Limbic system

边缘系统
  • 文章类型: Journal Article
    创伤后应激障碍(PTSD)目前纳入精神疾病诊断和统计,第五版,宏观类别“与创伤和压力事件有关的障碍”中的文本修订,是一种严重的精神困扰,由于直接或间接暴露于严重的压力和创伤事件而急剧产生。关于创伤后应激障碍的心理和行为表现,有大量的文献;然而,关于这种疾病更纯粹的神经心理学方面,它们仍然是研究的主题,需要更加清晰,虽然丘脑的作用,下丘脑,杏仁核,扣带回,小脑,蓝斑,和海马在发病中的特征性症状已经被阐明。
    Post-traumatic stress disorder (PTSD), currently included by the Diagnostic and Statistical of Mental Disorders, Fifth Edition, Text Revision in the macro-category \"disorders related to traumatic and stressful events\", is a severe mental distress that arises acutely as a result of direct or indirect exposure to severely stressful and traumatic events. A large body of literature is available on the psychological and behavioral manifestations of PTSD; however, with regard to the more purely neuropsychological aspects of the disorder, they are still the subject of research and need greater clarity, although the roles of the thalamus, hypothalamus, amygdala, cingulate gyrus, cerebellum, locus coeruleus, and hippocampus in the onset of the disorder\'s characteristic symptoms have already been elucidated.
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  • 文章类型: Systematic Review
    急性遗忘综合征是神经系统疾病的罕见临床表现。鉴别诊断包括几种综合征,包括Wernicke-Korsakoff和短暂性全球健忘症(TGA)。穹窿的结构性病变占急性遗忘综合征的少数病例。病因从医源性损伤到缺血性,炎症,或者肿瘤性病变。对潜在病理的及时诊断是必不可少的,但具有挑战性。这篇综述的目的是系统地回顾与穹窿非医源性病变相关的急性遗忘综合征病例的现有文献。
    我们在PubMed上进行了系统的文献检索,Scopus,和WebofScience截至2023年9月,以确定病例报告和病例系列由于穹窿病变导致的遗忘综合征患者。系统审查是根据PRISMA指南进行的。这项研究仅限于用英语写的文章。排除了直接归因于外科手术的穹窿损伤的病例。
    本综述共纳入52篇报告55例病例的出版物。专注于急性/亚急性发作,血管病因非常普遍,负责78%的案件,其中40/55(74%)是由于急性缺血性卒中。遗忘综合征的特征是所有患者的顺行性健忘症,在27%的病例中与逆行性健忘症有关。健忘症在大多数情况下是孤立的表现。在随访中,多达三分之二的患者有任何严重程度的持续记忆障碍。
    急性遗忘综合征很少由穹窿病变引起。在大多数急性/亚急性表现病例中,病因是缺血性中风,主要由累及call下动脉区域的中风引起。鉴别诊断具有挑战性,并且在临床上通常很难与常见模拟物区分开。应保持高度怀疑指数,以避免误诊,并为有时间依赖性疾病的病人提供充分的急性治疗,还采用先进的神经成像技术。需要更多的研究来更好地了解结果并确定由于穹窿病变导致的遗忘综合征患者的预后因素。
    UNASSIGNED: Acute amnestic syndrome is an uncommon clinical presentation of neurological disease. Differential diagnosis encompasses several syndromes including Wernicke-Korsakoff and transient global amnesia (TGA). Structural lesions of the fornix account for a minority of cases of acute amnestic syndromes. Etiology varies from iatrogenic injury to ischemic, inflammatory, or neoplastic lesions. A prompt diagnosis of the underlying pathology is essential but challenging. The aim of this review is to systematically review the existing literature regarding cases of acute amnestic syndrome associated with non-iatrogenic lesions of the fornix.
