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Neuronal underpinnings of cognitive impairment and - improvement in mood disorders

机译：认知障碍的神经元支撑 - 情绪障碍的改善

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Neuropsychiatric illnesses including mood disorders are accompanied by cognitive impairment, which impairs work capacity and quality of life. However, there is a lack of treatment options that would lead to solid and lasting improvement of cognition. This is partially due to the absence of valid and reliable neurocircuitry-based biomarkers for pro-cognitive effects. This systematic review therefore examined the most consistent neural underpinnings of cognitive impairment and cognitive improvement in unipolar and bipolar disorders. We identified 100 studies of the neuronal underpinnings of working memory and executive skills, learning and memory, attention, and implicit learning and 9 studies of the neuronal basis for cognitive improvements. Impairments across several cognitive domains were consistently accompanied by abnormal activity in dorsal prefrontal (PFC) cognitive control regions—with the direction of this activity depending on patients’ performance levels—and failure to suppress default mode network (DMN) activity. Candidate cognition treatments seemed to enhance task-related dorsal PFC and temporo-parietal activity when performance increases were observed, and to reduce their activity when performance levels were unchanged. These treatments also attenuated DMN hyper-activity. In contrast, nonspecific cognitive improvement following symptom reduction was typically accompanied by decreased limbic reactivity and reversal of pre-treatment fronto-parietal hyper-activity. Together, the findings highlight some common neural correlates of cognitive impairments and cognitive improvements. Based on this evidence, studies are warranted to examine the reliability and predictive validity of target engagement in the identified neurocircuitries as a biomarker model of pro-cognitive effects.
机译：包括情绪障碍在内的神经精神疾病伴随着认知障碍，这损害了工作能力和生活质量。然而，缺乏治疗方案，导致认知的稳固和持久改善。这部分是由于没有基于有效且可靠的神经速率的生物标志物进行亲认知效果。因此，这种系统评价研究了单极和双相障碍的认知障碍和认知改善的最一致的神经内衬。我们确定了100项关于工作记忆力的神经元基础，学习技能，学习和记忆，注意力和隐含学习以及认知改善的神经元基础的研究。几个认知结构域的损伤始终如一地伴随着背部前额（PFC）认知控制区域的异常活性 - 根据患者的性能水平，并且失败抑制默认模式网络（DMN）活动，伴随着该活动的方向。当观察到性能增加时，候选认知治疗似乎增强了与任务相关的背部PFC和颞旁的活动，并在性能水平不变时降低他们的活动。这些治疗也衰减了DMN超活动。相比之下，症状减少后的非特异性认知改善通常伴随着肢体反应性降低和预治疗前旁观超活动的逆转。调查结果共同突出了认知障碍和认知改进的一些常见神经相关性。基于这一证据，有必要研究鉴定鉴定的神经细胞系为鉴定的神经皮序作为亲认知效果的生物标志物模型的可靠性和预测性有效性。

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