Neural association between cognitive function and anhedonia in adolescents with melancholic major depressive disorder: A fNIRS study.

Background: Cognitive dysfunction is common among adolescent patients with major depressive disorder (MDD). However, the pattern and magnitude of cognition impairment in patients during melancholic episodes remains unclear. The purpose of this study was to compare the neurocognitive performance and the underlying cerebral blood flow activation of adolescent patients with melancholic and non-melancholic features.

Methods: Fifty-seven and 44 adolescent patients with MDD with or without melancholic feature (MDD-MEL/nMEL) and 58 healthy controls (HCs) were recruited. We used the repeatable battery for the assessment of neuropsychological status (RBANS) measuring neurocognitive function, and used functional near infrared spectroscopy (fNIRS) monitoring cerebral hemodynamic changes, described by β value. The non-parametric test and post-hoc analysis were conducted in RBANS scores and β values among three groups. Spearman correlation and mediating analysis was performed for RBANS scores, β values, and clinical symptoms in the MDD-MEL group.

Results: There were no significant difference in RBANS scores between MDD-MEL and MDD-nMEL group. Compared with patients in MDD-nMEL, patients in MDD-MEL have lower β values in eight channels (ch10, ch16, ch20, ch25, ch27, ch37, ch41, ch45). The cognitive function is significantly correlated with anhedonia, and the β values play a partial mediating role between anhedonia and cognitive function.

Limitation: It's a cross-sectional study and monitoring longitudinal effects are needed to further elucidate the mechanism.

Conclusion: The cognitive function in adolescents with MDD-MEL may not significantly differ from those with MDD-nMEL. However, the anhedonia may influenced the cognitive function by altering the function of medial frontal cortex.