无抽搐电休克治疗对重性抑郁障碍脑结构功能影响研究进展  

Research progress on brain structure and function in patients with major depressive disorder after modified electroconvulsive therapy

作　　者：杨依依 洪雅雯 何永光 王继军[1] 张天宏[1] YANG Yiyi;HONG Yawen;HE Yongguang;WANG Jijun;ZHANG Tianhong(Shanghai Key Laboratory of Psychotic Disorders,Shanghai Mental Health Center,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心脑电影像研究室,上海200030 [2]上海交通大学医学院附属精神卫生中心

出　　处：《中国神经精神疾病杂志》2024年第8期503-507,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：无抽搐电休克治疗(modified electroconvulsive therapy,MECT)对重性抑郁障碍具有较好的治疗效果,但其作用机制尚不明确。近年来,研究利用神经影像技术和通过全球合作获得的大型数据集,证实MECT对脑部结构和功能存在影响,且结论日渐一致,如海马、杏仁核等多个特定脑区的灰质体积增加,多处白质微结构完整性增加,以及海马-杏仁核-膝下前扣带回-额叶皮质网络、海马-丘脑-颞叶-顶叶皮质网络等与重性抑郁障碍相关的脑部功能连接正常化。然而这些改变与MECT作用机制的关系仍需深入研究。本文对MECT脑结构和功能改变的研究进展进行综述,可为其在临床诊疗中更好地应用提供方法支持及理论依据。Modified electroconvulsive therapy(MECT)has a good therapeutic effect on major depressive disorder(MDD),but its mechanism of action is still unclear.In recent years,accumulated studies have confirmed the effects of MECT on brain structure and function using neuroimaging techniques and large datasets obtained through global collaborations and the conclusions are becoming increasingly consistent.For example,there is an increase in gray matter volume in specific brain regions such as the hippocampus and amygdala,an increase in white matter microstructural integrity and normalization of brain functional connections associated with MDD,such as the hippocampus-amygdalasubgenual anterior cingulate cortex-prefrontal cortex network,hippocampus-thalamus-temporal cortex-parietal cortex network,etc.However,the relationship between these changes and the mechanism of MECT action still needs further investigation.This review provides an overview of the research progress on the structural and functional changes of the brain by MECT to provide methodological support and theoretical basis for its better application in clinical diagnosis and treatment.

关 键 词：电休克疗法 重性抑郁障碍 磁共振成像 灰质 白质 神经网络 神经元可塑性 

分 类 号：R749.054[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]