整个大脑网络对治疗耐药性抑郁症的下带深层大脑刺激的影响
Jungho Cha1, Justin Justin Rajendra2, Callie McGrath2
1Icahn School of Medicine at Mount Sinai.
Research square
|July 3, 2023
概括
治疗耐药性抑郁症 (TRD) 的下带深脑刺激 (SCC DBS) 随着时间的推移改变了大脑活动. 默认模式网络 (DMN) 的变化与症状改善相关,这表明了治疗疗效的潜在生物标志物.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 医疗成像医学成像
背景情况:
- 耐治疗抑郁症 (TRD) 是一个重大的临床挑战.
- 低带深脑刺激 (SCC DBS) 是对TRD的一种实验性疗法.
- 了解SCC DBS的纵向神经生物学影响对于优化治疗至关重要.
研究的目的:
- 在六个月的TRD中,在SCC DBS期间,在内在连接网络 (ICNs) 中研究区域脑血流 (rCBF) 的纵向变化.
- 为了将这些神经成像发现与一个单独的队列中的葡萄糖代谢变化相关联.
- 为了检查大脑活动变化和随着时间的推移临床反应之间的关系.
主要方法:
- 接受SCC DBS的22名TRD患者在基线,手术后1个月,以及1个月和6个月的刺激期间进行了连续PET扫描 (使用 [15O] - 水或 [18F] - FDG).
- 线性混合模型分析了ICNs的纵向rCBF变化.
- 后期分析确定了特定时间和特定响应的影响.
主要成果:
- SCC DBS在突出网络 (SN) 和默认模式网络 (DMN) 中引发了显著的特定时间变化.
- 手术后SN和DMN的初始rCBF下降之后,响应者与非响应者的轨迹不同.
- 受访者在慢性刺激时显示DMN活动的净增加,这与抑郁症严重程度的降低相关. 在葡萄糖代谢队列中观察到类似的DMN变化.
结论:
- 在SCC DBS中PET变化的轨迹是非线性的,反映了行为效应的时间表.
- SCC DBS在DMN中诱导了急性和持续的神经可塑性变化.
- 这些发现表明,DMN活性变化可能成为未来的生物标志物,用于跟踪接受SCC DBS的TRD患者的临床改善.
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