抑郁症发病的脑机制研究:来自大脑中线脑区的证据
The Brain Mechanism of Depression: Evidence from the Brain Midline Areas
DOI: 10.12677/AP.2016.611147, PDF, HTML, XML, 下载: 2,412  浏览: 7,590 
作者: 刘 永, 裘吉成, 何雨霞, 孟亚运, 袁 宏, 雷 旭:西南大学心理学部,认知与人格教育部重点实验室,重庆
关键词: 抑郁症脑机制中线脑区Depression Brain Mechanism Brain Midline Areas
摘要: 抑郁症是一种高患病率和高致残率的精神疾病,以情绪低落为主要特征,经临床治疗后复发率高。研究证明抑郁症患者存在广泛的脑网络的异常。本文通过梳理了大量的国内外相关文献,发现抑郁症患者的发病脑机制集中在大脑的中线脑区。由于抑郁症患者,尤其是重度抑郁症患者的脑功能和结构都发生了病变,因此治疗抑郁症不仅要消除症状,更要关注的是患者的脑功能以及脑结构的恢复。本文从这个角度对抑郁症的未来研究及治疗进行了展望。
Abstract: Depression is a mental illness with high prevalence and morbidity, low mood is the main charac-teristics, and the recurrence rate is high after clinical treatment. A large number of studies have found the abnormalities of brain networks among patients with depression. From consulting a lot of studies, we found that the lesion brain mechanism of depression distributed in brain midline areas. Because of the lesion of brain function and brain structure of patients with depression, especially major depressive disorder, so depression treatments do not stop with the symptoms relieving; the key step is the improvement of brain function and brain structure. From the view, we discussed the study and therapy of depression in the future.
文章引用:刘永, 裘吉成, 何雨霞, 孟亚运, 袁宏, 雷旭 (2016). 抑郁症发病的脑机制研究:来自大脑中线脑区的证据. 心理学进展, 6(11), 1166-1173. http://dx.doi.org/10.12677/AP.2016.611147

参考文献

[1] 王丽, 姚志全, 卢青, 刘海燕, 陈景旭, 卞清涛(2010). 重度抑郁症症状缓解前后海马局部一致性研究. 中国神经精神疾病杂志, 36(5), 264-267.
[2] 张江华, 肖晶, 朱雪玲, 王湘, 姚树桥(2011). 首发抑郁症患者大脑灰质密度基于体素的形态测量学分析. 中南大学学报 (医学版), 36(4), 307-311.
[3] Andrews-Hanna, J. R. (2012). The Brain’s De-fault Network and Its Adaptive Role in Internal Mentation. The Neuroscientist, 18, 251-270. https://doi.org/10.1177/1073858411403316
[4] Binnewijzend, M. A., Schoonheim, M. M., Sanz-Arigita, E., Wink, A. M., van der Flier, W. M., Tolboom, N. et al. (2012). Resting-State fMRI Changes in Alzheimer’s Disease and Mild Cognitive Impairment. Neurobiology of Aging, 33, 2018- 2028. https://doi.org/10.1016/j.neurobiolaging.2011.07.003
[5] Bishop, S. J. (2007). Neurocognitive Mechanisms of Anxiety: An Integrative Account. Trends in Cognitive Sciences, 11, 307-316. https://doi.org/10.1016/j.tics.2007.05.008
[6] Bluhm, R., Williamson, P., Lanius, R., Théberge, J., Densmore, M., Bartha, R. et al. (2009). Resting State Default-Mode Network Connectivity in Early Depression Using a Seed Region-of-Interest Analysis: Decreased Connectivity with Caudate Nucleus. Psychiatry and Clinical Neurosciences, 63, 754-761. https://doi.org/10.1111/j.1440-1819.2009.02030.x
[7] Briceño, E. M., Rapport, L. J., Kassel, M. T., Bieliauskas, L. A., Zubieta, J.-K., Weisenbach, S. L., & Langenecker, S. A. (2015). Age and Gender Modulate the Neural Circuitry Supporting Facial Emotion Processing in Adults with Major Depressive Disorder. The American Journal of Geriatric Psychiatry, 23, 304-313. https://doi.org/10.1016/j.jagp.2014.05.007
[8] Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-Based Cognitive Therapy Improves Emotional Reactivity to Social Stress: Results from a Randomized Controlled Trial. Behavior Therapy, 43, 365-380. https://doi.org/10.1016/j.beth.2011.08.006
[9] Burschka, J. M., Keune, P. M., Hofstadt-van Oy, U., Oschmann, P., & Kuhn, P. (2014). Mindfulness-Based Interventions in Multiple Sclerosis: Beneficial Effects of Tai Chi on Balance, Coordination, Fatigue and Depression. BMC Neurology, 14, 1. https://doi.org/10.1186/s12883-014-0165-4
