功能连接预测跨诊断治疗结果在内化精神病理
Kai Zhang1, Heide Klumpp2,3, Jagan Jimmy4
1Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston.
JAMA network open
|September 3, 2025
概括
全脑功能连接 (FC) 可靠地预测了包括抑郁和焦虑在内的心理病理的治疗结果. 通过将神经模式与不同疗法的治疗反应联系起来, 这一发现支持个性化精神病学.
科学领域:
- 神经科学
- 精神病学
- 精准医学
背景情况:
- 抑郁症和焦虑症等内化精神病症需要有效的个性化治疗.
- 通过神经影像预测治疗反应可以在精神病学中推进精确医学.
- 整个大脑功能连接 (FC) 对跨模式的IP治疗结果的预测能力尚不清楚.
研究的目的:
- 确定治疗前的FC模式是否可以预测IP患者的多维治疗结果.
- 评估预测性表现是否在IP的不同诊断和治疗方式中具有普遍性.
主要方法:
- 一项预后研究分析了两项随机临床试验中的181名IP患者的基线神经影像和临床数据.
- 使用预处理FC模式训练了一种规范化的正统相关性分析模型.
- 该模型预测结果的能力 (抑郁,焦虑,担忧,反,情绪调节) 在诊断和治疗类型 (CBT,SSRI,ST) 中进行了测试.
主要成果:
- 在IP患者中,基线全脑CF强有力的预测了多维症状变化.
- 在个人水平 (r=0.37),跨诊断 (r=0.24) 和跨治疗方式 (ST: r=0.28;SSRI: r=0.39;CBT: r=0.32) 的预测显著.
- 在默认模式网络和注意力网络中发现了关键的预测连接;随着神经系统或结果维度的减少,性能下降.
结论:
- 全脑CF可靠地预测跨诊断和治疗类型的IP治疗结果.
- 神经连接模式与各种精神治疗的临床改善有关.
- 这些发现支持基于神经生物学标记的精神病学个性化治疗方法的发展.
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