Gallucci Julia, Secara Maria T, Chen Oliver, Oliver Lindsay D, Jones Brett D M, Marawi Tulip, Foussias George, Voineskos Aristotle N, Hawco Colin
Campbell Family Mental Health Research Institute, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Schizophrenia (Heidelb). 2024 Jul 4;10(1):59. doi: 10.1038/s41537-024-00478-w.
Depressive symptoms in Schizophrenia Spectrum Disorders (SSDs) negatively impact suicidality, prognosis, and quality of life. Despite this, efficacious treatments are limited, largely because the neural mechanisms underlying depressive symptoms in SSDs remain poorly understood. We conducted a systematic review to provide an overview of studies that investigated the neural correlates of depressive symptoms in SSDs using neuroimaging techniques. We searched MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane Library databases from inception through June 19, 2023. Specifically, we focused on structural and functional magnetic resonance imaging (MRI), encompassing: (1) T1-weighted imaging measuring brain morphology; (2) diffusion-weighted imaging assessing white matter integrity; or (3) T2*-weighted imaging measures of brain function. Our search yielded 33 articles; 14 structural MRI studies, 18 functional (f)MRI studies, and 1 multimodal fMRI/MRI study. Reviewed studies indicate potential commonalities in the neurobiology of depressive symptoms between SSDs and major depressive disorders, particularly in subcortical and frontal brain regions, though confidence in this interpretation is limited. The review underscores a notable knowledge gap in our understanding of the neurobiology of depression in SSDs, marked by inconsistent approaches and few studies examining imaging metrics of depressive symptoms. Inconsistencies across studies' findings emphasize the necessity for more direct and comprehensive research focusing on the neurobiology of depression in SSDs. Future studies should go beyond "total score" depression metrics and adopt more nuanced assessment approaches considering distinct subdomains. This could reveal unique neurobiological profiles and inform investigations of targeted treatments for depression in SSDs.
精神分裂症谱系障碍(SSDs)中的抑郁症状对自杀倾向、预后和生活质量产生负面影响。尽管如此,有效的治疗方法仍然有限,主要原因是SSDs中抑郁症状背后的神经机制仍知之甚少。我们进行了一项系统综述,以概述使用神经成像技术研究SSDs中抑郁症状神经相关性的研究。我们检索了MEDLINE、PsycINFO、EMBASE、Web of Science和Cochrane图书馆数据库,检索时间从数据库创建到2023年6月19日。具体而言,我们专注于结构和功能磁共振成像(MRI),包括:(1)测量脑形态的T1加权成像;(2)评估白质完整性的扩散加权成像;或(3)脑功能的T2 *加权成像测量。我们的检索产生了33篇文章;14项结构MRI研究、18项功能(f)MRI研究和1项多模态fMRI/MRI研究。综述研究表明,SSDs和重度抑郁症之间在抑郁症状的神经生物学方面可能存在共性,特别是在皮质下和额叶脑区,尽管对此解释的信心有限。该综述强调了我们在理解SSDs中抑郁症神经生物学方面存在明显的知识空白,其特点是方法不一致,且很少有研究检查抑郁症状的成像指标。研究结果的不一致强调了有必要进行更直接和全面的研究,聚焦于SSDs中抑郁症的神经生物学。未来的研究应该超越抑郁症“总分”指标,采用更细致入微的评估方法,考虑不同的子领域。这可能揭示独特的神经生物学特征,并为SSDs中抑郁症的靶向治疗研究提供信息。
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