Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review.
Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review.
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DOI：
10.3389/fnhum.2015.00582
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发表时间：
2015
影响因子：
2.9
通讯作者：
Guàrdia-Olmos J
中科院分区：
文献类型：
--
作者：
Gudayol-Ferré E;Peró-Cebollero M;González-Garrido AA;Guàrdia-Olmos J
抑郁症是一种精神疾病，表现为默认模式网络（DMN），情感网络（AN）和其他皮质边缘网络以及认知控制网络（CCN）等大脑连接的改变。近年来，人们对不同抗抑郁药治疗对功能连接可能产生的影响的兴趣大幅增加。本文的目的是对抑郁症治疗与脑连接关系的研究进行系统综述。在一项关于这一主题的系统综述中发现了19项研究。所有患者经抗抑郁治疗后临床症状均有改善。在19项研究中，有18项研究的临床改善与大脑连接的变化有关。似乎DMN和皮质与边缘结构之间的连接在抗抑郁药治疗后持续变化。然而，目前的证据并不允许我们确保抑郁症的治疗会导致CCN的变化。在这方面，一些论文报道了大脑连接的变化与抑郁症的改善之间的正相关性，特别是当他们测量皮质-边缘连接时，而DMN的变化与临床改善不显著相关。最后，一些论文表明，抗抑郁药治疗后连接的变化可能部分与治疗的作用机制有关。在两项刺激治疗研究（一项使用rTMS，一项使用ECT）和两篇给予三种不同药物治疗的论文中观察到了这种效应。我们的综述使我们能够提出一系列建议，这些建议可能会指导未来的研究人员探索抗抑郁治疗对大脑连接的影响。
Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity.