Northoff Georg
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Center for Brain and Consciousness, Taipeh Medical University (TMU), Taipeh, Taiwan; College for Humanities and Medicine, Taipeh Medical University (TMU), Taipeh, Taiwan; ITAB, University of Chieti, Chieti, Italy.
J Affect Disord. 2016 Jan 15;190:854-866. doi: 10.1016/j.jad.2015.05.007. Epub 2015 May 14.
Despite intense neurobiological investigation in psychiatric disorders like major depressive disorder (MDD), the basic disturbance that underlies the psychopathological symptoms of MDD remains, nevertheless, unclear. Neuroimaging has focused mainly on the brain's extrinsic activity, specifically task-evoked or stimulus-induced activity, as related to the various sensorimotor, affective, cognitive, and social functions. Recently, the focus has shifted to the brain's intrinsic activity, otherwise known as its resting state activity. While various abnormalities have been observed during this activity, their meaning and significance for depression, along with its various psychopathological symptoms, are yet to be defined. Based on findings in healthy brain resting state activity and its particular spatial and temporal structure - defined in a functional and physiological sense rather than anatomical and structural - I claim that the various depressive symptoms are spatiotemporal disturbances of the resting state activity and its spatiotemporal structure. This is supported by recent findings that link ruminations and increased self-focus in depression to abnormal spatial organization of resting state activity. Analogously, affective and cognitive symptoms like anhedonia, suicidal ideation, and thought disorder can be traced to an increased focus on the past, increased past-focus as basic temporal disturbance o the resting state. Based on these findings, I conclude that the various depressive symptoms must be conceived as spatiotemporal disturbances of the brain's resting state's activity and its spatiotemporal structure. Importantly, this entails a new form of psychopathology, "Spatiotemporal Psychopathology" that directly links the brain and psyche, therefore having major diagnostic and therapeutic implications for clinical practice.
尽管对诸如重度抑郁症（MDD）等精神疾病进行了深入的神经生物学研究，但MDD精神病理症状背后的基本障碍仍不清楚。神经影像学主要关注大脑的外在活动，特别是与各种感觉运动、情感、认知和社会功能相关的任务诱发或刺激诱发活动。最近，研究重点已转向大脑的内在活动，即其静息状态活动。虽然在此活动期间观察到了各种异常情况，但它们对抑郁症及其各种精神病理症状的意义和重要性尚未明确。基于健康大脑静息状态活动及其特定时空结构的研究结果——从功能和生理意义而非解剖和结构意义上定义——我认为各种抑郁症状是静息状态活动及其时空结构的时空紊乱。最近的研究结果支持了这一观点，这些研究将抑郁症中的反复思考和自我关注增加与静息状态活动的异常空间组织联系起来。类似地，诸如快感缺失、自杀意念和思维障碍等情感和认知症状可以追溯到对过去的关注增加，即作为静息状态基本时间紊乱的过去关注增加。基于这些发现，我得出结论，各种抑郁症状必须被视为大脑静息状态活动及其时空结构的时空紊乱。重要的是，这需要一种新的精神病理学形式，即“时空精神病理学”，它直接将大脑和心理联系起来，因此对临床实践具有重大的诊断和治疗意义。
