Neuronal connectivity in major depressive disorder: a systematic review.
Neuronal connectivity in major depressive disorder: a systematic review.
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DOI：
10.2147/ndt.s170989
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发表时间：
2018
影响因子：
3.2
通讯作者：
Schiepek G
中科院分区：
文献类型：
--
作者：
Helm K;Viol K;Weiger TM;Tass PA;Grefkes C;Del Monte D;Schiepek G
作为最常见的精神疾病之一，严重抑郁障碍(MDD)的病因仍不清楚。神经成像在很大程度上有助于理解抑郁症患者抑郁情绪和动机以及认知障碍的潜在神经机制。特别是，处理区域间连通性变化的分析似乎是在系统一级捕捉MDD影响的一种很有前途的方法。然而，到目前为止，已经公布了太多不同的、有时相互矛盾的结果，使得得出普遍结论变得困难。在这里，我们对过去十年在该领域发表的关于连接性的研究进行了系统的概述，考虑到不同的方法学以及临床问题。从2002年至2015年发表的研究中提取神经元连接结果，进行了系统的综述。调查结果汇总在表格中，并以图形方式可视化。这篇综述支持并总结了MDD患者额叶边缘情绪调节回路改变的概念，但也强调了研究结果的异质性。在所有研究中，受影响最持续的大脑区域是眼眶内侧前额叶皮质、前扣带回皮质、杏仁核、海马体、小脑和基底节。MDD中关于连通性的结果非常不同，部分原因是不同的方法和研究设计，但也由于连通性的时间动力学。虽然连通性研究是迈向大脑功能复杂系统方法的重要一步，但未来的研究应该专注于功能和有效连通性的动力学。
The causes of major depressive disorder (MDD), as one of the most common psychiatric disorders, still remain unclear. Neuroimaging has substantially contributed to understanding the putative neuronal mechanisms underlying depressed mood and motivational as well as cognitive impairments in depressed individuals. In particular, analyses addressing changes in interregional connectivity seem to be a promising approach to capture the effects of MDD at a systems level. However, a plethora of different, sometimes contradicting results have been published so far, making general conclusions difficult. Here we provide a systematic overview about connectivity studies published in the field over the last decade considering different methodological as well as clinical issues. A systematic review was conducted extracting neuronal connectivity results from studies published between 2002 and 2015. The findings were summarized in tables and were graphically visualized. The review supports and summarizes the notion of an altered frontolimbic mood regulation circuitry in MDD patients, but also stresses the heterogeneity of the findings. The brain regions that are most consistently affected across studies are the orbitomedial prefrontal cortex, anterior cingulate cortex, amygdala, hippocampus, cerebellum and the basal ganglia. The results on connectivity in MDD are very heterogeneous, partly due to different methods and study designs, but also due to the temporal dynamics of connectivity. While connectivity research is an important step toward a complex systems approach to brain functioning, future research should focus on the dynamics of functional and effective connectivity.