截距之间的关系，以评估诊断特异性：结果：扫描中儿童期杏仁核体积较小（截距；年龄以 13 岁为中心）与青少年期 BPD 症状较高有关（β=-0.25，adj. p=.015）。杏仁核体积斜率与 BPD 症状之间没有关系。海马体积与BPD之间没有关系，杏仁核或海马体积与青少年MDD症状之间也没有关系：我们的研究结果为杏仁核结构的改变在BPD发展中的作用提供了新的证据。13岁时杏仁核体积的减少可能是青春期BPD发展的早期指标。

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引用次数: 0

Altered Dynamic Network Stability in Remitted Late-Life Depression Associated With Depression Recurrence 改变动态网络稳定性与抑郁症复发相关的晚期抑郁缓解。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.08.013

Damek Homiack , Brian Boyd , Aifeng Zhang , J. Patrick Begnoche , Meryl Butters , Carmen Andreescu , Warren D. Taylor , Olusola Ajilore

Background

Late-life depression (LLD) is associated with negative outcomes including high rates of recurrence and cognitive decline. However, the neurobiological changes influencing such outcomes in LLD are not well understood. Disequilibrium in large-scale brain networks may contribute to LLD-related cognitive decline.

Methods

Never-depressed older adults and participants in early remission from LLD were recruited as part of the REMBRANDT study. At study entry, participants completed a resting-state functional magnetic resonance imaging scan and neuropsychological testing and were subsequently monitored over 2 years for depression recurrence. Using a previously described algorithm, recurring whole-brain states of spatial coactivation were identified by k-means consensus clustering. Co-occurring network state properties from never-depressed participants (n = 40) were then compared with participants with LLD who remained in remission (n = 50) or experienced depression recurrence (n = 33).

Results

A 3-network solution overlapping anatomically with the default mode network, cognitive control network, and anterior salience network best explained recurring network states. Compared with never-depressed older adults, participants who remitted from LLD exhibited decreased network resilience and altered transitions between networks. The stability of specific networks was associated with baseline clinical and neuropsychological markers in never-depressed participants and participants in sustained remission but was blunted for participants who experienced depression recurrence.

Conclusions

Collectively, these data suggest that LLD alters dynamic network stability, with effects that last into remission. Furthermore, the stability of specific network states is associated with clinical and neuropsychological markers that may predict the likelihood of a recurrent episode of LLD.

背景：老年抑郁症（LLD）与包括高复发率和认知能力下降在内的负面结果相关。然而，影响LLD这种结果的神经生物学变化尚不清楚。大尺度脑网络的不平衡可能导致与低密度相关的认知能力下降。方法：从未抑郁的老年人和LLD早期缓解的参与者被招募为伦勃朗研究的一部分。在研究开始时，参与者完成了静息状态fMRI扫描和神经心理测试，并随后监测了两年多的抑郁症复发情况。使用先前描述的算法，通过k-means共识聚类识别反复出现的全脑空间共激活状态。然后将从未抑郁的参与者（n = 40）的共同发生的网络状态属性与持续缓解的LLD参与者（n = 50）或经历抑郁复发的LLD参与者（n = 33）进行比较。结果：与默认模式网络、认知控制网络和前显性网络在解剖学上重叠的三网络解决方案最好地解释了反复出现的网络状态。与从未抑郁的老年人相比，从LLD中解脱出来的参与者表现出较低的网络弹性和网络之间转换的改变。在从未抑郁和持续缓解的参与者中，特定网络的稳定性与基线临床和神经心理学标志物相关，但在经历抑郁复发的参与者中则变得迟钝。结论：总的来说，这些数据表明LLD改变了持续到缓解期的动态网络稳定性。此外，特定网络状态的稳定性与临床和神经心理学标志物有关，这些标志物可以预测LLD复发的可能性。

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引用次数: 0

Craving Induction and Treatment Response in Transcranial Magnetic Stimulation for Tobacco Use Disorder 经颅磁刺激治疗烟草使用障碍的渴望诱导和治疗反应。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.10.004

