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冲动性的跨诊断神经调节:现状与未来发展轨迹

Transdiagnostic neuromodulation of impulsivity: current status and future trajectories.

作者信息

Zhong Gangliang, Chen Tianzhen, Zhong Na, Rezapour Tara, Haghparast Abbas, Jiang Haifeng, Su Hang, Yuan Tifei, Robbins Trevor William, Du Jiang, Zhao Min

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Cognitive Psychology Department, Institute for Cognitive Science Studies, Tehran, Iran.

出版信息

Transl Psychiatry. 2025 Jun 23;15(1):209. doi: 10.1038/s41398-025-03415-2.

Abstract

Impulsivity, increasingly perceived as a transdiagnostic characteristic, significantly influences diverse psychiatric conditions and emanates beyond the boundaries defined by traditional classification systems. Transdiagnostic research has shed light on the complex clinical manifestations of impulsivity, and the underpinning neural circuitry. The pressing challenge now is to translate this enhanced understanding into precise and potent interventions tailored to these different aspects of impulsivity. Recent advancements in neuromodulation, specifically targeting brain circuits, have provided encouraging evidence for improvements in clinical symptoms, and neural circuitry across various psychiatric conditions, signposting a transformative phase in crafting interventions that tackle impulsivity from a transdiagnostic perspective. However, the field continues to ascertain a universally embraced framework that effectively amalgamates these discoveries into a unified clinical methodology. The Research Domain Criteria (RDoC) delivers a neuroscientifically informed framework that aims to reconcile the neurobiological underpinnings with clinical symptoms, thereby facilitating targeted neuromodulation strategies. In this context, we propose a pioneering RDoC-compliant framework that strategically targets the neural circuits implicated in clinical impulsivity symptoms, applicable across diagnostic categories. Furthermore, we introduce a set of meticulously selected tools for each stage within this framework, thus reinforcing its applicability and aiding future investigative pursuits in this area.

摘要

冲动性日益被视为一种跨诊断特征,它对多种精神疾病有着重大影响,且超越了传统分类系统所定义的范畴。跨诊断研究揭示了冲动性的复杂临床表现及其潜在的神经回路。当前紧迫的挑战是将这种深入的理解转化为针对冲动性不同方面的精准且有效的干预措施。神经调节方面的最新进展,特别是针对脑回路的调节,为改善各种精神疾病的临床症状和神经回路提供了令人鼓舞的证据,标志着从跨诊断角度应对冲动性的干预措施进入了一个变革阶段。然而,该领域仍在探寻一个被广泛接受的框架,以便有效地将这些发现整合为统一的临床方法。研究领域标准(RDoC)提供了一个基于神经科学的框架,旨在协调神经生物学基础与临床症状,从而促进有针对性的神经调节策略。在此背景下,我们提出了一个首创的符合RDoC的框架,该框架有策略地针对与临床冲动性症状相关的神经回路,适用于各个诊断类别。此外,我们为该框架内的每个阶段引入了一套精心挑选的工具,从而增强其适用性,并有助于该领域未来的研究探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f603/12185744/81e9e4aec475/41398_2025_3415_Fig1_HTML.jpg

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