The unique face of comorbid anxiety and depression: Increased frontal, insula and cingulate cortex response during Pavlovian fear-conditioning.

Autor: Poplin T; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA., Ironside M; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA. Electronic address: mironside@laureateinstitute.org., Kuplicki R; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA., Aupperle RL; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA., Guinjoan SM; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA., Khalsa SS; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA., Stewart JL; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA., Victor TA; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA., Paulus MP; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA., Kirlic N; Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Dec 01; Vol. 366, pp. 98-105. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.1016/j.jad.2024.08.143
Abstrakt: 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; ηp 2  = 0.02), dorsolateral prefrontal cortex (ηp 2  = 0.01) and dorsal anterior/mid cingulate cortex (ηp 2  = 0.01). These differences were driven by greater activation to the CS+ in AnxMDD versus MDD.
Limitations: 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.
Competing Interests: Declaration of competing interest This work has been supported in part by The William K. Warren Foundation and the National Institute of General Medical Sciences center grant award number P20GM121312. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Maria Ironside, Rayus Kuplicki, Jennifer Stewart, Robin Aupperle, and Martin Paulus receive funding from the National Institute of General Medical Sciences (NIGMS) center grant P20GM121312; Maria Ironside has additional funding from National Institute of Mental Health (NIMH; R01MH132565). Sahib Khalsa has grant funding from the NIMH (K23MH112949, R01MH127225); Robin Aupperle has additional grant funding from NIMH (K23MH108707; R01MH123691); Jennifer Stewart has additional grant funding from the National Institute of Drug Abuse (NIDA) (R01DA050677), Rayus Kuplicki has additional funding from NIDA (R01DA050677); and Martin Paulus has additional grant funding from the NIDA (U01DA041089, R01DA050677).
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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