1
|
Wang HY, You HL, Song CL, Zhou L, Wang SY, Li XL, Liang ZH, Zhang BW. Shared and distinct prefrontal cortex alterations of implicit emotion regulation in depression and anxiety: An fNIRS investigation. J Affect Disord 2024; 354:126-135. [PMID: 38479517 DOI: 10.1016/j.jad.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Emotion regulation deficits, particularly in cognitive reappraisal, are crucial in depression and anxiety. However, research on the neural mechanisms of implicit emotion regulation is lacking, and it remains unclear whether these mechanisms are shared or distinct between the two disorders. METHODS We investigated the neural mechanisms of implicit cognitive reappraisal in 28 individuals with major depressive disorder (MDD), 25 with generalized anxiety disorder (GAD), and 30 healthy controls (HC) using functional near-infrared spectroscopy (fNIRS). Participants completed an implicit cognitive reappraisal task and underwent neuropsychological and clinical assessments. RESULTS We found that MDD patients reported higher levels of rumination and lower utilization of cognitive reappraisal, while GAD patients reported reduced use of perspective-taking. Notably, both MDD and GAD patients exhibited decreased activation in the dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) compared to HC participants during implicit cognitive reappraisal. Specifically, inadequate OFC activation was observed in MDD patients, while GAD patients demonstrated OFC deactivation during the task. Furthermore, DLPFC activation showed a negative correlation with depression severity in MDD patients, while OFC activation was positively correlated with perspective-taking in GAD patients. LIMITATIONS fNIRS has limited depth and spatial resolution. CONCLUSION Our fNIRS study is the first to reveal shared and distinct neurobiological profiles of depression and anxiety in implicit emotion regulation. These findings underscore the significance of reduced DLPFC/OFC activation in emotion regulation impairment and highlight unique OFC activation patterns in these disorders. These insights have potential implications for developing cognitive-behavioral therapy and transcranial magnetic stimulation as treatment approaches.
Collapse
Affiliation(s)
- Hai-Yang Wang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; Department of Neurology, Jining No. 1 People's Hospital, Jining 272000, China
| | - Hui-Li You
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Chun-Li Song
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Lu Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Shi-Yao Wang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Xue-Lin Li
- Department of Intensive Care Unit, Jining No. 1 People's Hospital, Jining 272000, China
| | - Zhan-Hua Liang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Bing-Wei Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; Department of Psychology, Dalian Medical University, Dalian 116044, China.
| |
Collapse
|
2
|
Wang HY, Li LZ, Chang Y, Pang XM, Zhang BW. Impaired implicit emotion regulation in patients with panic disorder: An event-related potential study on affect labeling. World J Psychiatry 2024; 14:234-244. [PMID: 38464769 PMCID: PMC10921280 DOI: 10.5498/wjp.v14.i2.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Panic disorder (PD) involves emotion dysregulation, but its underlying mechanisms remain poorly understood. Previous research suggests that implicit emotion regulation may play a central role in PD-related emotion dysregulation and symptom maintenance. However, there is a lack of studies exploring the neural mechanisms of implicit emotion regulation in PD using neurophysiological indicators. AIM To study the neural mechanisms of implicit emotion regulation in PD with event-related potentials (ERP). METHODS A total of 25 PD patients and 20 healthy controls (HC) underwent clinical eva-luations. The study utilized a case-control design with random sampling, selecting participants for the case group from March to December 2018. Participants performed an affect labeling task, using affect labeling as the experimental condition and gender labeling as the control condition. ERP and behavioral data were recorded to compare the late positive potential (LPP) within and between the groups. RESULTS Both PD and HC groups showed longer reaction times and decreased accuracy under the affect labeling. In the HC group, late LPP amplitudes exhibited a dynamic pattern of initial increase followed by decrease. Importantly, a significant group × condition interaction effect was observed. Simple effect analysis revealed a reduction in the differences of late LPP amplitudes between the affect labeling and gender labeling conditions in the PD group compared to the HC group. Furthermore, among PD patients under the affect labeling, the late LPP was negatively correlated with disease severity, symptom frequency, and intensity. CONCLUSION PD patients demonstrate abnormalities in implicit emotion regulation, hampering their ability to mobilize cognitive resources for downregulating negative emotions. The late LPP amplitude in response to affect labeling may serve as a potentially valuable clinical indicator of PD severity.