    UNASSIGNED: We performed a systematic literature search on PubMed, Scopus, and Web of Science up to September 2023 to identify case reports and case series of patients with amnestic syndrome due to fornix lesions. The systematic review was conducted according to PRISMA guidelines. The research was limited to articles written in English. Cases of fornix damage directly ascribable to a surgical procedure were excluded.
    UNASSIGNED: A total of 52 publications reporting 55 cases were included in the review. Focusing on acute/subacute onset, vascular etiology was highly prevalent, being responsible for 78% of cases, 40/55 (74%) of which were due to acute ischemic stroke. The amnestic syndrome was characterized by anterograde amnesia in all patients, associated with retrograde amnesia in 27% of cases. Amnesia was an isolated presentation in most cases. Up to two thirds of patients had persistent memory deficits of any severity at follow-up.
    UNASSIGNED: Acute amnestic syndrome can be rarely caused by fornix lesions. In most cases of acute/subacute presentation, the etiology is ischemic stroke, mainly caused by strokes involving the subcallosal artery territory. The differential diagnosis is challenging and a distinction from common mimics is often difficult on a clinical basis. A high index of suspicion should be maintained to avoid misdiagnosis and provide adequate acute treatment to patients with time-dependent disease, also employing advanced neuroimaging. More research is needed to better understand the outcome and identify prognostic factors in patients with amnestic syndrome due to fornix lesions.
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  • 文章类型: Meta-Analysis
    背景:重度抑郁症(MDD)和焦虑症(ANX)是具有较高的共同发病率的精神疾病,这可能表明它们之间存在一些共同的神经生物学途径。但它们保留了特定特征的不同表型。然而,没有一致的证据表明它们之间存在共同的和特定于疾病的灰质体积(GMV)交替。
    方法:对MDD和ANX患者的基于体素的形态计量学研究进行系统评价和荟萃分析。在特定于疾病的分析过程中明确控制了合并症的影响,特别是在合并症患者中进行了研究。
    结果:共有45项研究,54个数据集,包括2196名患者和2055名健康参与者,符合纳入标准。眶额皮质的缺损,纹状体,在MDD和ANX中发现了边缘区域。疾病特异性分析显示双侧前扣带皮质GMV降低,右纹状体,海马体,和小脑在MDD中,而左纹状体的GMV下降,杏仁核,脑岛,ANX的小脑体积增加。在合并症患者中,双侧颞叶和顶叶回和左侧梭状回显示出完全不同的GMV交替模式。
    结论:由于纳入研究的设计,共病组中只有部分患者诊断为继发性共病.
    结论:患有MDD和ANX的患者在眶额-边缘-纹状体系统中共享结构破坏。疾病特异性效应表现为最大的严重程度,表现为区分MDD和ANX的这些变化的明显偏侧化和方向性。合并症组表现出完全不同的GMV交替模式,可能提示另一种需要进一步调查的疾病亚型。
    BACKGROUND: Major depressive disorder (MDD) and anxiety disorders (ANX) are psychiatric disorders with high mutual comorbidity rates that might indicate some shared neurobiological pathways between them, but they retain diverse phenotypes that characterize themselves specifically. However, no consistent evidence exists for common and disorder-specific gray matter volume (GMV) alternations between them.
    METHODS: A systematic review and meta-analysis on voxel-based morphometry studies of patients with MDD and ANX were performed. The effect of comorbidity was explicitly controlled during disorder-specific analysis and particularly investigated in patient with comorbidity.
    RESULTS: A total of 45 studies with 54 datasets comprising 2196 patients and 2055 healthy participants met the inclusion criteria. Deficits in the orbitofrontal cortex, striatum, and limbic regions were found in MDD and ANX. The disorder-specific analyses showed decreased GMV in the bilateral anterior cingulate cortex, right striatum, hippocampus, and cerebellum in MDD, while decreased GMV in the left striatum, amygdala, insula, and increased cerebellar volume in ANX. A totally different GMV alternation pattern was shown involving bilateral temporal and parietal gyri and left fusiform gyrus in patients with comorbidity.