Dhvani D. Mehta , Matthew E. Sloan , Alexandra Sas , Clara Freeman , Tony P. George , Peter Selby , Laurie Zawertailo , Abraham Zangen , Daniel M. Blumberger , Bernard Le Foll , Scott Veldhuizen , Victor M. Tang

Background

Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for several mental health conditions including substance use disorders. Symptom provocation before rTMS is hypothesized to activate disease-related neurocircuitry and enhance treatment effects. For addiction, craving induction is frequently used before treatment, but its clinical utility requires further exploration. To assess whether craving induction enhances treatment outcomes, we analyzed data from the pivotal multisite trial of deep TMS (DTMS) for tobacco use disorder (TUD).

Methods

A total of 262 participants were randomized to 6 weeks of active or sham DTMS and instructed to set a quit date within the first 2 weeks. Craving was assessed using a 10-point visual analog scale before and after craving induction across 18 treatment sessions. Mixed-effects models tested whether craving induction increased craving across sessions and whether its magnitude predicted end-of-trial 4-week continuous quit rate (4W-CQR).

Results

Craving induction produced small but significant increases in craving (b = 0.34, 95% CI 0.18 to 0.50, p < .05) without evidence of habituation across sessions (b = −0.01, 95% CI −0.02 to 0.50, p = .38). Change in craving after cue induction did not significantly predict end-of-trial 4W-CQR, and there was no interaction with study arm (p = .95).

Conclusions

Craving induction reliably increased craving, although the magnitude of cue-induced craving was not associated with end-of-trial smoking cessation. This finding suggests that greater craving induction does not predict greater therapeutic effect of rTMS. Further research is needed to understand the mechanisms and clinical implications of rTMS and brain state in TUD, including potential improvements in related domains such as inhibitory control.

背景：重复经颅磁刺激（rTMS）是一种新兴的治疗几种精神健康状况，包括物质使用障碍。在rTMS之前的症状激发被假设激活疾病相关的神经回路并增强治疗效果。对于成瘾，渴望诱导常用于治疗前，但其临床应用有待进一步探索。为了评估渴望诱导是否能提高治疗效果，我们分析了来自深度经颅磁刺激（dTMS）治疗烟草使用障碍（TUD）的关键多位点试验的数据。方法：262名参与者被随机分为6周的活动或假dTMS，并被指示在前2周内设定戒烟日期。在18个疗程中，使用10分视觉模拟量表（VAS）评估渴望诱导前和后。混合效应模型测试了渴望诱导是否会增加整个疗程的渴望，以及它的大小是否预测了试验结束后4周的持续戒烟率（4W-CQR）。结果：渴望诱导产生了少量但显著的渴望增加（b=0.34, 95% CI 0.18至0.50）；结论：渴望诱导确实增加了渴望，尽管线索诱导的渴望程度与试验结束戒烟无关。这一发现表明，更大的渴望诱导并不预示着rTMS更大的治疗效果。rTMS与脑状态在TUD中的作用机制和临床意义有待进一步研究，包括在抑制控制等相关领域的潜在改进。

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引用次数: 0

Editorial Board Page 编委会页面

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/S2451-9022(26)00007-8

引用次数: 0

Magnetic Resonance Imaging–Derived Markers of Acute and Chronic Inflammatory Processes in the Ventral Tegmental Area Associated With Depression 与抑郁症相关的VTA急性和慢性炎症过程的mri衍生标志物。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.09.003

Sarah Khalife , Steffen Bollmann , Andrew Zalesky , Lena K.L. Oestreich

Background

Depression is a leading cause of disability worldwide, with inflammation increasingly recognized as a contributing factor. Inflammatory processes can disrupt the brain’s reward circuitry, particularly the ventral tegmental area (VTA), which is central to dopamine-mediated motivation and reward. This study investigates whether magnetic resonance imaging–derived markers sensitive to neuroinflammation and microstructure in the VTA are associated with depression diagnosis and symptom severity.

