Jawahar Nitish, Jawahar Bavesh, Sayal Kapil, Auer Dorothee P
Mental Health & Clinical Neurosciences, School of Medicine, Queen's Medical Centre, Derby Rd, Nottingham NG7 2UH, United Kingdom; Sir Peter Mansfield Imaging Centre, Nottingham, United Kingdom.
GKT School of Medical Education, King's College London, 1st Floor, Henriette Raphael Building, Guy's Campus, London SE1 1UL, United Kingdom.
Neurosci Biobehav Rev. 2025 Jul;174:106196. doi: 10.1016/j.neubiorev.2025.106196. Epub 2025 May 3.
Childhood and adolescence are neurodevelopmentally critical periods, during which psychological adversity can increase the risk of subsequent mental health difficulties. However, the increased neuroplasticity during this window also confers potential for developing resilience, which is now seen as a dynamic process of adapting to adversity. This pre-registered systematic review (PROSPERO-CRD42024537715) summarises the post-intervention neuroimaging outcomes of non-invasive, non-pharmacological interventions aimed at promoting resilience in samples with a mean age of < 25 years exposed to any explicit psychological stress. Studies involving traumatic or focal brain lesions were excluded. MEDLINE, PsycINFO and CENTRAL databases were searched from inception to 14/7/2024. Magnetic Resonance Imaging (MRI) outcomes were the primary focus. Risk of bias was assessed against adapted Joanna Briggs Institute checklist items. A narrative synthesis was conducted due to study heterogeneity. We identified 13 eligible studies: 1 reporting structural and diffusion-weighted MRI (performed after 2 years of intervention), 1 resting-state fMRI (14 years after end of intervention) and 11 task-based fMRI metrics (ranging from immediately post-intervention to 8 years after end of intervention). Resilience interventions reduce limbic activity (thalamus, amygdala and right anterior insula) in task-based fMRI. In older adolescents, social, mindfulness, and exercise interventions strengthen Prefrontal Cortex(PFC)-limbic connectivity, decreasing limbic activity. Evidence in younger adolescents is sparse, showing mixed effects on PFC-limbic connectivity. Five studies were at high risk of bias; the most common limitation was no pre-intervention MRI scans. Overall, this study summarises promising mechanisms, as demonstrated on neuroimaging, through which resilience can be enhanced in stressed youth through psychosocial interventions.
童年和青少年时期是神经发育的关键时期，在此期间，心理逆境会增加随后出现心理健康问题的风险。然而，这一时期神经可塑性的增强也赋予了发展复原力的潜力，现在人们将复原力视为一个适应逆境的动态过程。这项预先注册的系统评价（PROSPERO-CRD42024537715）总结了旨在提高平均年龄<25岁且暴露于任何明确心理压力的样本的复原力的非侵入性、非药物干预的干预后神经影像学结果。涉及创伤性或局灶性脑损伤的研究被排除。检索了MEDLINE、PsycINFO和CENTRAL数据库，时间范围从创建到2024年7月14日。磁共振成像（MRI）结果是主要关注点。根据改编后的乔安娜·布里格斯研究所检查表项目评估偏倚风险。由于研究的异质性，进行了叙述性综合分析。我们确定了13项符合条件的研究：1项报告了结构和扩散加权MRI（在干预2年后进行），1项静息态功能磁共振成像（在干预结束后14年）和11项基于任务的功能磁共振成像指标（从干预后立即到干预结束后8年）。在基于任务的功能磁共振成像中，复原力干预可降低边缘系统活动（丘脑、杏仁核和右前岛叶）。在年龄较大的青少年中，社交、正念和运动干预可加强前额叶皮质（PFC）与边缘系统的连接，降低边缘系统活动。在年龄较小的青少年中，证据稀少，对PFC与边缘系统的连接显示出混合效应。五项研究存在高偏倚风险；最常见的局限性是没有干预前的MRI扫描。总体而言，本研究总结了通过神经影像学证明的有前景的机制，通过社会心理干预可以增强处于压力下的年轻人的复原力。
