Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression.
Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression.
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DOI：
10.1007/s00429-008-0189-x
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发表时间：
2008-09
影响因子：
3.1
通讯作者：
Furey, Maura L.
中科院分区：
文献类型：
--
作者：
Drevets, Wayne C.;Price, Joseph L.;Furey, Maura L.
通过汇集神经影像学、神经病理学和病变分析研究的证据，推测调节正常情绪行为方面的神经网络与情绪障碍的病理生理学有关。这些网络涉及内侧前额叶皮层 (MPFC) 以及内侧和尾外侧眼眶皮层（内侧前额叶网络）、杏仁核、海马和基底神经节腹内侧部分的密切相关区域，在抑郁反复发作的情况下，会发现这些区域的灰质体积和神经生理活动发生变化。这些发现对于抑郁症背后的神经回路模型具有重大意义。特别是来自病变分析研究的证据表明，MPFC 和相关的边缘系统和纹状体-苍白球-丘脑结构组织情绪表达。 MPFC 是更大的皮质区域“默认系统”的一部分，该区域包括背侧 PFC、中后扣带皮层、前颞叶皮层以及内嗅和海马旁皮层，这些区域与自我参照功能有关。该回路结构内部和结构之间的功能障碍可能会引起人类抑郁综合征的情绪行为和其他认知方面的紊乱。此外，由于 MPFC 和相关边缘结构提供前脑对下丘脑和脑干内脏控制结构的调节，因此它们的功能障碍可以解释与情绪障碍相关的自主调节和神经内分泌反应的紊乱。本文讨论了这些系统以及影响它们的神经化学系统，并构成了大多数药物治疗的基础。
The neural networks that putatively modulate aspects of normal emotional behavior have been implicated in the pathophysiology of mood disorders by converging evidence from neuroimaging, neuropathological and lesion analysis studies. These networks involve the medial prefrontal cortex (MPFC) and closely related areas in the medial and caudolateral orbital cortex (medial prefrontal network), amygdala, hippocampus, and ventromedial parts of the basal ganglia, where alterations in grey matter volume and neurophysiological activity are found in cases with recurrent depressive episodes. Such findings hold major implications for models of the neurocircuits that underlie depression. In particular evidence from lesion analysis studies suggests that the MPFC and related limbic and striato-pallido-thalamic structures organize emotional expression. The MPFC is part of a larger “default system” of cortical areas that include the dorsal PFC, mid- and posterior cingulate cortex, anterior temporal cortex, and entorhinal and parahippocampal cortex, which has been implicated in self-referential functions. Dysfunction within and between structures in this circuit may induce disturbances in emotional behavior and other cognitive aspects of depressive syndromes in humans. Further, because the MPFC and related limbic structures provide forebrain modulation over visceral control structures in the hypothalamus and brainstem, their dysfunction can account for the disturbances in autonomic regulation and neuroendocrine responses that are associated with mood disorders. This paper discusses these systems together with the neurochemical systems that impinge on them and form the basis for most pharmacological therapies.
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