Methods

We analyzed diffusion-weighted imaging and quantitative susceptibility mapping data from 32,495 UK Biobank participants, including 3807 individuals with ICD-10–diagnosed major depressive disorder (MDD). Metrics sensitive to neuroinflammation (free water [FW], isotropic volume fraction [ISOVF], magnetic susceptibility) and microstructure (intracellular volume fraction [ICVF], orientation dispersion index [ODI], volume) were extracted from the VTA. Group differences between the MDD group and healthy control (HC) group matched on body mass index, sex, and age were assessed using analysis of variance. Linear regression was used to predict acute symptom severity based on Recent Depressive Symptoms scores.

Results

Participants with an MDD diagnosis had significantly higher FW (p < .001) and ISOVF (p = .001) compared with HCs, indicating increased extracellular processes such as inflammation in the VTA. Lower ISOVF (β = −0.28, p = .033) and higher ICVF (β = 0.29, p = .017) and ODI (β = 0.4, p = .007) were associated with higher depression severity, independent of depressive diagnosis history.

Conclusions

Our findings reveal distinct patterns of VTA microstructural changes associated with major depression history versus acute depressive symptom severity, suggesting different underlying pathophysiological mechanisms. Distinct patterns of neuroinflammation may differentiate acute from chronic depression, informing targeted interventions.

背景：抑郁症是世界范围内致残的主要原因，炎症越来越被认为是一个促成因素。炎症过程可以破坏大脑的奖励回路，特别是腹侧被盖区（VTA），这是多巴胺介导的动机和奖励的核心。本研究探讨mri衍生的神经炎症敏感标志物和VTA微结构是否与抑郁症诊断和症状严重程度相关。方法：我们分析了32,495名英国生物银行参与者的扩散加权成像和定量敏感性制图数据，其中包括3,807名ICD-10诊断为抑郁症的个体。从VTA中提取神经炎症敏感指标（游离水分[FW]、各向同性体积分数[ISOVF]、磁化率）和微观结构（细胞内体积分数[ICVF]、取向弥散指数[ODI]体积）。重度抑郁组与BMI、性别和年龄匹配的健康对照组之间的组间差异采用方差分析评估，并采用线性回归预测基于近期抑郁症状评分的急性症状严重程度。结果：与hc患者相比，抑郁症患者的FW （p < 0.001）和ISOVF （p = 0.001）明显更高，表明VTA炎症等细胞外过程增加。较低的ISOVF （β = -0.28, p = 0.033）、较高的ICVF （β = 0.29, p = 0.017）和ODI （β = 0.4, p = 0.007）与较高的抑郁严重程度相关，与抑郁诊断史无关。结论：我们的研究结果揭示了与抑郁病史和急性抑郁症状严重程度相关的VTA微结构变化的不同模式，提示不同的潜在病理生理机制。不同的神经炎症模式可以区分急性和慢性抑郁症，为有针对性的干预提供信息。

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引用次数: 0

Maternal Antenatal Depression and Deviations From Normative Brain Development in Offspring 母亲产前抑郁和偏离正常大脑发育的后代。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.09.001

Klara Mareckova , Radek Marecek , Jana Klanova , Yuliya S. Nikolova

Background

Maternal mental health during pregnancy is important for optimal brain development in offspring. Exposure to maternal depression in utero has been shown to be associated with accelerated global cortical brain aging in young adulthood. However, it is not clear whether maternal antenatal depression (MAD) also predicts region-specific deviations from normative development of cortical thickness, surface area, and subcortical volume in offspring or whether the region-specific deviations remain stable throughout the third decade of life.

Methods

Two neuroimaging follow-ups of a prenatal birth cohort in young adulthood tested whether MAD was associated with deviations from normative brain development in the offspring in their early and late 20s, as modeled using 37,407 magnetic resonance images from individuals 3 to 90 years of age (CentileBrain).

