Ressler Kerry J, Mayberg Helen S
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 954 Gatewood Drive, Atlanta, Georgia 30329, USA.
Nat Neurosci. 2007 Sep;10(9):1116-24. doi: 10.1038/nn1944.
Recent decades have witnessed tremendous advances in the neuroscience of emotion, learning and memory, and in animal models for understanding depression and anxiety. This review focuses on new rationally designed psychiatric treatments derived from preclinical human and animal studies. Nonpharmacological treatments that affect disrupted emotion circuits include vagal nerve stimulation, rapid transcranial magnetic stimulation and deep brain stimulation, all borrowed from neurological interventions that attempt to target known pathological foci. Other approaches include drugs that are given in relation to specific learning events to enhance or disrupt endogenous emotional learning processes. Imaging data suggest that common regions of brain activation are targeted with pharmacological and somatic treatments as well as with the emotional learning in psychotherapy. Although many of these approaches are experimental, the rapidly developing understanding of emotional circuit regulation is likely to provide exciting and powerful future treatments for debilitating mood and anxiety disorders.
近几十年来,情绪、学习和记忆的神经科学以及用于理解抑郁症和焦虑症的动物模型都取得了巨大进展。本综述聚焦于从临床前人体和动物研究中合理设计出的新型精神科治疗方法。影响紊乱情绪回路的非药物治疗方法包括迷走神经刺激、快速重复经颅磁刺激和深部脑刺激,这些都是借鉴了试图针对已知病理病灶的神经学干预措施。其他方法包括与特定学习事件相关给予的药物,以增强或扰乱内源性情绪学习过程。影像学数据表明,大脑激活的共同区域是药物治疗、躯体治疗以及心理治疗中的情绪学习的靶向目标。尽管这些方法中有许多仍处于实验阶段,但对情绪回路调节的快速深入理解很可能为使人衰弱的情绪和焦虑障碍提供令人兴奋且有效的未来治疗方法。