设计的功能磁共振成像研究与实现研究思想抑制在年轻妇女，以及在风险，为抑郁症
Summary
我们的目标是确定相关的神经基础的持续和瞬态抑制的思想，并认为重新出现在控制，在风险和抑郁症患者。活化是最大为对照相比有风险的和凹陷组中的背外侧前额叶皮层中思想抑制和前扣带皮层中的思想重新出现。
Abstract
Ruminative brooding is associated with increased vulnerability to major depression. Individuals who regularly ruminate will often try to reduce the frequency of their negative thoughts by actively suppressing them. We aim to identify the neural correlates underlying thought suppression in at-risk and depressed individuals. Three groups of women were studied; a major depressive disorder group, an at-risk group (having a first degree relative with depression) and controls. Participants performed a mixed block-event fMRI paradigm involving thought suppression, free thought and motor control periods. Participants identified the re-emergence of “to-be-suppressed” thoughts (“popping” back into conscious awareness) with a button press. During thought suppression the control group showed the greatest activation of the dorsolateral prefrontal cortex, followed by the at-risk, then depressed group. During the re-emergence of intrusive thoughts compared to successful re-suppression of those thoughts, the control group showed the greatest activation of the anterior cingulate cortices, followed by the at-risk, then depressed group. At-risk participants displayed anomalies in the neural regulation of thought suppression resembling the dysregulation found in depressed individuals. The predictive value of these changes in the onset of depression remains to be determined.
Introduction
与严重抑郁症（MDD）个人一个共同特点是从事沉思思维1的倾向。这种应对机制被认为是不适应的，因为它涉及到固定的被动消极的想法和事件，在2-5号决议没有尝试。反刍与患抑郁症1,6-9的风险抑郁发作10的增加，增加的长度和严重程度有关。
个人谁经常寻味往往会试图通过积极抑制他们11来减少这些消极思想的频率。然而，从事思想抑制能做出这样的想法更加方便和容易迅速重新出现在个人的想法12。这可能更经常在抑郁症患者作为他们的积极打压的想法可能会受到影响的能力可见一斑。另外，认为抑制已显示增加的催产素的可能性她的消极的想法在烦躁不安的人13。因此，对于抑郁症患者中的沉思的抑制可能导致症状的恶化;沉思入侵的增加自行车和提高的消极思想的产物。
抑郁症病理模型断定边缘，纹状体，丘脑和皮质的脑电路14的失调。区域新陈代谢和血液流动的中断休息一致地报道MDD，与提高基础水平的杏仁核，眶额叶皮质，腹内侧前额叶皮层和丘脑内侧观察。此外，降低水平被发现在背外侧前额叶皮层，和膝下和背侧前扣带皮层健康对照组相比15,16。这些观察导致了MDD涉及减少在背侧区域的活性和提高情绪边缘活性更腹侧和腹腔的概念n区。
关于思想的调控认知理论已经确定了在思想抑制两个独立的机制的作用。有人建议，控制的第一个机制是不断地进行，以保持思维抑制与第二机构的基线水平瞬时激活，重新打压的管理闯入高于此基准线17的任何有害的想法。功能磁共振成像数据牵连许多大脑区域在这些过程包括背外侧和腹外侧前额叶皮层18,19， 在岛19,20，前扣带回皮层20，和背内侧前额叶皮层19,21维修思想压制过程中。此外，重新出现抑制的思想已经专门与前扣带皮层18参与有关。因此，似乎是大脑区域之间有相当大的重叠证明是失调抑郁症，包括背外侧前额叶皮层，岛，前扣带皮层，背内侧前额叶皮层22和那些参与思想抑制。这表明，神经生理学，而不仅仅是一个行为的链接，思维抑制和抑郁症之间存在。
年轻妇女谁从事沉思的思想是在对患抑郁症23更大的风险。风险抑郁症也赋予基因;父母或兄弟姐妹患有抑郁症的人更容易患上抑郁症不是与疾病24没有家族病史的个体。这项研究进行了探讨参与镇压思想在一群年轻女性与家庭的风险抑郁症，一群年轻女性目前正经历着抑郁症，和一组健康对照者的神经系统。我们开发了一种新的思想沉思抑制范式检查以中性和个人相关的想法持续和瞬态抑制的思想变化相关的神经活动。这种设计使我们调查是否有对相对中立的思想与个人相关的思想抑制神经活动的差异。此外，测试在风险组提供了一个机会以确定是否风险的抑郁症与血氧水平依赖（BOLD）的信号在与抑郁症区域的大小相关联的探索抑郁的潜在脆弱性标记。
基于对周围神经活动在抑郁症15,16文献，以及反刍的研究，认为抑制25,26有人预测，思想的压制将与背外侧前额叶皮层的减少参与，参与者与MDD相关联，与对照组相比。据预计，更大的漏洞DEPression处于危险组将反映在背外侧皮层活动的控制和压抑组之间那年秋天的水平。另外，预计该重新出现抑制想法会与活化前扣带皮质的关联，并且这个激活将是更大的控制比所述风险组。此外，预计在为重新出现抑制的想法相比，在控制和风险的参与者，观察显著小于前扣带皮质的活化郁闷的参与者。
Protocol
Representative Results
Discussion
是神经电路打乱了抑郁症15,16,25的元素也有意识思维17,18的调节有关。通过考察抑制相关的神经处理在风险和压抑的参与者，我们能够检查是否有是在两个人有抑郁倾向遗传和当前抑郁发作常见的改变脑激活模式。
按照我们的假设与现有文献研究认为抑制健康对照组，背外侧前额叶皮层的响应要求参与镇压的想法在一段被认定18,20较长的时间。这个区?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
We would like to thank Richie Davidson, Waisman Center, University of Wisconsin-Madison, for his guidance and support.
Materials
| Magnetic Resonance Imaging Scanner | General Electric | 3T, whole body, short bore scanner, Milwaukee, WI | |
| Brain Voyageur, QX, V2.1 | Brain Innovation (B.V.) | Maastricht, The Netherlands | |
| E-prime | Psychology Software Tools | Pennsylvania, USA | |
| Hamilton Depression Rating Scale (HAM-D) | Hamilton M (1967) Development of a rating scale for primary depressive illness. The British journal of social and clinical psychology 6: 278–296 | ||
| Rosenberg Self-Esteem Questionnaire (RSE) | Rosenberg M (1965). Society and the Adolescent Self-Image. Princeton University Press : Princeton, NJ. | ||
| Childhood Trauma Questionnaire (CTQ) | Bernstein DP, Stein JA, Newcomb M, et al. (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect 27: 169–190. | ||
| NEO-FFI Neuroticism questionnaire | Costa, P. T., & McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO‐PI‐R) and NEO Five‐Factor Inventory (NEO‐FFI) professional manual. Odessa, FL: Psychological Assessment Resources. | ||
| Mini International Neuropsychiatric Inventory (MINI) | Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state.” Journal of Psychiatric Research, 12(3), 189–198. | ||
| Beck Depression Inventory-Version II (BDI-II) | Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression Archives of General Psychiatry 4:561 – 571 | ||
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