Pediatric Mental Health Institute, School of Medicine, University of Colorado, Denver.
J Am Acad Child Adolesc Psychiatry. 2019 Nov;58(11):1057-1058. doi: 10.1016/j.jaac.2019.04.019. Epub 2019 May 3.
A major goal of psychiatric neuroscience is to identify brain regions and circuits that underlie clinical phenomena to gain a more precise understanding of their nature and treatment. These are early days in this effort, especially for pediatric mental health, but already there is evidence that brain changes may herald psychosis in youths at genetic risk for schizophrenia or response to therapy in youths with anxiety. Elucidating these brain-behavior relationships requires one to identify a clinically meaningful phenotype and associate it with specific brain regions or circuits that plausibly underlie the phenotype. In their article, Spechler et al. do just that by linking parent reports of broadly defined emotional and behavioral difficulties with gray matter volume in the orbitofrontal cortex (OFC). It is a compelling find because the OFC is thought to play a role in adaptive socioemotional functioning. The OFC is necessary for evaluating what outcome is most desirable in complex situations and is interconnected with other regions, such as the amygdala, that underlie social and emotional responses.
精神病神经科学的主要目标是确定大脑区域和回路,以了解临床现象的本质,从而更准确地了解其性质和治疗方法。这方面的研究还处于早期阶段,特别是在儿科心理健康方面,但已经有证据表明,大脑变化可能预示着精神分裂症遗传风险的青少年出现精神病,或预示着焦虑症青少年对治疗有反应。为了阐明这些大脑-行为关系,需要确定一个具有临床意义的表型,并将其与可能是该表型基础的特定大脑区域或回路联系起来。Spechler 等人在文章中通过将父母对广泛定义的情绪和行为困难的报告与眶额叶皮层(OFC)的灰质体积联系起来,做到了这一点。这是一个引人注目的发现,因为 OFC 被认为在适应性社会情感功能中发挥作用。OFC 对于评估在复杂情况下什么结果是最理想的是必要的,并且与其他区域(如杏仁核)相互连接,这些区域是社会和情感反应的基础。