Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China; School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, PR China.
Asian J Psychiatr. 2024 Jul;97:104092. doi: 10.1016/j.ajp.2024.104092. Epub 2024 May 25.
Early life stress (ELS) significantly increases the risk of mood disorders and affects the neurodevelopment of the primary cortex.
Modulating the primary cortex through neural intervention can ameliorate the impact of ELS on brain development and consequently alleviate its effects on mood disorders.
We induced the chronic unpredictable mild stress (CUMS) model in adolescent rats, followed by applying repetitive transcranial magnetic stimulation (rTMS) to their primary cortex in early adulthood. To assess the applicability of primary cortex rTMS in humans, we recruited individuals aged 17-25 with mood disorders who had experienced ELS and performed primary cortex rTMS on them. Functional magnetic resonance imaging (fMRI) and depression-related behavioral and clinical symptoms were conducted in both rats and human subjects before and after the rTMS.
In animals, fMRI analysis revealed increased activation in the primary cortex of CUMS rats and decrease subcortical activation. Following the intervention of primary cortex rTMS, the abnormal functional activity was reversed. Similarly, in mood disorders patients with ELS, increased activation in the primary cortex and decreased activation in the frontal cortex were observed. During rTMS intervention, similar neuroimaging improvements were noted, particularly decreased activation in the primary cortex. This suggests that targeted rTMS in the primary cortex can reverse the abnormal neuroimaging.
This cross-species translational study has identified the primary cortex as a key region in mood disorders patients with ELS. Targeting the primary cortex with rTMS can correct abnormal functional activity while improving symptoms. Our study provides translational evidence for therapeutics targeting the ELS factor of mood disorders patients.
早期生活应激(ELS)显著增加了情绪障碍的风险,并影响了初级皮层的神经发育。
通过神经干预调节初级皮层可以改善 ELS 对大脑发育的影响,从而减轻其对情绪障碍的影响。
我们在青春期大鼠中诱导慢性不可预测轻度应激(CUMS)模型,然后在成年早期对其初级皮层施加重复经颅磁刺激(rTMS)。为了评估初级皮层 rTMS 在人类中的适用性,我们招募了患有 ELS 且经历过 ELS 的 17-25 岁情绪障碍个体,并对其进行初级皮层 rTMS。在 rTMS 前后,对大鼠和人类受试者进行功能磁共振成像(fMRI)以及与抑郁相关的行为和临床症状评估。
在动物中,fMRI 分析显示 CUMS 大鼠初级皮层的激活增加,而皮质下激活减少。在初级皮层 rTMS 干预后,异常的功能活动得到了逆转。同样,在患有 ELS 的情绪障碍患者中,观察到初级皮层的激活增加和额叶皮层的激活减少。在 rTMS 干预期间,也观察到类似的神经影像学改善,特别是初级皮层的激活减少。这表明靶向初级皮层的 rTMS 可以逆转异常的神经影像学。
这项跨物种转化研究确定了初级皮层是患有 ELS 的情绪障碍患者的关键区域。rTMS 靶向初级皮层可以纠正异常的功能活动,同时改善症状。我们的研究为针对情绪障碍患者 ELS 因素的治疗提供了转化证据。