重性抑郁障碍快感缺失的磁共振成像与神经生物学机制研究进展  

Research progress on magnetic resonance imaging and neurobiological mechanisms of anhedonia in major depressive disorder

作　　者：黄佩姗 王克 张雪琳 苗懿 董强利[1] HUANG Peishan;WANG Ke;ZHANG Xuelin;MIAO Yi;DONG Qiangli(Department of Psychiatry,The Second Hospital&Clinical Medical School,Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院(第二临床医学院)心理卫生科,兰州730030

出　　处：《中国神经精神疾病杂志》2025年第3期180-185,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：“脑科学与类脑研究”重大项目(编号:2021ZD0202002);甘肃省科技计划项目(编号:25JRRA618);兰州大学医学卓越师资团队建设与教学名师培育项目(编号:lzuyxcx-2022-205);兰州大学第二临床医学院2022年度教育教学改革研究项目(编号:DELC-202203);兰州大学第二医院萃英学子科研培育计划(编号:CYXZ2023-55)。

摘　　要：重性抑郁障碍的核心症状之一是快感缺失,表现为个体对愉悦刺激的反应能力下降。伴快感缺失的重性抑郁障碍患者脑影像表现出一定特点,如纹状体、颞叶等脑区体积或皮质厚度减少,脑白质束微观结构改变,额叶、颞叶和边缘系统的神经元活动异常,默认模式网络、奖赏网络和额顶叶网络的连接性改变等。此外,压力应激、基因表达、谷氨酸系统及生物节律等因素也可能对快感缺失产生影响。快感缺失的神经生物学机制复杂多样,对重性抑郁障碍的诊断、治疗和预后具有重要指导意义。Major depressive disorder is a common mental disorder,one of the core symptoms of which is anhedonia,characterized by a reduced ability to respond to pleasurable stimuli.Brain images of patients with major depressive disorders with anhedonia show the following features:reduced volume or cortical thickness in brain regions such as the striatum and temporal lobe,changes in the microstructure of white matter tracts,abnormal neuronal activity in the frontal lobe,temporal lobe,and limbic system,and altered connectivity in the default mode network,reward network,and fronto-parietal network.Additionally,factors such as stress,gene expression,the glutamate system,and biological rhythms may also influence anhedonia.The neurobiological mechanisms of anhedonia are intricate,and are crucial for the diagnosis,treatment,and prognosis of depressive disorders.

关 键 词：快感缺失 重性抑郁障碍 磁共振成像 脑结构 脑功能 脑网络 奖赏网络 神经机制 

分 类 号：R749.4[医药卫生—神经病学与精神病学]