Abstract
Background: Impaired executive function (EF) is associated with a range of typical clinical characteristics and psychosocial dysfunction in major depressive disorder (MDD). However, because of the lack of objective cognitive tests, inconsistencies in research results, and improvement in patients' subjective experience, few clinicians are concerned with the persistent impairment of EF in euthymia. The study makes a further investigation for EF in remitted and partially remitted MDD patients via multiple EF tests and fMRI, so as to explore the executive function of patients in euthymia.Methods: We recruited 19 MDD patients and 17 age-, gender-, and education-matched healthy controls (HCs). All participants completed EF tests and fMRI scanning. Bilateral dorsolateral prefrontal cortex (dlPFC) regions were selected as the region of interests (ROIs) to conduct seed-based functional connectivity (FC). We conducted fractional amplitude of low-frequency fluctuations (fALFF) analysis for all ROIs and whole brain.Results: All MDD patients were in remission or partial remission, and they were comparable with HCs on all the EF tests. MDD group showed increased positive FC between left dlPFC and cerebellar Crus I, right dlPFC and supramarginal gyrus after 8-weeks treatment, even taking residual depressive symptoms into account. We did not find group difference of fALFF value.Conclusion: MDD patients persisted with EF impairment despite the remission or partially remission of depressive symptoms. Clinicians should focus on residual cognitive symptoms, which may contribute to maximize the efficacy of routine therapy.
Highlights
Major depressive disorder (MDD) is a major contributor of global burden of diseases [1], in which cognition deficits is a core symptom [2]
No significant difference was found between patients who was included in analysis and those excluded from analysis in age, gender, years of education, age of first onset, symptom severity, TABLE 1 | Demographic and clinical characteristic of MDD and healthy controls (HCs)
We found that MDD patients showed an increased functional connectivity (FC) between the right cerebellar Crus I and left Dorsolateral prefrontal cortex (dlPFC) than HC
Summary
Major depressive disorder (MDD) is a major contributor of global burden of diseases [1], in which cognition deficits is a core symptom [2]. Research has identified that patients with MDD have a broad range of cognition impairments, which still exists even after the remission of clinical symptoms [3], the impairment of executive function (EF) [4,5,6]. Increasing evidences have indicated that impaired EF, inhibition as the key component, is associated with a series of typical depressive characteristics: rumination [9, 10], negative attentional bias [11], emotion regulation dysfunction [12], etc. Impaired executive function (EF) is associated with a range of typical clinical characteristics and psychosocial dysfunction in major depressive disorder (MDD). The study makes a further investigation for EF in remitted and partially remitted MDD patients via multiple EF tests and fMRI, so as to explore the executive function of patients in euthymia
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