Early changes in neural circuit function engaged by negative emotion and modified by behavioural intervention are associated with depression and problem-solving outcomes: A report from the ENGAGE randomized controlled trial
| Autor: | Olusola Ajilore, Joseph Wielgosz, Patrick Stetz, Philip W. Lavori, Joshua M. Smyth, Leanne M. Williams, Lan Xiao, Jun Ma, Nan Lv, Janine M. Simmons, Andrea N. Goldstein-Piekarski, Trisha Suppes, Megan A. Lewis, Elizabeth M. Venditti, Lisa G. Rosas, Mark B Snowden, Carlos Alexander Grajales Correa, Sarah E. Chang |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult Male Medicine (General) Mediation (statistics) medicine.medical_specialty Emotions Problem-solving Collaborative Care Insula Neuroimaging General Biochemistry Genetics and Molecular Biology law.invention 03 medical and health sciences R5-920 0302 clinical medicine Physical medicine and rehabilitation Randomized controlled trial Functional neuroimaging law Behavior Therapy Intervention (counseling) Connectome Medicine Humans Obesity Anterior cingulate cortex Depression (differential diagnoses) Problem Solving Aged Cerebral Cortex business.industry Depression General Medicine Middle Aged Amygdala 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Female business Research Paper |
| Zdroj: | EBioMedicine EBioMedicine, Vol 67, Iss, Pp 103387-(2021) |
| ISSN: | 2352-3964 |
| Popis: | Background Depression exerts a staggering toll that is worsened with co-occurring chronic conditions such as obesity. It is imperative to develop more effective interventions for depression and to identify objective and biological plausible neural mechanisms to understand intervention outcomes. The current study uses functional neuroimaging to determine whether a behavioural intervention changes the negative affect circuit and whether these changes relate to subsequent improvements in both symptom and problem-solving outcomes in depressed patients with co-occurring obesity. Methods This study (‘ENGAGE’) was a pre-planned element of the randomized controlled trial, ‘RAINBOW’ (ClinicalTrials.gov NCT02246413). 108 depressed patients with obesity were randomized to receive an integrated collaborative care intervention (I-CARE) or usual care. Participants underwent functional neuroimaging using an established facial emotion task at baseline and two months (coinciding with the first two months of intervention focused on problem-solving therapy (‘PST’)). Amygdala, insula and anterior cingulate cortex activation was extracted using pre-planned definitions and standardized methods. The primary health and behavioural outcomes were depression symptom severity and problem-solving ability respectively, assessed at baseline, the main 6-month outcome point and at 12-month follow up. Mediation analyses used an intent-to-treat approach. Findings PST, relative to usual care, reduced amygdala activation engaged by threat stimuli at two months. This reduction mediated subsequent improvements in depression severity in an intervention-dependent manner. PST did not change insula activation at two months but did temper the strength of the relationship between insula activation and improvements in problem-solving ability. Interpretation The negative affect circuit may be an important neural target and potential mediator of PST in patients with comorbid obesity. Funding US National Institutes of Health/National Heart Lung and Blood Institute R01 HL119453 and UH2/UH3 HL132368 |
| Databáze: | OpenAIRE |
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