Major Depressive Disorder Is Associated With Abnormal Interoceptive Activity and Functional Connectivity in the Insula

被引:372
作者
Avery, Jason A. [1 ,2 ]
Drevets, Wayne C. [1 ,3 ]
Moseman, Scott E. [1 ,4 ]
Bodurka, Jerzy [1 ,5 ]
Barcalow, Joel C. [1 ]
Simmons, W. Kyle [1 ,6 ]
机构
[1] Univ Tulsa, Laureate Inst Brain Res, Tulsa, OK 74104 USA
[2] Univ Tulsa, Dept Biol Sci, Tulsa, OK USA
[3] Johnson & Johnson Inc, New Brunswick, NJ USA
[4] Univ Oklahoma, Laureate Psychiat Clin & Hosp, Norman, OK 73019 USA
[5] Univ Oklahoma, Coll Engn, Norman, OK 73019 USA
[6] Univ Tulsa, Fac Community Med, Tulsa, OK 74104 USA
关键词
Depression severity; fMRI; functional connectivity; insula; interoception; major depressive disorder; SUBGENUAL PREFRONTAL CORTEX; ATTENTIONAL MODULATION; HEARTBEAT PERCEPTION; CINGULATE CORTEX; NEURAL BASIS; PAIN; ANXIETY; ORGANIZATION; EMOTION; MONKEY;
D O I
10.1016/j.biopsych.2013.11.027
中图分类号
Q189 [神经科学];
学科分类号
071006 [神经生物学];
摘要
Background: Somatic complaints and altered interoceptive awareness are common features in the clinical presentation of major depressive disorder (MDD). Recently, neurobiological evidence has accumulated demonstrating that the insula is one of the primary cortical structures underlying interoceptive awareness. Abnormal interoceptive representation within the insula may thus contribute to the pathophysiology and symptomatology of MDD. Methods: We compared functional magnetic resonance imaging blood oxygenation level-dependent responses between 20 unmedicated adults with MDD and 20 healthy control participants during a task requiring attention to visceral interoceptive sensations and also assessed the relationship of this blood oxygenation level-dependent response to depression severity, as rated using the Hamilton Depression Rating Scale. Additionally, we examined between-group differences in insula resting-state functional connectivity and its relationship to Hamilton Depression Rating Scale ratings of depression severity. Results: Relative to the healthy control subjects, unmedicated MDD subjects exhibited decreased activity bilaterally in the dorsal mid-insula cortex (dmIC) during interoception. Activity within the insula during the interoceptive attention task was negatively correlated with both depression severity and somatic symptom severity in depressed subjects. Major depressive disorder also was associated with greater resting-state functional connectivity between the dmIC and limbic brain regions implicated previously in MDD, including the amygdala, subgenual prefrontal cortex, and orbitofrontal cortex. Moreover, functional connectivity between these regions and the dmIC was positively correlated with depression severity. Conclusions: Major depressive disorder and the somatic symptoms of depression are associated with abnormal interoceptive representation within the insula.
引用
收藏
页码:258 / 266
页数:9
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