Results

MAD predicted deviations from normative development of thalamus and nucleus accumbens but not other subcortical volumes, surface area, or cortical thickness. Women exposed to greater MAD showed a smaller thalamus and nucleus accumbens in both the early and late 20s than expected based on age- and sex-normative means. In contrast, men exposed to greater MAD showed no deviations from the development of the thalamus but did show a larger nucleus accumbens in their late 20s than expected based on age- and sex-normative means.

Conclusions

Given the importance of the thalamus in the pathogenesis of major depressive disorder and the critical role of the nucleus accumbens in reward and motivation, the altered development of these subcortical structures may contribute to a higher risk of depression.

背景：怀孕期间母亲的心理健康对后代的最佳大脑发育至关重要。在子宫内暴露于母亲抑郁与青年期大脑皮质加速老化有关。然而，尚不清楚母亲产前抑郁（MAD）是否也可能预测后代皮层厚度、表面积和皮层下体积的规范发育的区域特异性偏差，以及它们是否在生命的第三个十年中保持稳定。方法：对一个年轻成年期产前出生队列进行了两次神经影像学随访，测试了MAD是否可能与后代在20岁出头和晚些时候偏离正常大脑发育有关，使用来自3-90岁个体的37407张MRI图像进行建模（CentileBrain）。结果：MAD预测了丘脑和伏隔核正常发育的偏差，但没有预测其他皮层下体积、表面积或皮层厚度的偏差。在20岁出头和快30岁的时候，暴露于更严重的MAD环境下的女性，其丘脑和伏隔核都比基于年龄和性别标准方法的预期要小。相比之下，男性暴露在更大的MAD下，在20多岁时，丘脑的发育并没有偏离，但伏隔核的发育比年龄和性别标准所预测的要大。结论：考虑到丘脑在重度抑郁症发病机制中的重要性以及伏隔核在奖励和动机中的关键作用，这些皮质下结构的发育改变可能会导致抑郁症的高风险。

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引用次数: 0

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IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/S2451-9022(26)00008-X

引用次数: 0

Microstructural Alterations in Superficial White Matter Associated With Anhedonia and Suicidal Ideation in Major Depressive Disorder 重度抑郁症患者与快感缺乏和自杀意念相关的浅表白质微结构改变。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.02.010

Yichen Zhang , Guorong Wu , Sara De Witte , Chris Baeken

Background

Major depressive disorder (MDD) is characterized by impaired emotional and cognitive functions. Previous studies have focused on the long-range white matter bundles within the deep white matter connecting distant cortices. Less is known about the superficial white matter (SWM), which consists of short bundles connecting adjacent and precise cortices. Therefore, we investigated the differences in SWM between patients with MDD and healthy control participants (HCs) and its relationship with core clinical depressive symptoms.

Methods

Probabilistic tractography was used to generate the SWM bundles in 62 antidepressant-free patients with MDD and 77 HCs. Diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) were used to compare the microstructural differences of SWM between the 2 groups. Correlations were calculated between the diffusion metrics in the SWM showing significant between-group differences and core clinical depressive symptoms.

Results

Compared with HCs, patients with MDD showed DTI metric changes in the SWM bundles connecting frontal-parietal-temporal-occipital cortices. For the NODDI metrics, patients with MDD showed a lower neurite density index in the SWM bundles connecting frontal-parietal-temporal cortices. Here, the neurite density index in the SWM bundles connecting prefrontal-insula regions was significantly negatively correlated with anhedonia and suicidal ideation. Patients with MDD displayed a higher orientation dispersion index in the SWM bundles connecting parietal, occipital, and posterior cingulate cortices.

Conclusions

SWM plays a crucial role in the neuropathology of MDD. The decreased neurite density in the SWM connecting prefrontal-insula regions may underlie anhedonia and suicidal ideation. Furthermore, NODDI metrics may offer more specific detection of SWM microstructural abnormalities than DTI metrics.

