抗抑郁药物治疗前后抑郁症患者静息态功能磁共振脑影像的变化

抗抑郁药物治疗对抑郁症患者有效,但其机制不明,也难以客观预测疗效。目前抗抑郁治疗前后抑郁症患者局部自发脑活动的变化多集中在背外侧前额叶、腹内侧前额叶、前扣带回、楔前叶区域;脑功能交互涉及情绪环路、默认网络、中央执行网络及下丘脑-垂体-肾上腺皮质轴。未来研究应优化试验设计、增加样本量、减少样本异质性,比较不同类别抗抑郁药物的影响。文章从静息态功能磁共振影像角度系统综述抗抑郁药物治疗对抑郁症患者脑功能活动的影响,以期促进对抗抑郁药物作用机制的理解,促进可预测抑郁症药物治疗反应客观标记的发现。

Changes of resting state fMRI brain imaging in patients with depression after antidepressant treatment

Antidepressant therapy is effective for patients with major depressive disorder,however the mechanism is unclear and it is difficult to predict the efficacy objectively.At present,the changes of local spontaneous brain activity in patients with major depressive disorder after antidepressant treatment are mostly located in the dorsolateral prefrontal cortex,ventromedial prefrontal cortex,anterior cingulate gyrus and precuneus.The changes of brain function interaction involved in emotional circuit,default mode network,central executive network and hypothalamus-pituitary-adrenal axis.Future researches should optimize the experimental design,enlarge the sample size,reduce the sample heterogeneity,and compare the effects of different types of antidepressants.This paper reviews the effects of antidepressant therapy on brain function in patients with major depressive disorder from the perspective of resting fMRI,to promote our understanding of the mechanism of antidepressant therapy and to promote the discovery of objective biomarkers which can predict the response of antidepressant therapy.