ObjectiveBased on the pathological model of acceptance and commitment therapy(ACT), to explore the correlation between cognitive fusion and resting-state spontaneous brain activity amplitude of low frequency fluctuation in patients with major depressive disorder(MDD).

MethodsPatients with MDD ( n=19) and healthy controls (HCs, n=19)matched with gender, age, and years of education were enrolled from August 2022 to May 2023 in Hangzhou Seventh People's Hospital. 17-item Hamilton depression rating scale(HAMD-17) and cognitive fusion questionnaire(CFQ) were used to estimate the depressive symptoms and cognitive fusion of the participants. The amplitude of low frequency fluctuation(ALFF) data were collected on a 1.5 T-GE scanner. Based on DPABI v7.0 software of MATLAB 7.11.0 (R2018b), two independent sample t-test was used to compare the ALFF of the MDD group and HC group. ALFF values and the cognitive fusion scale scores were investigated by Pearson correlation analysis.

ResultsCompared with HCs, ALFF in patients with MDD was decreased relatively in the left triangular part of the inferior frontal gyrus(MNI: x, y, z=-36, 24, 21; t=-2.107, P=0.042), the right cuneus(CUN; MNI: x, y, z=12, -87, 24; t=-8.635, P<0.001) as well as the left calcarine fissure and surrounding cortex(MNI: x, y, z=-18, -57, 6; t=-14.188, P<0.001), while increased relatively in left superior occipital gyrus(MNI: x, y, z=-21, -72, 33; t=-7.253, P<0.001). There was a significant negative correlation between cognitive fusion and ALFF values of abnormal activity in left IFGtriang (belonging to ECN)( r=-0.57, P<0.05).

ConclusionThere is a correlation between cognitive fusion and resting-state spontaneous brain activity ALFF in patients with MDD. Both cognitive fusion and depressive symptoms may affect patients' cognitive control deficits through multiple sources.

目的基于接纳承诺疗法(acceptance and commitment therapy，ACT)的病理模型，探讨抑郁症(major depressive disorder，MDD)认知融合表现与静息态自发大脑活动低频幅度(amplitude of low frequency fluctuation，ALFF)的相关性。

方法纳入2022年8月至2023年5月在杭州市第七人民医院就诊的MDD患者( n＝19)和性别、年龄、教育程度相匹配的健康对照(HC组)( n＝19)。使用17项汉密尔顿抑郁量表(17-item Hamilton depression rating scale，HAMD-17)和认知融合问卷(cognitive fusion questionnaire，CFQ)对被试的抑郁症状及认知融合的情况进行评估；使用1.5 T-GE扫描仪采集被试的神经影像数据。基于MATLAB 7.11.0 (R2018b)的DPABI v7.0.软件对两组间ALFF进行双独立样本 t检验，并使用Pearson相关分析ALFF值和认知融合量表评分的相关性。

结果MDD患者的ALFF在左额下回三角部(MNI：x，y，z＝－36，24，21； t＝－2.107， P＝0.042)、右楔叶(MNI：x，y，z＝12，－87，24； t＝－8.635， P<0.001)以及左侧距状裂周围(MNI：x，y，z＝－18，－57，6； t＝－14.188， P<0.001)的ALFF值低于HC组，而在左枕上回(MNI：x，y，z＝－21，－72，33； t＝－7.253， P<0.001) ALFF值高于HC组。认知融合与左额下回三角部(属于ECN)异常活动的ALFF存在显著负相关( r＝－0.57， P<0.05)。

结论MDD认知融合表现与静息态自发大脑活动ALFF存在相关性，认知融合和抑郁症状都可能通过多种途径影响患者的认知控制缺陷。

杭州市科技计划引导项目（农业与社会发展）(20201231Y041)