精神分裂症电休克治疗效应的神经影像学进展

Electroconvulsive therapy in schizophrenia: a review of neuroimaging studies

电休克治疗(electroconvulsive therapy,ECT)是精神分裂症(schizophrenia,SZ)起效快、疗效显著的物理治疗方法,临床广泛应用于具有激惹冲动、木僵症状患者以及药物治疗效果不佳的难治性患者,但ECT治疗效应的神经生理机制至今尚未阐明。近十年来国内外逐渐报道ECT治疗SZ的磁共振成像(magnetic resonance imaging,MRI)研究,涉及磁共振波谱、结构态和静息态分析,初步发现ECT疗效可能与脑结构和功能改变存在一定关联,主要涉及海马、丘脑、前额叶皮质和岛叶等脑区形态学变化以及核心静息态网络,尤其是前额叶-边缘系统和默认网络功能变化。该领域结果尚存分歧,需待进一步研究探索,期望为深入探讨其ECT机制提供有价值线索。

Electroconvulsive therapy(ECT)is a physical therapy method with rapid onset and remarkable effect for schizophrenia(SZ).It is widely used in patients with agitated impulses,stupor and refractory patients with poor drug treatment effect.The neurophysiological mechanism of ECT effect has not been elucidated.In the past decade,the magnetic resonance imaging(MRI)studies of ECT for SZ have been gradually reported in domestic and international journal,involving magnetic resonance spectroscopy,structural state and resting state analysis,preliminary findings suggest that there may be a correlation between ECT efficacy and structural and functional brain changes,mainly involving morphological changes in brain regions such as the thalamus,hippocampus,insula and left medial prefrontal lobe,as well as functional changes in core resting state networks,particularly the dorsal frontoparietal network,default network and limbic network.More research and exploration are needed in the future to provide valuable clues to further explore the therapeutic mechanism of ECT treatment.