Depressive Rumination, the Default-Mode Network, and the Dark Matter of Clinical Neuroscience.
Depressive Rumination, the Default-Mode Network, and the Dark Matter of Clinical Neuroscience.
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DOI：
10.1016/j.biopsych.2015.02.020
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发表时间：
2015-08-15
影响因子：
10.6
通讯作者：
Gotlib IH
中科院分区：
文献类型：
--
作者：
Hamilton JP;Farmer M;Fogelman P;Gotlib IH
重性抑郁症（MDD）中自我关注的反刍与大脑默认模式网络（DMN）执行的自我参照操作之间的直观关联促使人们对研究DMN在MDD中的作用感兴趣。在本文中，我们提出了元分析的结果，显示可靠的DMN和亚膝前额叶皮层（sgPFC）之间的功能连接增加-连接，往往预测抑郁性反刍的水平。我们还提出了荟萃分析的结果，虽然有可靠的增加区域脑血流量在sgPFC在MDD，没有这样的异常已经可靠地观察到在节点的DMN。然后，我们详细介绍了一个模型，集成了研究机构。在这个模型中，我们提出，增加sgPFC和DMN之间的功能连接，在MDD表示的自我参考的过程支持的DMN与情感负荷，行为撤回过程与sgPFC的整合，产生一个功能的神经合奏非常适合抑郁性反刍，在MDD中，不正常的税收只有sgPFC，而不是DMN的整合。这种合成解释了广泛的现有数据有关抑郁性反刍的神经基板，并提供了一个明确的帐户，在MDD的sgPFC的功能异常。
The intuitive association between self-focused rumination in major depressive disorder (MDD) and the self-referential operations performed by the brain’s default-mode network (DMN) has prompted interest in examining the role of the DMN in MDD. In this paper we present meta-analytic findings showing reliably increased functional connectivity between the DMN and subgenual prefrontal cortex (sgPFC)—connectivity that often predicts levels of depressive rumination. We also present meta-analytic findings that, while there is reliably increased regional cerebral blood flow in sgPFC in MDD, no such abnormality has been reliably observed in nodes of the DMN. We then detail a model that integrates the body of research presented. In this model, we propose that increased functional connectivity between sgPFC and the DMN in MDD represents an integration of the self-referential processes supported by the DMN with the affectively laden, behavioral withdrawal processes associated with sgPFC—an integration that produces a functional neural ensemble well suited for depressive rumination and that, in MDD, abnormally taxes only sgPFC and not the DMN. This synthesis explains a broad array of existing data concerning the neural substrates of depressive rumination and provides an explicit account of functional abnormalities in sgPFC in MDD.