Collapse
Affiliation(s)
- Hai-Yang Wang
- Department of Neurology, Jining No. 1 People's Hospital, Shandong First Medical University, Jining 272000, Shandong Province, China
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Li-Zhu Li
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
- Department of Neurology, Sixth Peoples' Hospital of Shenyang, Shenyang 110003, Liaoning Province, China
| | - Yi Chang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Xiao-Mei Pang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Bing-Wei Zhang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| |
Collapse
|
3
|
Oussi A, Hamid K, Bouvet C. Managing emotions in panic disorder: A systematic review of studies related to emotional intelligence, alexithymia, emotion regulation, and coping. J Behav Ther Exp Psychiatry 2023; 79:101835. [PMID: 36680910 DOI: 10.1016/j.jbtep.2023.101835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 12/05/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Panic disorder is defined by recurring and unexpected panic attacks, accompanied by anticipatory anxiety about future attacks and their consequences. This generally involves avoiding situations and behaviors that can produce panic attacks (American Psychiatric Association [APA], 2013). Among anxiety disorders, panic disorder is associated with some of the greatest burdens in terms of personal suffering, occupational disability, and societal cost. The objective of this article is to systematically identify and review the empirical literature on emotional management processes and strategies associated with panic disorder, with the aim of evaluating their role in the development and maintenance of panic disorder, in order to better understand the pathogenesis of the disorder and guide clinicians to improve their current treatments. METHODS Four databases were searched for studies which were based on self-reported questionnaires or a methodology based on an experimental procedure. RESULTS Of the 1719 articles identified, 61 referred to different aspects of emotional management. People living with PD are characterized by low emotional intelligence levels, excessive use of suppression, impaired cognitive reappraisal, high levels of alexithymia and maladaptive coping strategies. LIMITATIONS Most of the reviewed studies used measures of emotional management in cross-sectional models and were based on self-assessment reports. CONCLUSIONS Improving emotional intelligence levels is key to increasing emotion regulation flexibility for people living with PD. Automatic cognitive reappraisal impairment in these people indicates low importance of cognitive restructuring in psychotherapeutic treatment.
Collapse
Affiliation(s)
- Abdellah Oussi
- CLIPSYD Research Unit, UFR SPSE, Paris Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France.
| | | | - Cyrille Bouvet
- CLIPSYD Research Unit, UFR SPSE, Paris Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France.
| |
Collapse
|
4
|
Wang HY, Xu GQ, Ni MF, Zhang CH, Li XL, Chang Y, Sun XP, Zhang BW. Neural basis of implicit cognitive reappraisal in panic disorder: an event-related fMRI study. J Transl Med 2021; 19:304. [PMID: 34256777 PMCID: PMC8276458 DOI: 10.1186/s12967-021-02968-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/28/2021] [Indexed: 12/28/2022] Open
Abstract
Background Panic disorder (PD) is thought to be related with deficits in emotion regulation, especially in cognitive reappraisal. According to the cognitive model, PD patients’ intrinsic and unconscious misappraisal strategies are the cause of panic attacks. However, no studies have yet been performed to explore the underlying neuromechanism of cognitive reappraisal that occur on an unconscious level in PD patients. Methods Twenty-six patients with PD and 25 healthy controls (HC) performed a fully-verified event-block design emotional regulation task aimed at investigating responses of implicit cognitive reappraisal during an fMRI scan. Participants passively viewed negatively valanced pictures that were beforehand neutrally, positively, or adversely portrayed in the task. Results Whole-brain analysis of fMRI data showed that PD patients exhibited less activation in the right dorsolateral prefrontal cortex (dlPFC) and right dorsomedial prefrontal cortex (dmPFC) compared to HC, but presented greater activation in parietal cortex when negative pictures were preceded by positive/neutral vs negative descriptions. Simultaneously, interactive effects of Group × Condition were observed in the right amygdala across both groups. Furthermore, activation in dlPFC and dmPFC was is negatively correlated to severity of anxiety and panic in PD when negative images were preceded by non-negative vs negative descriptions. Conclusions Emotional dysregulation in PD is likely the result of deficient activation in dlPFC and dmPFC during implicit cognitive reappraisal, in line with impaired automatic top-down regulation. Correlations between severity of anxiety and panic attack and activation of right dlPFC and dmPFC suggest that the failure to engage prefrontal region during implicit cognitive reappraisal might be associated wtih the severity of anxiety and panic; such functional patterns might be the target of possible treatments.
Collapse
Affiliation(s)
- Hai-Yang Wang
- Department of Neurology, Jining No. 1 People's Hospital, Jining, 272000, China.,Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Guo-Qing Xu
- Department of Psychology, Dalian Medical University, Dalian, 116044, China
| | - Ming-Fei Ni
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Cui-Hong Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China.,Department of Geriatric Medicine, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou, 516000, China
| | - Xue-Lin Li
- Department of Intensive Care Unit, Jining No. 1 People's Hospital, Jining, 272000, China
| | - Yi Chang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Xiao-Pei Sun
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Bing-Wei Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China. .,Department of Psychology, Dalian Medical University, Dalian, 116044, China.
| |
Collapse
|