Orbitofrontal cortex function and structure in depression
Orbitofrontal cortex function and structure in depression
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DOI：
10.1196/annals.1401.029
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发表时间：
2007-01-01
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影响因子：
--
通讯作者：
Drevets, Wayne C.
中科院分区：
文献类型：
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作者：
Drevets, Wayne C.
利用神经影像学、神经病理学和病变分析技术获得的证据表明，眶额皮质（OFC）与抑郁症的病理生理有关。这些技术揭示的异常表现出区域特异性，并建议，一些OFC地区出现cytoarchitectonically不同的功能也不同的情绪调节。例如，抑郁症的严重程度与后外侧和内侧眶额皮层部分的生理活动呈负相关，这与脑血管病变相关的眶额皮层功能障碍增加了发展为重度抑郁综合征的脆弱性的证据一致。后外侧和内侧OFC功能也可能在患有原发性情绪障碍的个体中受损，因为这些患者表现出灰质体积减少，组织病理学异常，以及对情绪化刺激，概率逆转学习和奖励处理的血流动力学反应改变。与此相反，生理活动的前内侧OFC位于腹内侧额叶极皮层增加抑郁与缓解阶段的抑郁症的程度是正相关的抑郁症的严重程度。有效的抗抑郁治疗与该区域活动的减少有关。这些数据与实验动物研究的证据相一致，表明某些眶额和内侧前额叶皮层区域的功能是抑制情绪表达，而其他区域的功能是增强情绪表达。因此，这些区域之间的功能平衡以及它们与颞叶、纹状体、丘脑和脑干等解剖学相关区域形成的回路的改变可能是情绪障碍（如重度抑郁症）的病理生理学基础。
The orbitofrontal cortex (OFC) has been implicated in the pathophysiology of major depression by evidence obtained using neuroimaging, neuropathologic, and lesion analysis techniques. The abnormalities revealed by these techniques show a regional specificity, and suggest that some OFC regions which appear cytoarchitectonically distinct also are functionally distinct with respect to mood regulation. For example, the severity of depression correlates inversely with physiological activity in parts of the posterior lateral and medial OFC, consistent with evidence that dysfunction of the OFC associated with cerebrovascular lesions increases the vulnerability for developing the major depressive syndrome. The posterior lateral and medial OFC function may also be impaired in individuals who develop primary mood disorders, as these patients show grey-matter volumetric reductions, histopathologic abnormalities, and altered hemodynamic responses to emotionally valenced stimuli, probabilistic reversal learning, and reward processing. In contrast, physiological activity in the anteromedial OFC situated in the ventromedial frontal polar cortex increases during the depressed versus the remitted phases of major depressive disorder to an extent that is positively correlated with the severity of depression. Effective antidepressant treatment is associated with a reduction in activity in this region. Taken together these data are compatible with evidence from studies in experimental animals indicating that some orbitofrontal and medial prefrontal cortex regions function to inhibit, while others function to enhance, emotional expression. Alterations in the functional balance between these regions and the circuits they form with anatomically related areas of the temporal lobe, striatum, thalamus, and brain stem thus may underlie the pathophysiology of mood disorders, such as major depression.