From the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine (Dr. McNamara); Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH (Dr. Almeida).
Harv Rev Psychiatry. 2019 Mar/Apr;27(2):94-107. doi: 10.1097/HRP.0000000000000199.
Meta-analytic evidence indicates that mood and psychotic disorders are associated with both omega-3 polyunsaturated fatty acid (omega-3 PUFA) deficits and progressive regional gray and white matter pathology. Although the association between omega-3 PUFA insufficiency and progressive neuropathological processes remains speculative, evidence from translational research suggests that omega-3 PUFA insufficiency may represent a plausible and modifiable risk factor not only for enduring neurodevelopmental abnormalities in brain structure and function, but also for increased vulnerability to neurodegenerative processes. Recent evidence from human neuroimaging studies suggests that lower omega-3 PUFA intake/status is associated with accelerated gray matter atrophy in healthy middle-aged and elderly adults, particularly in brain regions consistently implicated in mood and psychotic disorders, including the amygdala, anterior cingulate, hippocampus, prefrontal cortex, and temporal cortex. Human neuroimaging evidence also suggests that both low omega-3 PUFA intake/status and psychiatric disorders are associated with reductions in white matter microstructural integrity and increased rates of white matter hyperintensities. Preliminary evidence suggests that increasing omega-3 PUFA status is protective against gray matter atrophy and deficits in white matter microstructural integrity in patients with mood and psychotic disorders. Plausible mechanisms mediating this relationship include elevated pro-inflammatory signaling, increased synaptic regression, and reductions in cerebral perfusion. Together these associations encourage additional neuroimaging research to directly investigate whether increasing omega-3 PUFA status can mitigate neuropathological processes in patients with, or at high risk for, psychiatric disorders.
荟萃分析证据表明,情绪和精神病障碍与ω-3 多不饱和脂肪酸(ω-3 PUFA)缺乏和进行性区域性灰质和白质病理学有关。尽管 ω-3 PUFA 不足与进行性神经病理学过程之间的关联仍在推测之中,但转化研究的证据表明,ω-3 PUFA 不足不仅可能代表一个合理且可改变的风险因素,不仅与大脑结构和功能的持久神经发育异常有关,而且与神经退行性过程的易感性增加有关。来自人类神经影像学研究的最新证据表明,较低的 ω-3 PUFA 摄入量/状态与健康中年和老年人的灰质萎缩加速有关,特别是在与情绪和精神病障碍一致相关的大脑区域,包括杏仁核、前扣带回、海马体、前额叶皮层和颞叶皮层。人类神经影像学证据还表明,低 ω-3 PUFA 摄入量/状态和精神疾病与白质微观结构完整性降低以及白质高信号增加率有关。初步证据表明,增加 ω-3 PUFA 状态可预防情绪和精神病障碍患者的灰质萎缩和白质微观结构完整性缺陷。介导这种关系的可能机制包括炎症信号的升高、突触退化的增加以及脑灌注的减少。这些关联共同鼓励进行更多的神经影像学研究,以直接调查增加 ω-3 PUFA 状态是否可以减轻精神病患者或有精神病风险患者的神经病理学过程。