Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Göttingen, Germany.
Transl Psychiatry. 2023 Jun 9;13(1):196. doi: 10.1038/s41398-023-02499-y.
Major depressive disorder (MDD) is a very prevalent mental disorder that imposes an enormous burden on individuals, society, and health care systems. Most patients benefit from commonly used treatment methods such as pharmacotherapy, psychotherapy, electroconvulsive therapy (ECT), and repetitive transcranial magnetic stimulation (rTMS). However, the clinical decision on which treatment method to use remains generally informed and the individual clinical response is difficult to predict. Most likely, a combination of neural variability and heterogeneity in MDD still impedes a full understanding of the disorder, as well as influences treatment success in many cases. With the help of neuroimaging methods like functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), the brain can be understood as a modular set of functional and structural networks. In recent years, many studies have investigated baseline connectivity biomarkers of treatment response and the connectivity changes after successful treatment. Here, we systematically review the literature and summarize findings from longitudinal interventional studies investigating the functional and structural connectivity in MDD. By compiling and discussing these findings, we recommend the scientific and clinical community to deepen the systematization of findings to pave the way for future systems neuroscience roadmaps that include brain connectivity parameters as a possible precision component of the clinical evaluation and therapeutic decision.
重度抑郁症（MDD）是一种非常普遍的精神障碍，给个人、社会和医疗保健系统带来了巨大的负担。大多数患者从常用的治疗方法中受益，如药物治疗、心理治疗、电惊厥治疗（ECT）和重复经颅磁刺激（rTMS）。然而，对于使用哪种治疗方法的临床决策通常是基于信息的，并且个体的临床反应难以预测。很可能，MDD 中的神经变异性和异质性的组合仍然阻碍了对该疾病的全面理解，并在许多情况下影响了治疗的成功。借助功能磁共振成像（fMRI）和弥散张量成像（DTI）等神经影像学方法，可以将大脑理解为具有功能和结构网络的模块化集合。近年来，许多研究调查了治疗反应的基线连通性生物标志物以及成功治疗后的连通性变化。在这里，我们系统地回顾了文献，并总结了关于 MDD 功能和结构连通性的纵向干预研究的发现。通过编译和讨论这些发现，我们建议科学界和临床界深化发现的系统化，为未来的系统神经科学路线图铺平道路，将大脑连通性参数作为临床评估和治疗决策的一个可能的精确组成部分。
