Macêdo Marcos Antônio, Sato João Ricardo, Bressan Rodrigo A, Pan Pedro Mario
Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, Santo André, SP, Brazil. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Braz J Psychiatry. 2022 Jul 26;44(4):420-33. doi: 10.47626/1516-4446-2021-2032.
The neurobiological factors associated with the emergence of major depressive disorder (MDD) in adolescence are still unclear. Previous cross-sectional studies have documented aberrant connectivity in resting-state functional magnetic resonance imaging (rs-fMRI) networks. However, whether these findings precede MDD onset has not been established. This scoping review mapped key methodological aspects and main findings of longitudinal rs-fMRI studies of MDD in adolescence. Three sets of neuroimaging methods to analyze rs-fMRI data were identified: seed-based analysis, independent component analysis, and network-based approaches. Main findings involved aberrant connectivity within and between the default mode network (DMN), the cognitive control network (CCN), and the salience network (SN). Accordingly, we utilized Menon's (2011) triple-network model for neuropsychiatric disorders to summarize key results. Adolescent MDD was associated with hyperconnectivity within the SN and between DMN and SN, as well as hypoconectivity within the CCN. These findings suggested that dysfunctional connectivity among the three main large-scale brain networks preceded MDD onset. However, there was high heterogeneity in neuroimaging methods and sampling procedures, which may limit comparisons between studies. Future studies should consider some level of harmonization for clinical instruments and neuroimaging methods.
与青少年期重度抑郁症(MDD)发生相关的神经生物学因素仍不明确。以往的横断面研究记录了静息态功能磁共振成像(rs-fMRI)网络中的异常连接。然而,这些发现是否先于MDD发病尚未得到证实。本综述概述了青少年MDD纵向rs-fMRI研究的关键方法学方面和主要发现。确定了三组用于分析rs-fMRI数据的神经成像方法:基于种子点的分析、独立成分分析和基于网络的方法。主要发现涉及默认模式网络(DMN)、认知控制网络(CCN)和突显网络(SN)内部及之间的异常连接。因此,我们利用梅农(2011年)的神经精神疾病三网络模型总结关键结果。青少年MDD与SN内部以及DMN和SN之间的连接增强,以及CCN内部的连接减弱有关。这些发现表明,三个主要大规模脑网络之间的连接功能障碍先于MDD发病。然而,神经成像方法和抽样程序存在高度异质性,这可能会限制研究之间的比较。未来的研究应考虑在临床工具和神经成像方法方面进行一定程度的统一。