适应性认知控制回路的变化与问题解决能力和抑郁症状的24个月结果有关。

IF 15.8 1区 医学 Q1 CELL BIOLOGY Science Translational Medicine Pub Date : 2024-09-04 DOI:10.1126/scitranslmed.adh3172
Xue Zhang, Adam Pines, Patrick Stetz, Andrea N. Goldstein-Piekarski, Lan Xiao, Nan Lv, Leonardo Tozzi, Philip W. Lavori, Mark B. Snowden, Elizabeth M. Venditti, Joshua M. Smyth, Trisha Suppes, Olusola Ajilore, Jun Ma, Leanne M. Williams
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引用次数: 0

摘要

有针对性的机制行为干预是改善抑郁症治疗效果的一种亟需的策略,尤其是对肥胖等合并症的弱势群体而言。此类干预可能会通过改变潜在的神经回路功能来改变行为和结果。然而,这些神经回路层面的改变是如何随着干预而展开的,早期神经回路层面改变的个体差异又是如何解释治疗效果的异质性的,这些都是未知数。我们在一项针对有抑郁症状和合并肥胖症的参与者的问题解决疗法临床试验中满足了这一需求,并将重点放在认知控制回路这一可能的神经作用机制上。该研究采用功能磁共振成像技术,在 24 个月内的五个时间点测量认知控制回路的活动。与接受常规治疗的参与者相比,接受问题解决疗法的参与者显示认知控制回路活动的减弱与问题解决能力的增强有关,这表明该回路在问题解决疗法的机制中起着关键作用。认知控制回路活动的减弱也与抑郁症状的改善有关。2个月时认知控制回路活动的变化能更好地预测6、12和24个月时问题解决能力和抑郁症状的变化,预测改善率从17.8%到104.0%不等,超过了基线人口统计学和症状特征。我们的研究结果表明,以回路作用机制为目标可以提高对治疗结果的预测能力,因此未来有必要对模型进行完善和改进,为其临床应用铺平道路。
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Adaptive cognitive control circuit changes associated with problem-solving ability and depression symptom outcomes over 24 months
Mechanistically targeted behavioral interventions are a much-needed strategy for improving outcomes in depression, especially for vulnerable populations with comorbidities such as obesity. Such interventions may change behavior and outcome by changing underlying neural circuit function. However, it is unknown how these circuit-level modifications unfold over intervention and how individual differences in early circuit-level modifications may explain the heterogeneity of treatment effects. We addressed this need within a clinical trial of problem-solving therapy for participants with depression symptoms and comorbid obesity, focusing on the cognitive control circuit as a putative neural mechanism of action. Functional magnetic resonance imaging was applied to measure the cognitive control circuit activity at five time points over 24 months. Compared with participants who received usual care, those receiving problem-solving therapy showed that attenuations in cognitive control circuit activity were associated with enhanced problem-solving ability, which suggests that this circuit plays a key role in the mechanisms of problem-solving therapy. Attenuations in circuit activity were also associated with improved depression symptoms. Changes in cognitive control circuit activity at 2 months better predicted changes in problem-solving ability and depression symptoms at 6, 12, and 24 months, with predictive improvements ranging from 17.8 to 104.0%, exceeding baseline demographic and symptom characteristics. Our findings suggest that targeting the circuit mechanism of action could enhance the prediction of treatment outcomes, warranting future model refinement and improvement to pave the way for its clinical application.
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来源期刊
Science Translational Medicine
Science Translational Medicine CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
26.70
自引率
1.20%
发文量
309
审稿时长
1.7 months
期刊介绍: Science Translational Medicine is an online journal that focuses on publishing research at the intersection of science, engineering, and medicine. The goal of the journal is to promote human health by providing a platform for researchers from various disciplines to communicate their latest advancements in biomedical, translational, and clinical research. The journal aims to address the slow translation of scientific knowledge into effective treatments and health measures. It publishes articles that fill the knowledge gaps between preclinical research and medical applications, with a focus on accelerating the translation of knowledge into new ways of preventing, diagnosing, and treating human diseases. The scope of Science Translational Medicine includes various areas such as cardiovascular disease, immunology/vaccines, metabolism/diabetes/obesity, neuroscience/neurology/psychiatry, cancer, infectious diseases, policy, behavior, bioengineering, chemical genomics/drug discovery, imaging, applied physical sciences, medical nanotechnology, drug delivery, biomarkers, gene therapy/regenerative medicine, toxicology and pharmacokinetics, data mining, cell culture, animal and human studies, medical informatics, and other interdisciplinary approaches to medicine. The target audience of the journal includes researchers and management in academia, government, and the biotechnology and pharmaceutical industries. It is also relevant to physician scientists, regulators, policy makers, investors, business developers, and funding agencies.
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