National Institute of Psychiatry and Addictions, Nyírő Gyula Hospital (OPAI), Budapest, Hungary.
National Institute of Psychiatry and Addictions, Nyírő Gyula Hospital (OPAI), Budapest, Hungary; Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary; Department of Physiology, University of Szeged, Szeged, Hungary.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Apr 20;83:1-7. doi: 10.1016/j.pnpbp.2017.12.011. Epub 2017 Dec 19.
Prior studies indicated that neuroinflammation might play a role in the pathophysiology of major depressive disorder (MDD). The purpose of this study was to examine changes in a microglial marker in the brain of patients with MDD during cognitive-behavioral therapy (CBT) and supportive psychotherapy (SPT). Participants were newly diagnosed patients with MDD receiving CBT (n=20) or SPT (n=20) who were compared with 20 healthy control subjects. We used [F]-FEPPA positron emission tomography (PET) to examine translocator protein total distribution volume (TSPO V), a marker of microglial density and inflammation. Patients were scanned before and after CBT and SPT. Before therapy, TSPO V was significantly elevated in neocortical grey matter, frontal cortex, temporal cortex, and hippocampus in MDD relative to the control subjects. In the CBT group, but not in the SPT group, TSPO V was significantly reduced during the treatment period. Reductions in TSPO V were correlated with the amelioration of depressive symptoms. This correlation was consistent in the hippocampus in both CBT and SPT groups. In conclusion, CBT, when it reduced symptoms, also decreased TSPO V. Efficient psychosocial interventions were accompanied by the normalization of a glial marker in the brain of patients with MDD, which may indicate reduced pro-inflammatory activity.
先前的研究表明，神经炎症可能在重度抑郁症（MDD）的病理生理学中起作用。本研究的目的是在认知行为疗法（CBT）和支持性心理治疗（SPT）期间检查 MDD 患者大脑中小胶质细胞标志物的变化。参与者为新诊断为 MDD 的患者，他们接受 CBT（n=20）或 SPT（n=20）治疗，并与 20 名健康对照组进行比较。我们使用 [F]-FEPPA 正电子发射断层扫描（PET）来检查转位蛋白总分布容积（TSPO V），这是小胶质细胞密度和炎症的标志物。患者在 CBT 和 SPT 之前和之后进行扫描。在治疗前，与对照组相比，MDD 患者的新皮质灰质、额叶皮层、颞叶皮层和海马体中的 TSPO V 显著升高。在 CBT 组中，但在 SPT 组中，TSPO V 在治疗期间显著降低。TSPO V 的减少与抑郁症状的改善相关。这种相关性在 CBT 和 SPT 组的海马体中均一致。总之，CBT 在减轻症状的同时，也降低了 TSPO V。有效的心理社会干预伴随着 MDD 患者大脑中胶质标志物的正常化，这可能表明促炎活性降低。
