Xie Musi, Huang Ying, Cai Wendan, Zhang Bingqi, Huang Haonan, Li Qingwei, Qin Pengmin, Han Junrong
Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China.
Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China.
Brain Sci. 2024 Jan 4;14(1):50. doi: 10.3390/brainsci14010050.
Patients with major depressive disorder (MDD) exhibit an abnormal physiological arousal pattern known as hyperarousal, which may contribute to their depressive symptoms. However, the neurobiological mechanisms linking this abnormal arousal to depressive symptoms are not yet fully understood. In this review, we summarize the physiological and neural features of arousal, and review the literature indicating abnormal arousal in depressed patients. Evidence suggests that a hyperarousal state in depression is characterized by abnormalities in sleep behavior, physiological (e.g., heart rate, skin conductance, pupil diameter) and electroencephalography (EEG) features, and altered activity in subcortical (e.g., hypothalamus and locus coeruleus) and cortical regions. While recent studies highlight the importance of subcortical-cortical interactions in arousal, few have explored the relationship between subcortical-cortical interactions and hyperarousal in depressed patients. This gap limits our understanding of the neural mechanism through which hyperarousal affects depressive symptoms, which involves various cognitive processes and the cerebral cortex. Based on the current literature, we propose that the hyperconnectivity in the thalamocortical circuit may contribute to both the hyperarousal pattern and depressive symptoms. Future research should investigate the relationship between thalamocortical connections and abnormal arousal in depression, and explore its implications for non-invasive treatments for depression.
重度抑郁症（MDD）患者表现出一种被称为过度觉醒的异常生理觉醒模式，这可能导致他们出现抑郁症状。然而，将这种异常觉醒与抑郁症状联系起来的神经生物学机制尚未完全明确。在本综述中，我们总结了觉醒的生理和神经特征，并回顾了表明抑郁症患者存在异常觉醒的文献。有证据表明，抑郁症中的过度觉醒状态表现为睡眠行为、生理（如心率、皮肤电导率、瞳孔直径）和脑电图（EEG）特征异常，以及皮层下（如下丘脑和蓝斑）和皮层区域的活动改变。虽然最近的研究强调了皮层下 - 皮层相互作用在觉醒中的重要性，但很少有人探讨抑郁症患者皮层下 - 皮层相互作用与过度觉醒之间的关系。这一差距限制了我们对过度觉醒影响抑郁症状的神经机制的理解，而这一机制涉及各种认知过程和大脑皮层。基于当前的文献，我们提出丘脑皮质回路中的高连接性可能导致过度觉醒模式和抑郁症状。未来的研究应调查丘脑皮质连接与抑郁症中异常觉醒之间的关系，并探索其对抑郁症非侵入性治疗的意义。
