功能性磁共振成像在精神分裂症:当前的证据,方法的进步,局限性和未来的方向
Aristotle N Voineskos1,2, Colin Hawco1,2, Nicholas H Neufeld1,2
1Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
概括
功能神经成像,特别是功能磁共振成像 (fMRI),提供了对精神分裂症的洞察力,但需要临床翻译. 未来的研究应该专注于可行的临床决策,以加强fMRI.
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:
- 功能神经成像,特别是fMRI,已经显著提高了对精神分裂症神经生物学的理解.
- 尽管有希望,但fMRI在治疗精神分裂症的临床翻译方面面临着挑战.
- 本综述批判性地检查了精神分裂症的fMRI文献,从早期激活研究到机器学习方法.
研究的目的:
- 提供功能神经成像 (fMRI) 在精神分裂症的全面审查.
- 批判性地评估fMRI发现的临床实用性和翻译.
- 讨论精神分裂症fMRI研究的局限性和未来方向.
主要方法:
- 对精神分裂症的fMRI研究的历史审查.
- 对生物标志物,症状和认知缺陷的fMRI研究的分析.
- 关于治疗反应,异质性和方法学的fMRI研究摘要.
主要成果:
- fMRI已经确定了负面症状和认知缺陷的神经标记,潜在的治疗目标.
- 研究探讨了fMRI在预测治疗反应和理解精神分裂症异质性方面的作用.
- 方法学的进步包括联盟和精确的fMRI,但临床效用仍然是一个挑战.
结论:
- 对于精神分裂症的实际应用,fMRI需要专注于可操作的临床决策 (例如治疗选择,预后).
- 成本和可访问性是影响fMRI临床实用性的关键因素.
- 未来的研究应该将健康经济学纳入预后和治疗反应研究.
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