在治疗耐药性抑郁症的治疗中,全脑网络效应的下带深层大脑刺激对治疗耐药性抑郁症的影响
Jungho Cha1, Ki Sueng Choi2, Justin K Rajendra3
1Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Molecular psychiatry
|November 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. 慢性SCC DBS显示了默认模式网络 (DMN) 的持久变化,可能作为治疗反应的生物标志物.
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:
- 在六个月的时间内,调查SCC DBS中TRD内在内在连接网络 (ICNs) 中区域脑血流 (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.
- 探索大脑活动变化与抑郁症严重程度之间的关系.
主要方法:
- 22名TRD患者接受了SCC DBS. 二十二名TRD患者接受了SCC DBS.
- 使用 [15O] - 水或 [18F] - 氧糖 (FDG) 的正子发射断层扫描 (PET) 扫描在基线,手术后1个月和刺激后1个月和6个月获得.
- 线性混合模型分析了ICN中的纵向rCBF变化,随时测试检查了时间和响应特异性的影响.
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中最初降低的rCBF在响应者和非响应者之间有所不同,响应者随着时间的推移显示出DMN活性增加.
- DMN活动变化与抑郁症严重程度相关,葡萄糖代谢反映了这些DMN变化.
结论:
- 随着SCC DBS的神经生物学变化的轨迹是非线性的,与观察到的行为效应保持一致.
- SCC DBS 诱导了急性和持续的神经可塑性影响,特别是在DMN内.
- 这些发现表明,DMN活性变化可以作为生物标志物,用于跟踪接受SCC DBS的TRD患者的临床改善.
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