抑郁症神经解剖及其病理机制的研究进展

Advances in the neuroanatomy and pathophysiology of depression

抑郁症是对人类危害极大的一类精神类疾病,但对其发病机制仍存在争议。随着神经成像技术的进步,抑郁症的神经解剖学有了较大发展,使得阐明重度抑郁症和双相情感障碍的机制取得进步,其中研究较多的结构是前额皮层、杏仁核和海马区。目前关于抑郁症发病的假说主要有:神经化学假说、神经通路假说及神经营养因子假说等,这些假说都从较为单一的角度解释了抑郁症的发病机制,但抑郁症的发生需要全面考虑风险因素对基因、神经递质、神经元、脑部结构及个体行为的作用。该文探讨了抑郁症相关的神经解剖基础,并归纳了抑郁症的风险因素及发病机制,拟为临床治疗和新药开发提供参考。

Although depression constitutes leading causes of disability,controversial views exist about its pathogenesis. The development of neuroimaging techniques established the delineation of ' neurocircuit of emotion',which has enabled the significant advancement in elucidating the pathogenesis of MDD( major depressive depression) and BD( bipolar disorder). Prefrontal cortex,amygdala and hippocampus have received most attention among all the brain structures. A number of hypotheses have been proposed to explain the onset of depression,with risk factors including neurochemistry,neural circuit,neurotrophin and so on. However,every factor explains the onset of depression from a single aspect,but the overall consideration of effects in gene,neurotransmitter,brain structure and human behavior is needed. In this review,the neuroanatomy of depression has been discussed; risk factors and pathogenesis of depression have been summarized,aiming to provide reference to the clinical diagnosis and R&D of antidepressants.