寻找用于指导重度抑郁症治疗选择的神经影像学生物标志物:文献综述
In pursuit of neuroimaging biomarkers to guide treatment selection in major depressive disorder: a review of the literature.
作者信息
Lener Marc S, Iosifescu Dan V
机构信息
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
出版信息
Ann N Y Acad Sci. 2015 May;1344:50-65. doi: 10.1111/nyas.12759. Epub 2015 Apr 8.
Over the last few decades, neuroimaging techniques have advanced the identification of structural, functional, and neurochemical brain abnormalities that are associated with the increased risk, clinical course, and treatment outcomes of major depressive disorder (MDD). This paper reviews specific neuroimaging abnormalities that, on the basis of early studies, may discriminate between MDD patients who do or do not respond to current therapeutic modalities, such as antidepressants, cognitive behavioral therapy, or novel therapies. Differences in gray matter volume, white matter coherence, brain activity via structural and functional magnetic resonance imaging techniques, and concentrations of specific brain metabolites (as measured with magnetic resonance spectroscopy), are potential biomarkers discussed in this review. Given the heterogeneity of MDD, larger, multisite studies with increased statistical power will be needed to identify more precise imaging biomarkers of treatment response in MDD.
在过去几十年中,神经成像技术推动了对与重度抑郁症(MDD)风险增加、临床病程及治疗结果相关的大脑结构、功能和神经化学异常的识别。本文回顾了基于早期研究的特定神经成像异常情况,这些异常可能区分出对当前治疗方式(如抗抑郁药、认知行为疗法或新型疗法)有反应或无反应的MDD患者。通过结构和功能磁共振成像技术测量的灰质体积、白质连贯性、大脑活动以及特定脑代谢物浓度(通过磁共振波谱法测量)的差异,是本综述中讨论的潜在生物标志物。鉴于MDD的异质性,需要开展更大规模、多中心且具有更高统计效力的研究,以识别出MDD治疗反应更精确的成像生物标志物。