Mayberg H S
Department of Medicine (Neurology), University of Texas Health Science Center at San Antonio 78284-6240.
J Neuropsychiatry Clin Neurosci. 1994 Fall;6(4):428-42. doi: 10.1176/jnp.6.4.428.
Depression is common in patients with neurological disease, particularly with diseases involving the basal ganglia. Although the mechanisms of mood disorders in these patients are poorly understood, selective neural pathways affected directly and indirectly by basal ganglia injury provide a strategy for examining these patients with functional imaging techniques. Studies of regional cerebral glucose metabolism by use of positron-emission tomography are reviewed. These studies demonstrate bilateral hypometabolism of orbital-inferior prefrontal cortex and anterior temporal cortex in depressed subjects, independent of disease etiology. This pattern is similar to that seen in patients with primary unipolar depression. These findings suggest that disruption of paralimbic pathways linking frontal cortex, temporal cortex, and striatum may contribute to both primary depression and depression associated with basal ganglia disease. The findings support the evolving concept of a neuroanatomical locus for mood regulation.
抑郁症在神经疾病患者中很常见，尤其是在涉及基底神经节的疾病中。尽管这些患者情绪障碍的机制尚不清楚，但受基底神经节损伤直接和间接影响的选择性神经通路为使用功能成像技术检查这些患者提供了一种策略。本文综述了利用正电子发射断层扫描对局部脑葡萄糖代谢的研究。这些研究表明，抑郁症患者眶下前额叶皮质和颞叶前皮质双侧代谢减退，与疾病病因无关。这种模式与原发性单相抑郁症患者所见相似。这些发现表明，连接额叶皮质、颞叶皮质和纹状体的边缘旁通路的破坏可能导致原发性抑郁症和与基底神经节疾病相关的抑郁症。这些发现支持了情绪调节神经解剖学部位这一不断发展的概念。
