Stress is a strong risk factor for major depressive disorder, while sensitization to stress in remitted individuals plays a key role in depression recurrence. The present study explored the state-independent (trait) and dependent (state) neural responses to psychosocial stress in major depressive disorder.

Thirty-six patients with medication-naive first-episode current depression, 33 patients with remitted depression, and 36 demographically matched healthy control participants were administered the Montreal Imaging Stress Task during functional MRI. One-way analyses of variance were used to assess differences in stress responses in the three groups.

Both currently depressed and remitted patients exhibited higher stress levels and cortisol responses than control subjects. Compared with control subjects, both depressed and remitted patients exhibited reduced activation in the ventromedial prefrontal cortex and increased activation in the precuneus. The stress-induced ventromedial prefrontal cortex activation changes negatively correlated with cortisol increases in all three groups. Additional increased activations were found in the dorsolateral prefrontal cortex and bilateral striatum in remitted patients compared with control subjects, and activation in these regions correlated inversely with depressive symptoms in the remitted group.

These findings provide novel evidence regarding the trait and state markers of depression on neural responses to psychosocial stress. Regional activation changes in the ventromedial prefrontal cortex and precuneus may reflect the trait markers of depression. Hyperactivation in the dorsolateral prefrontal cortex and striatum may represent a state-dependent compensatory mechanism during depression remission.

压力是造成严重抑郁症的重要危险因素，而缓解的患者对压力的敏感性在抑郁症的复发中起着关键作用。本研究探讨了严重抑郁症患者对社会心理压力的状态独立（性状）和依赖性（状态）神经反应。

在功能性MRI期间，对36例初次使用药物的初发性当前抑郁症患者，33例缓解的抑郁症患者和36位人口统计学匹配的健康对照组参加者进行了蒙特利尔影像应激任务。使用单向方差分析来评估三组的压力反应差异。

当前抑郁和缓解的患者均表现出比对照组更高的压力水平和皮质醇反应。与对照组相比，抑郁症患者和缓解型患者的腹侧前额叶皮层激活均降低，而在胎前神经中激活增强。在所有三组中，应激诱导的腹膜前额叶皮层激活变化与皮质醇增加呈负相关。与对照组相比，缓解的患者在背外侧前额叶皮层和双侧纹状体中发现了更多的激活，这些区域的激活与缓解组的抑郁症状成反比。

这些发现为有关心理社会压力的神经反应中抑郁的特征和状态标志提供了新的证据。腹侧前额叶皮层和前神经的区域激活变化可能反映了抑郁的特征标志。在抑郁缓解期间，背外侧前额叶皮层和纹状体的过度活化可能代表了一种依赖状态的补偿机制。