Brain structural and functional changes in adolescents with psychiatric disorders.
Brain structural and functional changes in adolescents with psychiatric disorders.
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DOI：
10.1515/ijamh-2013-0058
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发表时间：
2013
影响因子：
--
通讯作者：
Miguel-Hidalgo JJ
中科院分区：
文献类型：
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作者：
Miguel-Hidalgo JJ
在青春期，荷尔蒙和神经发育的变化，以确保生殖和实现独立性，很可能介导的神经过程的增长，突触连接的重塑，增加髓鞘在前额区，和成熟的连接皮层下区域。这些过程在青春期大大加速，在不同的大脑区域遵循异步模式。使用功能和结构磁共振成像的神经影像学研究已经产生了关于青少年精神疾病的大脑结构和功能神经病理学的大部分见解。在精神分裂症中，青春期的第一次发作与灰质密度和白色物质完整性的异常损失有关，并显示出成熟轨迹与正常神经发育的偏离，进展类似于成年发作的精神分裂症。青少年的焦虑和情绪障碍与杏仁核和腹侧前额叶皮质区的活动异常增加有关，尽管一些数据表明，杏仁核和焦虑的神经异常在青少年中可能比成年人更常见。青少年时期的酒精滥用导致白色物质的完整性降低和灰质密度降低，鉴于青少年突触和髓鞘重塑的高强度，这可能导致支持记忆、情绪和食欲控制的回路发生持久和深刻的变化。持续的变化，由于产前暴露与同期表达的遗传因素和干扰性的环境暴露的相互作用可能是一个重要的因素，在青春期精神疾病的外观。进一步了解青少年的精神病理学的进展将需要青少年大脑的分子和细胞决定因素的死后研究。
During adolescence hormonal and neurodevelopmental changes geared to ensure reproduction and achieve independence are very likely mediated by growth of neural processes, remodeling of synaptic connections, increased myelination in prefrontal areas, and maturation of connecting subcortical regions. These processes, greatly accelerated in adolescence, follow an asynchronous pattern in different brain areas. Neuroimaging research using functional and structural magnetic resonance imaging has produced most of the insights regarding brain structural and functional neuropathology in adolescent psychiatric disorders. In schizophrenia, first episodes during adolescence are linked to greater-than-normal losses in gray matter density and white matter integrity, and show a divergence of maturational trajectories from normative neural development, in a progression similar to that of adult-onset schizophrenia. Anxiety and mood disorders in adolescence have been linked to abnormally increased activity in the amygdala and ventral prefrontal cortical areas, although some data suggest that neural abnormalities in the amygdala and anxiety maybe particularly more frequent in adolescents than in adults. Alcohol misuse in adolescence results in reduced integrity in the white matter and reduced gray matter density that, given the high intensity of adolescent synaptic and myelin remodeling, may result in persistent and profound changes in circuits supporting memory, emotional and appetitive control. Interaction of persistent changes due to prenatal exposure with contemporaneous expression of genetic factors and disturbing environmental exposure may be an important factor in the appearance of psychiatric disorders in adolescence. Further progress in understanding adolescent psychopathology will require postmortem research of molecular and cellular determinants in the adolescent brain.