[10] Caetano, S. C., Kaur, S., Brambilla, P., Nicoletti, M., Hatch, J. P., Sassi, R. B. et al. (2006). Smaller Cingulate Volumes in Unipolar Depressed Patients. Biological Psychiatry, 59, 702-706. https://doi.org/10.1016/j.biopsych.2005.10.011
[11] Chen, S.-Y., Jordan, C., & Thompson, S. (2006). The Effect of Cog-nitive Behavioral Therapy (CBT) on Depression: The Role of Problem-Solving Appraisal. Research on Social Work Practice, 16, 500-510. https://doi.org/10.1177/1049731506287302
[12] Davidson, R. J., Jackson, D. C., & Kalin, N. H. (2000). Emotion, Plas-ticity, Context, and Regulation: Perspectives from Affective Neuroscience. Psychological Bulletin, 126, 890-909. https://doi.org/10.1037/0033-2909.126.6.890
[13] Davidson, R. J., Pizzagalli, D., Nitschke, J. B., & Putnam, K. (2002). Depression: Perspectives from Affective Neuroscience. Annual Review of Psychology, 53, 545-574. https://doi.org/10.1146/annurev.psych.53.100901.135148
[14] Devinsky, O., Morrell, M. J., & Vogt, B. A. (1995). Con-tributions of Anterior Cingulate Cortex to Behaviour. Brain, 118, 279-306. https://doi.org/10.1093/brain/118.1.279
[15] Eisendrath, S. J., Gillung, E., Delucchi, K., Mathalon, D. H., Yang, T. T., Satre, D. D. et al. (2015). A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-Line Treatments for Major Depressive Disorder. Mindfulness, 6, 475-482. https://doi.org/10.1007/s12671-014-0280-8
[16] Fleisher, A. S., Sherzai, A., Taylor, C., Langbaum, J. B., Chen, K., & Buxton, R. B. (2009). Resting-State BOLD Networks versus Task-Associated Functional MRI for Distinguishing Alzhei-mer’s Disease Risk Groups. NeuroImage, 47, 1678-1690. https://doi.org/10.1016/j.neuroimage.2009.06.021
[17] Goulden, N., Khusnulina, A., Davis, N. J., Bracewell, R. M., Bokde, A. L., McNulty, J. P., & Mullins, P. G. (2014). The Salience Network Is Responsible for Switching between the Default Mode Network and the Central Executive Network: Replication from DCM. NeuroImage, 99, 180-190. https://doi.org/10.1016/j.neuroimage.2014.05.052
[18] Grieve, S. M., Korgaonkar, M. S., Koslow, S. H., Gordon, E., & Williams, L. M. (2013). Widespread Reductions in Gray Matter Volume in Depression. NeuroImage: Clinical, 3, 332-339. https://doi.org/10.1016/j.nicl.2013.08.016
[19] He, X., Qin, W., Liu, Y., Zhang, X., Duan, Y., Song, J. et al. (2014). Abnormal Salience Network in Normal Aging and in Amnestic Mild Cognitive Impairment and Alzheimer’s Disease. Human Brain Mapping, 35, 3446-3464. https://doi.org/10.1002/hbm.22414
[20] Jilka, S. R., Scott, G., Ham, T., Pickering, A., Bonnelle, V., Braga, R. M. et al. (2014). Damage to the Salience Network and Interactions with the Default Mode Network. The Journal of Neuroscience, 34, 10798-10807. https://doi.org/10.1523/JNEUROSCI.0518-14.2014
[21] Joshi, S. H., Espinoza, R. T., Pirnia, T., Shi, J., Wang, Y., Ayers, B. et al. (2016). Structural Plasticity of the Hippocampus and Amygdala Induced by Electroconvulsive Therapy in Major Depression. Biological Psychiatry, 79, 282-292. https://doi.org/10.1016/j.biopsych.2015.02.029
[22] Keller, M. B. (2003). Past, Present, and Future Directions for Defining Optimal Treatment Outcome in Depression: Remission and Beyond. JAMA, 289, 3152-3160. https://doi.org/10.1001/jama.289.23.3152
[23] Kennedy, N., Abbott, R., & Paykel, E. (2003). Remission and Recurrence of Depression in the Maintenance Era: Long-Term Outcome in a Cambridge Cohort. Psychological Medicine, 33, 827-838. https://doi.org/10.1017/S003329170300744X
[24] Lei, X., Luo, C., & Yao, D. (2011). Imaging Epileptic Networks Using Spatial-Temporal EEG-fMRI Fusion. International Journal of Bioelectromagnetism, 13, 249-254.
