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利用正电子发射断层扫描技术研究女性生命周期中激素介导的神经化学变化:对抑郁症的影响。

Using positron emission tomography to investigate hormone-mediated neurochemical changes across the female lifespan: implications for depression.

机构信息

a Emotion NeuroimaGinG(EGG)-Lab , Max Planck Institute for Cognitive and Brain Sciences , Leipzig , Germany.

b Department of Neurology , Max Planck Institute for Cognitive and Brain Sciences , Leipzig , Germany.

出版信息

Int Rev Psychiatry. 2017 Dec;29(6):580-596. doi: 10.1080/09540261.2017.1397607. Epub 2017 Dec 4.

DOI:10.1080/09540261.2017.1397607
PMID:29199875
Abstract

Ovarian hormones, particularly oestrogen and progesterone, undergo major fluctuations across the female lifespan. These hormone transition periods, such as the transition from pregnancy to postpartum, as well as the transition into menopause (perimenopause), are also known to be times of elevated susceptibility to depression. This study reviews how these transition periods likely influence neurochemical changes in the brain that result in disease vulnerability. While there are known associations between oestrogen/progesterone and different monoaminergic systems, the interactions and their potential implications for mood disorders are relatively unknown. Positron Emission Tomography (PET) allows for the in-vivo quantification of such neurochemical changes, and, thus, can provide valuable insight into how both subtle and dramatic shifts in hormones contribute to the elevated rates of depression during pre-menstrual, post-partum, and perimenopausal periods in a woman's life. As one better understands how to address the challenges of PET studies involving highly vulnerable populations, such as women who have recently given birth, one will gain the insight necessary to design and individualize treatment and therapy. Understanding the precise time-line in younger women when dramatic fluctuations in the hormonal milieu may contribute to brain changes may present a powerful opportunity to intervene before a vulnerable state develops into a diseased state in later life.

摘要

卵巢激素,特别是雌激素和孕激素,在女性一生中会经历重大波动。这些激素过渡时期,如从怀孕到产后的过渡,以及进入更年期(围绝经期),也被认为是抑郁症高发的时期。本研究综述了这些过渡时期如何影响大脑中的神经化学变化,从而导致疾病易感性。虽然已知雌激素/孕激素与不同的单胺能系统之间存在关联,但它们的相互作用及其对情绪障碍的潜在影响尚不清楚。正电子发射断层扫描(PET)允许对这些神经化学变化进行体内定量,因此,可以深入了解女性在月经前、产后和围绝经期期间,激素的细微和剧烈变化如何导致抑郁率升高。随着人们对涉及高脆弱人群的 PET 研究(如刚分娩的女性)的挑战的理解程度不断加深,就会获得设计和个性化治疗和疗法所需的洞察力。了解年轻女性中激素环境剧烈波动可能导致大脑变化的确切时间线,可能为在脆弱状态发展为老年疾病之前进行干预提供有力机会。

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