Abstract
Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) are highly debilitating and often co-morbid disorders. The disorders exhibit partly overlapping dysregulations on the behavioral and neurofunctional level. The determination of disorder-specific behavioral and neurofunctional dysregulations may therefore promote neuro-mechanistic and diagnostic specificity. In order to determine disorder-specific alterations in the domain of emotion-cognition interactions the present study examined emotional context-specific inhibitory control in treatment-naïve MDD (n = 37) and GAD (n = 35) patients and healthy controls (n = 35). On the behavioral level MDD but not GAD exhibited impaired inhibitory control irrespective of emotional context. On the neural level, MDD-specific attenuated recruitment of inferior/medial parietal, posterior frontal, and mid-cingulate regions during inhibitory control were found during the negative context. GAD exhibited a stronger engagement of the left dorsolateral prefrontal cortex relative to MDD. Overall the findings from the present study suggest disorder- and emotional context-specific behavioral and neurofunctional inhibitory control dysregulations in major depression and may point to a depression-specific neuropathological and diagnostic marker.
Highlights
With global prevalence rates as high as 7% [1,2], depression and anxiety disorders have become one of the leading causes of disabilities [3]
Participants in the Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), and Healthy controls (HC) groups were of comparable age (p=0·33), gender distribution (c2=0·06), and education level (p=0·27)
One-way analysis of variance (ANOVA) analysis for depressive symptom load revealed a significant main effect of group (BDI-II, F2,86 =80·60, p< 0.001, η2p= 0·66) with post-hoc analyses indicating that depressive symptom load was higher in both, GAD and MDD patients compared to HC, and in MDD compared to GAD patients (p values, GAD vs HC
Summary
With global prevalence rates as high as 7% [1,2], depression and anxiety disorders have become one of the leading causes of disabilities [3]. In line with the differential profiles on the symptomatic level, initial transdiagnostic neuroimaging studies that directly compared MDD and GAD patients revealed disorder-specific neurofunctional alterations [13,14,15], which are of particular importance to promote neuro-mechanistic, diagnostic and therapeutic specificity. The disorders exhibit partly overlapping dysregulations on the behavioral and neurofunctional level, and the determination of disorder-specific alterations may promote neuro-mechanistic and diagnostic specificity. Findings: On the behavioral level MDD but not GAD patients exhibited impaired inhibitory control irrespective of emotional context. Interpretation: Findings from the present study suggest disorder- and emotional context-specific behavioral and neurofunctional deficits in inhibitory control in MDD in negative emotional contexts and may point to a depression-specific neuropathological and diagnostic marker. GAD patients may maintain intact inhibitory performance via compensatory recruitment of prefrontal regulatory regions
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