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联合治疗神经精神社会功能障碍。

Combinatorial approaches for treating neuropsychiatric social impairment.

机构信息

Department of Psychiatry, UCLA, Los Angeles, CA, USA.

Department of Psychiatry, Yale University, New Haven, CT, USA.

出版信息

Philos Trans R Soc Lond B Biol Sci. 2022 Aug 29;377(1858):20210051. doi: 10.1098/rstb.2021.0051. Epub 2022 Jul 11.

Abstract

Social behaviour is an essential component of human life and deficits in social function are seen across multiple psychiatric conditions with high morbidity. However, there are currently no FDA-approved treatments for social dysfunction. Since social cognition and behaviour rely on multiple signalling processes acting in concert across various neural networks, treatments aimed at social function may inherently require a combinatorial approach. Here, we describe the social neurobiology of the oxytocin and endocannabinoid signalling systems as well as translational evidence for their use in treating symptoms in the social domain. We leverage this systems neurobiology to propose a network-based framework that involves pharmacology, psychotherapy, non-invasive brain stimulation and social skills training to combinatorially target trans-diagnostic social impairment. Lastly, we discuss the combined use of oxytocin and endocannabinoids within our proposed framework as an illustrative strategy to treat specific aspects of social function. Using this framework provides a roadmap for actionable treatment strategies for neuropsychiatric social impairment. This article is part of the theme issue 'Interplays between oxytocin and other neuromodulators in shaping complex social behaviours'.

摘要

社会行为是人类生活的重要组成部分,多种精神疾病都存在社会功能缺陷,发病率很高。然而,目前还没有获得 FDA 批准的治疗社会功能障碍的方法。由于社会认知和行为依赖于多个信号传递过程在各种神经网络中协同作用,针对社会功能的治疗方法可能本质上需要一种组合方法。在这里,我们描述了催产素和内源性大麻素信号系统的社会神经生物学,以及它们在治疗社会领域症状方面的转化证据。我们利用这种系统神经生物学来提出一个基于网络的框架,该框架涉及药理学、心理治疗、非侵入性脑刺激和社交技能训练,以组合方式针对跨诊断的社会障碍。最后,我们讨论了在我们提出的框架中内源性大麻素和内源性大麻素的联合使用,作为治疗特定社会功能方面的一种示意性策略。使用这个框架为神经精神性社会障碍的治疗策略提供了一个可行的路线图。本文是主题为“催产素和其他神经调质在塑造复杂社会行为中的相互作用”的一部分。

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Combinatorial approaches for treating neuropsychiatric social impairment.联合治疗神经精神社会功能障碍。
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引用本文的文献

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Dissecting social decision-making: A spotlight on oxytocinergic transmission.剖析社会决策:聚焦催产素能传递。
Front Mol Neurosci. 2022 Dec 22;15:1061934. doi: 10.3389/fnmol.2022.1061934. eCollection 2022.
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Oxytocin does not stand alone.催产素并非独立存在。
Philos Trans R Soc Lond B Biol Sci. 2022 Aug 29;377(1858):20210047. doi: 10.1098/rstb.2021.0047. Epub 2022 Jul 11.

本文引用的文献

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Treatment resistance in psychiatry: state of the art and new directions.精神病学中的治疗抵抗:现状与新方向。
Mol Psychiatry. 2022 Jan;27(1):58-72. doi: 10.1038/s41380-021-01200-3. Epub 2021 Jul 13.

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