迈向炎症性抑郁症的多维模型。

Towards a multidimensional model of inflamed depression.

作者信息

Wijaya Maria Teresa, Jin Rachel R, Liu Xingguo, Zhang Ruibin, Lee Tatia M C

机构信息

State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.

Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong.

出版信息

Brain Behav Immun Health. 2022 Nov 20;26:100564. doi: 10.1016/j.bbih.2022.100564. eCollection 2022 Dec.

Abstract

Major depressive disorder (MDD) continues to impose a significant burden on individuals and society. Existing data support the important role that inflammatory responses play in its pathophysiology, with new findings continuing to be reported. In this narrative review paper, we focus on three dimensions of inflamed depression: risk factors, clinical symptoms, and neurofunctional changes. We aim to answer the following questions: What characteristics most robustly discriminate between inflamed and non-inflamed depression? How can we leverage on these discriminative characteristics to classify inflamed depressed patients? One important point that has emerged is the heterogeneous nature of the relationship between inflammation and depression. Not all inflamed patients are depressed, and not all depressed patients are inflamed. Some risk factors heighten vulnerability to inflamed depression, including childhood adversity, old age, and being female. The inflamed depression subtype has been associated with distinct clinical phenotypes, most robustly with physical symptoms such as sleep problems, changes in appetite, and fatigue. Neurofunctional changes are found in the dopaminergic reward processing pathways. A better characterization of the inflamed depression subtype by leveraging multidimensional data will help craft a more precise treatment for these patients.

摘要

重度抑郁症(MDD)继续给个人和社会带来重大负担。现有数据支持炎症反应在其病理生理学中所起的重要作用,并且不断有新的研究结果被报道。在这篇叙述性综述论文中,我们聚焦于炎症性抑郁症的三个维度:危险因素、临床症状和神经功能变化。我们旨在回答以下问题:哪些特征能够最有力地区分炎症性抑郁症和非炎症性抑郁症?我们如何利用这些鉴别特征对炎症性抑郁症患者进行分类?一个已出现的重要观点是炎症与抑郁症之间关系的异质性。并非所有炎症患者都会抑郁,也并非所有抑郁症患者都有炎症。一些危险因素会增加患炎症性抑郁症的易感性,包括童年逆境、老年和女性。炎症性抑郁症亚型与独特的临床表型相关,最显著的是与睡眠问题、食欲变化和疲劳等躯体症状相关。在多巴胺能奖赏处理通路中发现了神经功能变化。通过利用多维度数据更好地描述炎症性抑郁症亚型,将有助于为这些患者制定更精准的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7c9/9694059/af0ed5a70174/gr1.jpg

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