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精神疾病风险的跨诊断神经影像学标志物:叙事性综述。

Transdiagnostic neuroimaging markers of psychiatric risk: A narrative review.

机构信息

Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, United Kingdom.

Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom.

出版信息

Neuroimage Clin. 2021;30:102634. doi: 10.1016/j.nicl.2021.102634. Epub 2021 Mar 17.

Abstract

Several decades of neuroimaging research in psychiatry have shed light on structural and functional neural abnormalities associated with individual psychiatric disorders. However, there is increasing evidence for substantial overlap in the patterns of neural dysfunction seen across disorders, suggesting that risk for psychiatric illness may be shared across diagnostic boundaries. Gaining insights on the existence of shared neural mechanisms which may transdiagnostically underlie psychopathology is important for psychiatric research in order to tease apart the unique and common aspects of different disorders, but also clinically, so as to help identify individuals early on who may be biologically vulnerable to psychiatric disorder in general. In this narrative review, we first evaluate recent studies investigating the functional and structural neural correlates of a general psychopathology factor, which is thought to reflect the shared variance across common mental health symptoms and therefore index psychiatric vulnerability. We then link insights from this research to existing meta-analytic evidence for shared patterns of neural dysfunction across categorical psychiatric disorders. We conclude by providing an integrative account of vulnerability to mental illness, whereby delayed or disrupted maturation of large-scale networks (particularly default-mode, executive, and sensorimotor networks), and more generally between-network connectivity, results in a compromised ability to integrate and switch between internally and externally focused tasks.

摘要

几十年来,精神病学领域的神经影像学研究揭示了与个体精神障碍相关的结构和功能神经异常。然而,越来越多的证据表明,跨障碍的神经功能障碍模式存在实质性重叠,这表明精神疾病的风险可能跨越诊断界限共享。深入了解可能跨诊断地为精神病理学提供基础的共享神经机制对于精神病学研究很重要,以便梳理出不同障碍的独特和共同方面,而且在临床上也很重要,以便帮助识别出一般来说可能在生物学上容易受到精神障碍影响的个体。在这篇叙述性评论中,我们首先评估了最近研究普遍精神病理学因素的功能和结构神经相关性的研究,普遍精神病理学因素被认为反映了常见心理健康症状的共同方差,因此是精神脆弱性的指标。然后,我们将这些研究的见解与跨分类精神障碍的神经功能障碍的现有荟萃分析证据联系起来。最后,我们提供了一种对精神疾病易感性的综合解释,即大规模网络(特别是默认模式、执行和感觉运动网络)的延迟或中断成熟,以及更普遍的网络间连通性,导致内部和外部焦点任务之间的整合和切换能力受损。

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