Imaging the pathophysiology of major depressive disorder - from localist models to circuit-based analysis.
Imaging the pathophysiology of major depressive disorder - from localist models to circuit-based analysis.
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DOI：
10.1186/2045-5380-4-5
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发表时间：
2014-03-07
期刊：
影响因子：
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通讯作者：
Pizzagalli DA
中科院分区：
文献类型：
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作者：
Treadway MT;Pizzagalli DA
在过去的几十年里，重性抑郁症（MDD）的神经影像学文献大幅增长，促进了与抑郁症相关的特定脑区，神经递质系统和网络的识别方面的巨大进步。尽管取得了这些进展，但关于MDD的病理生理学和病因学的基本问题仍然存在。更重要的是，这项工作尚未直接影响临床实践。长期以来，临床心理学和精神病学领域的目标是有一种对精神障碍进行客观诊断的方法。然而，令人沮丧的是，在这方面取得的进展很少，诊断有效性和可靠性的“黄金标准”仍然是专家的共识。鉴于这一挑战，目前审查的重点是提供一个关键的总结，从不同的神经影像学方法在MDD研究，包括结构，功能和神经化学成像研究的关键结果。在此总结之后，我们讨论了一些目前的概念障碍，以更好地理解抑郁症的病理生理学，并得出结论，为未来的神经影像学研究的建议。
The neuroimaging literature of Major Depressive Disorder (MDD) has grown substantially over the last several decades, facilitating great advances in the identification of specific brain regions, neurotransmitter systems and networks associated with depressive illness. Despite this progress, fundamental questions remain about the pathophysiology and etiology of MDD. More importantly, this body of work has yet to directly influence clinical practice. It has long been a goal for the fields of clinical psychology and psychiatry to have a means of making objective diagnoses of mental disorders. Frustratingly little movement has been achieved on this front, however, and the 'gold-standard’ of diagnostic validity and reliability remains expert consensus. In light of this challenge, the focus of the current review is to provide a critical summary of key findings from different neuroimaging approaches in MDD research, including structural, functional and neurochemical imaging studies. Following this summary, we discuss some of the current conceptual obstacles to better understanding the pathophysiology of depression, and conclude with recommendations for future neuroimaging research.