背景：重度抑郁障碍（MDD）以情绪和认知功能受损为特征。以前的研究集中在深层白质中连接远端皮层的长程白质束。浅表白质（SWM）由连接相邻和精确皮层的短束组成，对它的了解较少。因此，我们研究了重度抑郁症患者和健康对照（hc）之间SWM的差异及其与核心临床抑郁症状的关系。方法：对62例无抗抑郁MDD患者和77例hc患者采用概率神经束造影方法生成SWM束。采用弥散张量成像（DTI）和神经突定向弥散密度成像（NODDI）比较两组SWM的显微结构差异。计算SWM中显示组间显著差异的扩散指标与核心临床抑郁症状之间的相关性。结果：与正常人相比，MDD患者连接额-顶叶-颞-枕皮质的SWM束显示DTI测量改变。对于NODDI指标，MDD患者在连接额-顶叶-颞叶皮质的SWM束中显示出较低的神经突密度指数。在这里，连接前额叶-脑岛区的SWM束的神经突密度指数与快感缺乏和自杀意念呈显著负相关。MDD患者在连接顶叶、枕叶和后扣带皮层的SWM束中表现出较高的定向弥散指数。结论：SWM在MDD的神经病理学中起着至关重要的作用。连接前额叶-脑岛区的SWM神经突密度降低可能是快感缺乏和自杀意念的基础。此外，NODDI指标可能比DTI指标提供更具体的SWM微结构异常检测。

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引用次数: 0

Representing Brain-Behavior Associations by Retaining High-Motion Minoritized Youth 通过保留高运动的少数民族青年来代表大脑行为联系。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.01.014

Jivesh Ramduny , Lucina Q. Uddin , Tamara Vanderwal , Eric Feczko , Damien A. Fair , Clare Kelly , Arielle Baskin-Sommers

Background

Population neuroscience datasets provide an opportunity for researchers to estimate reproducible effect sizes for brain-behavior associations because of their large sample sizes. However, these datasets undergo strict quality control to mitigate sources of noise, such as head motion. This practice often excludes a disproportionate number of minoritized individuals.

Methods

We used motion-ordering and motion-ordering+resampling (bagging) to test whether these methods preserve functional magnetic resonance imaging (fMRI) data in the Adolescent Brain Cognitive Development (ABCD) Study (N = 5733). For the 2 methods, brain-behavior associations were computed as the partial Spearman’s rank correlations (R_s) between functional connectivity and cognitive performance (NIH Cognition Toolbox) as well as externalizing and internalizing psychopathology (Child Behavior Checklist) while adjusting for participant sex assigned at birth and head motion.

Results

Black and Hispanic youth exhibited excess head motion relative to data collected from White youth and were discarded disproportionately when conventional approaches were used. Motion-ordering and bagging methods retained more than 99% of Black and Hispanic youth. Both methods produced reproducible brain-behavior associations across low-/high-motion racial/ethnic groups based on motion-limited fMRI data.

Conclusions

The motion-ordering and bagging methods are 2 feasible approaches that can enhance sample representation for testing brain-behavior associations and that result in reproducible effect sizes in diverse populations.

背景：人口神经科学数据集由于样本量大，为研究人员估计脑-行为关联的可重复效应量提供了机会。然而，这些数据集经过严格的质量控制，以减轻噪声源，如头部运动。这种做法往往将不成比例的少数群体排除在外。方法：我们采用动作排序和动作排序+重采样（bagging）来测试这些方法是否保留了青少年大脑认知发展研究（N = 5,733）中的功能MRI （fMRI）数据。对于这两种方法，脑行为关联被计算为功能连通性与认知表现（NIH认知工具箱）以及外化和内化精神病理（儿童行为检查表[CBCL]）之间的部分Spearman's秩相关（Rs），同时调整了参与者出生时的性别和头部运动。结果：与从白人青年收集的数据相比，黑人和西班牙裔青年表现出过度的头部运动，并且在使用传统方法时不成比例地被丢弃。动作排序和装袋方法保留了99%以上的黑人和西班牙裔青年。基于运动受限的fMRI数据，这两种方法在低/高运动的种族/民族群体中产生了可重复的大脑行为关联。结论：动作排序法和装袋法是两种可行的方法，可以增强脑行为关联测试的样本代表性，并在不同人群中产生可重复的效应量。

