Psychiatric University Hospital, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.
J Psychiatr Res. 2017 Sep;92:147-159. doi: 10.1016/j.jpsychires.2017.04.007. Epub 2017 Apr 24.
The alterations of functional connectivity brain networks in major depressive disorder (MDD) have been subject of a large number of studies. Using different methodologies and focusing on diverse aspects of the disease, research shows heterogeneous results lacking integration. Disrupted network connectivity has been found in core MDD networks like the default mode network (DMN), the central executive network (CEN), and the salience network, but also in cerebellar and thalamic circuitries. Here we review literature published on resting state brain network function in MDD focusing on methodology, and clinical characteristics including symptomatology and antidepressant treatment related findings. There are relatively few investigations concerning the qualitative aspects of symptomatology of MDD, whereas most studies associate quantitative aspects with distinct resting state functional connectivity alterations. Such depression severity associated alterations are found in the DMN, frontal, cerebellar and thalamic brain regions as well as the insula and the subgenual anterior cingulate cortex. Similarly, different therapeutical options in MDD and their effects on brain function showed patchy results. Herein, pharmaceutical treatments reveal functional connectivity alterations throughout multiple brain regions notably the DMN, fronto-limbic, and parieto-temporal regions. Psychotherapeutical interventions show significant functional connectivity alterations in fronto-limbic networks, whereas electroconvulsive therapy and repetitive transcranial magnetic stimulation result in alterations of the subgenual anterior cingulate cortex, the DMN, the CEN and the dorsal lateral prefrontal cortex. While it appears clear that functional connectivity alterations are associated with the pathophysiology and treatment of MDD, future research should also generate a common strategy for data acquisition and analysis, as a least common denominator, to set the basis for comparability across studies and implementation of functional connectivity as a scientifically and clinically useful biomarker.
功能连接脑网络在重度抑郁症（MDD）中的改变是大量研究的主题。使用不同的方法学并关注疾病的不同方面，研究显示出缺乏整合的异质结果。已经发现核心 MDD 网络（如默认模式网络（DMN）、中央执行网络（CEN）和突显网络）以及小脑和丘脑电路的网络连接中断，但也发现了小脑和丘脑电路的网络连接中断。在这里，我们回顾了关于 MDD 静息态脑网络功能的文献，重点关注方法学和临床特征，包括症状学和与抗抑郁治疗相关的发现。关于 MDD 症状学的定性方面的研究相对较少，而大多数研究将定量方面与明显的静息态功能连接改变联系起来。在 DMN、额叶、小脑和丘脑脑区以及岛叶和扣带回前部皮质中发现了与抑郁严重程度相关的这种改变。同样，MDD 中不同的治疗选择及其对大脑功能的影响显示出零星的结果。在这里，药物治疗显示出贯穿多个脑区的功能连接改变，特别是 DMN、额-边缘和顶-颞区。心理治疗干预显示出在额-边缘网络中显著的功能连接改变，而电惊厥治疗和重复经颅磁刺激导致扣带回前部皮质、DMN、CEN 和背外侧前额叶皮质的改变。虽然功能连接改变与 MDD 的病理生理学和治疗密切相关，但未来的研究还应该生成一个通用的数据采集和分析策略，作为一个最低公分母，为跨研究的可比性和实施功能连接作为一个科学和临床有用的生物标志物奠定基础。
