From Harvard Medical School; Department of Psychiatry (all) and Mood and Psychosis Program (Drs. Millett and Burdick), Brigham and Women's Hospital, Boston, MA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA (Dr. Kubicki).
Harv Rev Psychiatry. 2022;30(1):54-58. doi: 10.1097/HRP.0000000000000323.
In the field of neuropsychiatry, neuroinflammation is one of the prevailing hypotheses to explain the pathophysiology of mood and psychotic disorders. Neuroinflammation encompasses an ill-defined set of pathophysiological processes in the central nervous system that cause neuronal or glial atrophy or death and disruptions in neurotransmitter signaling, resulting in cognitive and behavioral changes. Positron emission tomography for the brain-based translocator protein has been shown to be a useful tool to measure glial activation in neuropsychiatric disorders. Recent neuroimaging studies also indicate a potential disruption in the choroid plexus and blood-brain barrier, which modulate the transfer of ions, molecules, toxins, and cells from the periphery into the brain. Simultaneously, peripheral inflammatory markers have consistently been shown to be altered in mood and psychotic disorders. The crosstalk (i.e., the communication between peripheral and central inflammatory pathways) is not well understood in these disorders, however, and neuroimaging studies hold promise to shed light on this complex process. In the current Perspectives article, we discuss the neuroimaging insights into neuroimmune crosstalk offered in selected works. Overall, evidence exists for peripheral immune cell infiltration into the central nervous system in some patients, but the reason for this is unknown. Future neuroimaging studies should aim to extend our knowledge of this system and the role it likely plays in symptom onset and recurrence.
在神经精神病学领域,神经炎症是解释情绪和精神病性障碍病理生理学的流行假设之一。神经炎症包含中枢神经系统中一系列定义不明确的病理生理过程,这些过程导致神经元或神经胶质萎缩或死亡,并破坏神经递质信号转导,导致认知和行为改变。基于脑的转位蛋白的正电子发射断层扫描已被证明是测量神经精神疾病中神经胶质激活的有用工具。最近的神经影像学研究也表明脉络丛和血脑屏障可能存在破坏,这些屏障调节离子、分子、毒素和细胞从外周向大脑的转移。同时,情绪和精神病性障碍中外周炎症标志物也一直被证明发生改变。然而,在这些疾病中,外周和中枢炎症途径之间的串扰(即交流)尚不清楚,神经影像学研究有望阐明这一复杂过程。在当前的观点文章中,我们讨论了选定研究中提供的神经影像学对神经免疫串扰的见解。总的来说,一些患者存在外周免疫细胞浸润中枢神经系统的证据,但原因尚不清楚。未来的神经影像学研究应旨在扩展我们对该系统的认识及其在症状发作和复发中可能发挥的作用。