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静息态功能连接与重性抑郁障碍共病焦虑的相关性。

Resting-state functional connectivity correlates of anxiety co-morbidity in major depressive disorder.

机构信息

Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK; Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.

Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.

出版信息

Neurosci Biobehav Rev. 2022 Jul;138:104701. doi: 10.1016/j.neubiorev.2022.104701. Epub 2022 May 20.

Abstract

Major depressive disorder (MDD) is frequently co-morbid with anxiety disorders. The co-morbid state has poorer functional outcomes and greater resistance to first line treatments, highlighting the need for novel treatment targets. This systematic review examined differences in resting-state brain connectivity associated with anxiety comorbidity in young- and middle-aged adults with MDD, with the aim of identifying novel targets for neuromodulation treatments, as these treatments are thought to work partly by altering dysfunctional connectivity pathways. Twenty-one studies met inclusion criteria, including a total of 1292 people with MDD. Only two studies included people with MDD and formally diagnosed co-morbid anxiety disorders; the remainder included people with MDD with dimensional anxiety measurement. The quality of most studies was judged as fair. Results were heterogeneous, partly due to a focus on a small set of connectivity relationships within individual studies. There was evidence for dysconnectivity between the amygdala and other brain networks in co-morbid anxiety, and an indication that abnormalities of default mode network connectivity may play an underappreciated role in this condition.

摘要

重度抑郁症(MDD)常与焦虑症共病。共病状态的功能预后较差,对一线治疗的抵抗性更强,这凸显了寻找新的治疗靶点的必要性。本系统综述考察了与年轻和中年 MDD 患者伴发焦虑相关的静息态脑连接差异,旨在确定神经调节治疗的新靶点,因为这些治疗方法部分被认为是通过改变功能失调的连接途径起作用的。21 项研究符合纳入标准,共纳入了 1292 名 MDD 患者。只有两项研究纳入了经正式诊断为伴发焦虑障碍的 MDD 患者;其余研究纳入了伴有焦虑维度测量的 MDD 患者。大多数研究的质量被评为中等。结果存在异质性,部分原因是各研究中仅关注了一小部分连接关系。在伴发焦虑症中,杏仁核与其他脑网络之间存在连接异常,并且表明默认模式网络连接异常可能在这种情况下发挥了未被充分认识的作用。

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