【摘要】抑郁症与对负面信息和远离正面信息的认知偏见有关。这种偏见的情绪处理可能是抑郁症的核心症状，包括持续的悲伤感和体验快乐的能力下降。导致这种偏见的情绪处理的神经机制仍然未知。在这里，我们有了一个独特的机会来记录5名难治性抑郁症 (TRD) 患者和12名癫痫患者（作为对照）在参与一项评估快乐和悲伤面孔的情感偏见任务时杏仁核和前额叶皮质 (PFC) 的立体定向脑电图信号。首先，与对照组相比，TRD患者在面孔出现后的早期（约300毫秒）杏仁核对悲伤面孔的反应增加，而在晚期（约600 毫秒）杏仁核对快乐面孔的反应减少。此外，在快乐面孔加工的后期，TRD患者的PFC中α波段活动以及杏仁核与PFC之间的α相位锁定显著高于对照组。在悲伤面孔加工的早期阶段，杏仁核激活的增加表明TRD中自下而上的加工系统过于活跃。同时，快乐面孔加工后期杏仁核反应的减少可能是由于PFC通过α波段振荡增加了自上而下的抑制，这种抑制可能在对胼胝体下扣带回和腹侧囊/腹侧纹状体进行深部脑刺激后得到缓解。

    [Abstract] Depression is associated with a cognitive bias towards negative information and away from positive information. This biased emotion processing may underlie core depression symptoms, including persistent feelings of sadness and a reduced capacity to experience pleasure. The neural mechanisms responsible for this biased emotion processing remain unknown. Here we had a unique opportunity to record stereotactic electroencephalography signals in the amygdala and prefrontal cortex (PFC) from 5 patients with treatment-resistant depression (TRD) and 12 patients with epilepsy (as control) while they participated in an affective bias task in which happy and sad faces were evaluated. First, compared with the control group, patients with TRD showed increased amygdala responses to sad faces in the early stage (around 300 ms) and decreased amygdala responses to happy faces in the late stage (around 600 ms) following the onset of faces. Furthermore, during the late stage of happy-face processing, alpha-band activity in the PFC as well as alpha-phase locking between the amygdala and the PFC were significantly greater in patients with TRD compared with the control group. The increased amygdala activation during the early stage of sad-face processing suggests an overactive bottom-up processing system in TRD. Meanwhile, the reduced amygdala response during the late stage of happy-face processing could be attributed to increased top-down inhibition by the PFC through alpha-band oscillation, which may be relieved following deep brain stimulation in the subcallosal cingulate and the ventral capsule/ventral striatum.

    论文原文：Xiaoxu Fan, Madaline Mocchi, Bailey Pascuzzi, et al. (2024). Brain mechanisms underlying the emotion processing bias in treatment-resistant depression. Nature - Mental Health, Volume 2, Issue 5, Pages 583–592.

https://doi.org/10.1038/s44220-024-00238-w