Strawn Jeffrey R, Levine Amir
Department of Psychiatry and Behavioral Neuroscience; Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Department of Pediatrics, Division of Child & Adolescent Psychiatry and Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Biomark Neuropsychiatry. 2020 Dec;3. doi: 10.1016/j.bionps.2020.100024. Epub 2020 Jul 17.
Multiple and diverse psychotherapeutic or psychopharmacologic treatments effectively reduce symptoms for many patients with anxiety disorders, but the trajectory and magnitude of response vary considerably. This heterogeneity of treatment response has invigorated the search for biomarkers of treatment response in anxiety disorders, across the lifespan. In this review, we summarize evidence for biomarkers of treatment response in children, adolescents and adults with generalized, separation and social anxiety disorders as well as panic disorder. We then discuss the relationship between these biomarkers of treatment response and the pathophysiology of anxiety disorders. Finally, we provide context for treatment response biomarkers of the future, including neuronally-derived extracellular vesicles in anxiety disorders and discuss challenges that must be overcome prior to the debut of treatment response biomarkers in the clinic. A number of promising treatment response biomarkers have been identified, although there is an urgent need to replicate findings and to identify which biomarkers might guide clinicians in selecting from available treatments rather than just simply identifying patients who may be less likely to respond to a given intervention.
多种不同的心理治疗或精神药物治疗可有效减轻许多焦虑症患者的症状，但反应的轨迹和程度差异很大。这种治疗反应的异质性激发了人们在整个生命周期中寻找焦虑症治疗反应生物标志物的研究。在本综述中，我们总结了广泛性焦虑症、分离性焦虑症、社交焦虑症以及惊恐障碍儿童、青少年和成人治疗反应生物标志物的证据。然后，我们讨论这些治疗反应生物标志物与焦虑症病理生理学之间的关系。最后，我们为未来的治疗反应生物标志物提供背景信息，包括焦虑症中神经元衍生的细胞外囊泡，并讨论在临床中出现治疗反应生物标志物之前必须克服的挑战。尽管迫切需要重复研究结果并确定哪些生物标志物可以指导临床医生从现有治疗方法中进行选择，而不仅仅是简单地识别可能对特定干预反应较小的患者，但目前已经确定了一些有前景的治疗反应生物标志物。
