Identifying predictors, moderators, and mediators of antidepressant response in major depressive disorder: neuroimaging approaches.
Identifying predictors, moderators, and mediators of antidepressant response in major depressive disorder: neuroimaging approaches.
复制标题
DOI：
10.1176/appi.ajp.2014.14010076
复制
发表时间：
2015-02-01
期刊：
影响因子：
--
通讯作者：
Trivedi MH
中科院分区：
文献类型：
--
作者：
Phillips ML;Chase HW;Sheline YI;Etkin A;Almeida JR;Deckersbach T;Trivedi MH
尽管神经科学和治疗发展取得了重大进展，但没有广泛接受的生物标志物可用于诊断或确定重度抑郁症患者的首选治疗方法。在这篇重要的综述中，作者研究了多模式神经成像技术在多大程度上可以识别反映抑郁症关键病理生理过程的生物标志物，以及这些生物标志物是否可以作为治疗反应的预测因子、调节因子和介质，从而促进基于对这些过程更好理解的个性化治疗的发展。作者首先强调了使用不同技术对抑郁症进行的神经成像研究中最一致的发现，包括两个平行神经回路的结构和功能异常：以杏仁核和内侧前额叶皮层的不同区域为中心的血清素能调节的内隐情绪调节回路；多巴胺能调节奖励神经回路，以腹侧纹状体和内侧前额皮质为中心。然后，他们描述了相对少量研究的关键发现，这些研究表明，对这些神经回路的区域功能和结构的特定测量，在较小程度上，可以预测抑郁症的治疗反应。现有研究的局限性包括样本量小，仅使用一种神经成像模式，以及关注于识别预测因子而不是鉴别治疗反应的调节因子和介质。通过解决这些限制，最重要的是，利用多模态神经成像的好处，未来的研究可以产生抑郁症治疗反应的调节剂和介质，以促进短期和长期临床和功能结果的显著改善。
Despite significant advances in neuroscience and treatment development, no widely accepted biomarkers are available to inform diagnostics or identify preferred treatments for individuals with major depressive disorder. In this critical review, the authors examine the extent to which multimodal neuroimaging techniques can identify biomarkers reflecting key pathophysiologic processes in depression and whether such biomarkers may act as predictors, moderators, and mediators of treatment response that might facilitate development of personalized treatments based on a better understanding of these processes. The authors first highlight the most consistent findings from neuroimaging studies using different techniques in depression, including structural and functional abnormalities in two parallel neural circuits: serotonergically modulated implicit emotion regulation circuitry, centered on the amygdala and different regions in the medial prefrontal cortex; and dopaminergically modulated reward neural circuitry, centered on the ventral striatum and medial prefrontal cortex. They then describe key findings from the relatively small number of studies indicating that specific measures of regional function and, to a lesser extent, structure in these neural circuits predict treatment response in depression. Limitations of existing studies include small sample sizes, use of only one neuroimaging modality, and a focus on identifying predictors rather than moderators and mediators of differential treatment response. By addressing these limitations and, most importantly, capitalizing on the benefits of multimodal neuroimaging, future studies can yield moderators and mediators of treatment response in depression to facilitate significant improvements in shorter- and longer-term clinical and functional outcomes.
登录
查看更多内容
DOI：
10.1176/appi.neuropsych.19.3.274
发表时间：
2007-06-01
影响因子：
2.9
作者：
Anand, Amit;Li, Yu;Lowe, Mark J.
通讯作者：
Lowe, Mark J.
影响因子：
10.5
作者：
Cole, James;Chaddock, Christopher A.;Fu, Cynthia H. Y.
通讯作者：
Fu, Cynthia H. Y.
DOI：
10.1016/j.jaac.2009.11.005
发表时间：
2010-02-01
影响因子：
13.3
作者：
Cullen, Kathryn R.;Klimes-Dougan, Bonnie;Lim, Kelvin O.
通讯作者：
Lim, Kelvin O.
DOI：
10.1177/0269881109105786
发表时间：
2010-08
期刊：
Journal of psychopharmacology (Oxford, England)
影响因子：
--
作者：
de Almeida JR;Phillips ML;Cerqueira CT;Zilberman M;Lobo D;Henna E;Tavares H;Amaro E;Gorenstein C;Gentil V;Busatto GF
通讯作者：
Busatto GF
影响因子：
64.8
作者：
Collins, Pamela Y.;Patel, Vikram;Joestl, Sarah S.;March, Dana;Insel, Thomas R.;Daar, Abdallah S.
通讯作者：
Daar, Abdallah S.