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引用次数: 0

Systematic Review and Meta-Analysis of Executive Function Following Remission From Major Depression 重度抑郁症缓解后执行功能的系统回顾和荟萃分析。

IF 4.8 2区医学 Q1 NEUROSCIENCES

Biological Psychiatry-Cognitive Neuroscience and Neuroimaging

Pub Date : 2026-02-01 DOI: 10.1016/j.bpsc.2025.09.006

Maria Semkovska, Jelena Nikolic, Sigurd Dølven, Hanna Nygård Roth

Background

Executive function is significantly impaired during an acute episode of major depressive disorder (MDD). Following remission, executive deficits recede, but whether they fully dissipate is unclear. Evidence is also mixed regarding the extent to which persisting deficits reflect decreased processing speed or a distinct executive dysfunction.

Methods

We aimed to systematically evaluate how executive function following MDD remission compares with normal function, specify the pattern and severity of persistent deficits, examine effects of prespecified moderators, and determine if processing speed explains observed executive dysfunctions. Electronic databases and relevant reviews were systematically searched for studies published from January 1, 1972, to April 23, 2024. The main outcome was difference in test performance between patients with remitted MDD and healthy control participants. Effect sizes were calculated with random-effects models. Significant moderators of between-study variability were combined to identify the best goodness-of-fit model using multiple method of moments meta-regressions.

Results

Meta-analysis of 61 variables from 244 studies (12,814 remitted patients; 10,578 healthy control participants) was performed. Significant deficits relative to controls were found in all but one speed-constrained executive tests, with effect sizes ranging from small (Hedges’ g = 0.24) to large (Hedges’ g = 0.86). Between-group differences became nonsignificant after controlling for processing speed. Remitted patients and controls had comparable performance on unconstrained by speed tests of executive function except for auditory and spatial working memory, where negligible (Hedges’ g = 0.19) to small (Hedges’ g = 0.31) deficits were observed.

Conclusions

Executive dysfunction observed in auditory working memory, set-shifting, inhibition, planning, fluency, and intellectual functioning following depression remission is largely explained by persistent impairment in processing speed.

背景：在重度抑郁症（MDD）急性发作期间，执行功能明显受损。在缓解后，执行缺陷会消退，但是否完全消失尚不清楚。关于持续的缺陷在多大程度上反映了处理速度下降或明显的执行功能障碍，证据也很复杂。方法：我们旨在系统地评估重度抑郁症缓解后的执行功能与正常功能的比较，明确持续性缺陷的模式和严重程度，检查预先指定的调节因子的影响，并确定处理速度是否解释了观察到的执行功能障碍。系统检索1972年1月1日至2024年4月23日期间发表的研究，检索电子数据库和相关综述。主要结局为重度抑郁症缓解者与健康对照者在测试表现上的差异。效应量采用随机效应模型计算。结合研究间可变性的显著调节因子，使用多重矩元回归方法确定最佳拟合优度模型。结果：244项研究的61个变量（12814名重度抑郁症缓解者；10578名健康对照）进行了meta分析。除了一个速度受限的执行测试外，在所有测试中都发现了相对于对照组的显著缺陷，效应大小从小（g=0.24）到大（g=0.86）不等。在控制处理速度后，组间差异变得不显著。MDD缓解者和对照组在执行功能的无约束速度测试中表现相当，除了听觉和空间工作记忆，其中观察到可忽略不计（g=0.19）到小（g=0.31）的缺陷。结论：抑郁症缓解后在听觉工作记忆、场景转移、抑制、计划、流畅性和智力功能等方面的执行功能障碍主要与加工速度的持续损害有关。

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引用次数: 0