[25] Lei, X., Qiu, C., Xu, P., & Yao, D. (2010). A Parallel Framework for Simultaneous EEG/fMRI Analysis: Methodology and Simulation. NeuroImage, 52, 1123-1134. https://doi.org/10.1016/j.neuroimage.2010.01.024
[26] Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Journal of Consulting and Clinical Psychology, 72, 31-40. https://doi.org/10.1037/0022-006X.72.1.31
[27] Murphy, C. F., Gunning-Dixon, F. M., Hoptman, M. J., Lim, K. O., Ar-dekani, B., Shields, J. K. et al. (2007). White-Matter Integrity Predicts Stroop Performance in Patients with Geriatric De-pression. Biological Psychiatry, 61, 1007-1010. https://doi.org/10.1016/j.biopsych.2006.07.028
[28] O’Doherty, V., Carr, A., McGrann, A., O’Neill, J. O., Dinan, S., Graham, I., & Maher, V. (2015). A Controlled Evaluation of Mindfulness-Based Cognitive Therapy for Patients with Co-ronary Heart Disease and Depression. Mindfulness, 6, 405-416. https://doi.org/10.1007/s12671-013-0272-0
[29] Pérez-Mata, N., López-Martín, S., Albert, J., Carretié, L., & Tapia, M. (2012). Recognition of Emotional Pictures: Behavioural and Electrophysiological Measures. Journal of Cognitive Psychology, 24, 256-277. https://doi.org/10.1080/20445911.2011.613819
[30] Raichle, M. E., MacLeod, A. M., Snyder, A. Z., Powers, W. J., Gus-nard, D. A., & Shulman, G. L. (2001). A Default Mode of Brain Function. Proceedings of the National Academy of Sciences of the United States of America, 98, 676-682. https://doi.org/10.1073/pnas.98.2.676
[31] Rajkowska, G., Miguel-Hidalgo, J. J., Wei, J., Dilley, G., Pittman, S. D., Meltzer, H. Y. et al. (1999). Morphometric Evidence for Neuronal and Glial Prefrontal Cell Pathology in Major Depression. Biological Psychiatry, 45, 1085-1098. https://doi.org/10.1016/S0006-3223(99)00041-4
[32] Salvadore, G., Nugent, A. C., Lemaitre, H., Luckenbaugh, D. A., Tinsley, R., Cannon, D. M. et al. (2011). Prefrontal Cortical Abnormalities in Currently Depressed versus Currently Re-mitted Patients with Major Depressive Disorder. NeuroImage, 54, 2643-2651. https://doi.org/10.1016/j.neuroimage.2010.11.011
[33] Sarmiento-Bolaños, M. J., & Gómez-Acosta, A. (2013). Mindful-ness: A Proposed of Application in Neuropsychological Rehabilitation. Avances en Psicologia Latinoamericana, 31, 140-155.
[34] Sheline, Y. I., Wang, P. W., Gado, M. H., Csernansky, J. G., & Vannier, M. W. (1996). Hippocampal Atrophy in Recurrent Major Depression. Proceedings of the National Academy of Sciences of the United States of America, 93, 3908-3913. https://doi.org/10.1073/pnas.93.9.3908
[35] Spreng, R. N., & Grady, C. L. (2010). Patterns of Brain Activity Supporting Autobiographical Memory, Prospection, and Theory of Mind, and Their Relationship to the Default Mode Network. Journal of Cognitive Neuroscience, 22, 1112-1123. https://doi.org/10.1162/jocn.2009.21282
[36] Tang, Y.-Y., Hölzel, B. K., & Posner, M. I. (2015). The Neuroscience of Mindfulness Meditation. Nature Reviews Neuroscience, 16, 213-225. https://doi.org/10.1038/nrn3916
[37] Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive Awareness and Prevention of Relapse in Depression: Empirical Evidence. Journal of Consulting and Clinical Psychology, 70, 275-287. https://doi.org/10.1037/0022-006X.70.2.275
[38] Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of Relapse/Recurrence in Major Depression by Mindfulness-Based Cog-nitive Therapy. Journal of Consulting and Clinical Psychology, 68, 615-623. https://doi.org/10.1037/0022-006X.68.4.615
[39] Thayer, J. F., & Lane, R. D. (2000). A Model of Neurovisceral Integra-tion in Emotion Regulation and Dysregulation. Journal of Affective Disorders, 61, 201-216. https://doi.org/10.1016/S0165-0327(00)00338-4
[40] van Tol, M.-J., van der Wee, N. J., van den Heuvel, O. A., Nielen, M. M., Demenescu, L. R., Aleman, A. et al. (2010). Regional Brain Volume in Depression and Anxiety Disorders. Archives of General Psychiatry, 67, 1002-1011. https://doi.org/10.1001/archgenpsychiatry.2010.121
[41] van Tol, M.-J., Veer, I. M., van der Wee, N. J., Aleman, A., van Buchem, M. A., Rombouts, S. A. et al. (2013). Whole-Brain Functional Connectivity during Emotional Word Classification in Medication-Free Major Depressive Disorder: Abnormal Salience Circuitry and Relations to Positive Emotionality. NeuroImage: Clinical, 2, 790-796. https://doi.org/10.1016/j.nicl.2013.05.012
[42] Wei, M., Qin, J., Yan, R., Bi, K., Liu, C., Yao, Z., & Lu, Q. (2015). Association of Resting-State Network Dysfunction with Their Dynamics of Inter-Network Interactions in Depression. Journal of Affective Disorders, 174, 527-534. https://doi.org/10.1016/j.jad.2014.12.020