    CONCLUSIONS: Owing to the design of included studies, only partial patients in the comorbid group had a secondary comorbidity diagnosis.
    CONCLUSIONS: Patients with MDD and ANX shared a structural disruption in the orbitofrontal-limbic-striatal system. The disorder-specific effects manifested their greatest severity in distinct lateralization and directionality of these changes that differentiate MDD from ANX. The comorbid group showed a totally different GMV alternation pattern, possibly suggesting another illness subtype that requires further investigation.
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  • 文章类型: Journal Article
    肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是一种衰弱的疾病,其特征是病因和病理生理学难以捉摸。本研究旨在通过对65项观察性研究进行详尽分析,评估神经炎症在ME/CFS中的病理作用。四种神经成像技术,包括磁共振成像(MRI),磁共振波谱(MRS),脑电图(EEG),和正电子发射断层扫描(PET),被用来比较评估大脑区域结构,代谢物谱,电活动,1529例ME/CFS患者的神经胶质活动(277例男性,1252名女性)和1715名对照(469名男性,1246名女性)。临床特征,包括性,年龄,和疲劳严重程度,符合既定的流行病学模式。区域改变最常见于大脑皮层,值得注意的是额叶皮层。然而,我们的荟萃分析数据显示,在岛区和丘脑区存在显著的活动不足,与观察到的频率相反。这些异常,发生在连接理性和情感的关键网络中心,破坏与边缘系统的连接,导致ME/CFS的标志性症状。此外,我们讨论了经常观察到神经炎症特征的区域,并解决了关键的神经影像学限制,包括与评估者间可靠性相关的问题。本系统综述为未来ME/CFS神经影像学研究中定义感兴趣区域(ROI)提供了有价值的指导。
    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition characterized by an elusive etiology and pathophysiology. This study aims to evaluate the pathological role of neuroinflammation in ME/CFS by conducting an exhaustive analysis of 65 observational studies. Four neuroimaging techniques, including magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), electroencephalography (EEG), and positron emission tomography (PET), were employed to comparatively assess brain regional structure, metabolite profiles, electrical activity, and glial activity in 1529 ME/CFS patients (277 males, 1252 females) and 1715 controls (469 males, 1246 females). Clinical characteristics, including sex, age, and fatigue severity, were consistent with established epidemiological patterns. Regional alterations were most frequently identified in the cerebral cortex, with a notable focus on the frontal cortex. However, our meta-analysis data revealed a significant hypoactivity in the insular and thalamic regions, contrary to observed frequencies. These abnormalities, occurring in pivotal network hubs bridging reason and emotion, disrupt connections with the limbic system, contributing to the hallmark symptoms of ME/CFS. Furthermore, we discuss the regions where neuroinflammatory features are frequently observed and address critical neuroimaging limitations, including issues related to inter-rater reliability. This systematic review serves as a valuable guide for defining regions of interest (ROI) in future neuroimaging investigations of ME/CFS.
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  • 文章类型: Journal Article
    我们对姿势控制的理解的进步强调了需要检查高级大脑中枢在调节这种复杂功能中的影响。有强有力的证据表明情绪状态之间存在联系,姿势控制中的自主神经系统(ANS)活动和躯体神经系统(躯体NS)活动。例如,已经证明了姿势威胁之间的关系,焦虑,害怕跌倒,平衡信心,和生理唤醒。行为上,在安静的站立过程中,唤醒的增加与姿势摇摆的速度和幅度的变化有关。ANS和体细胞NS之间的潜在联系,观察到控制姿势,与中枢神经系统(CNS)内共享的神经解剖连接相关。情绪状态对姿势控制的影响可能反映了边缘系统对这些ANS/躯体NS控制网络的重要影响。这篇叙述性综述将强调一些行为的例子,这些行为通常需要ANS和躯体NS之间的协调,强调这些系统之间神经功能联系的重要性。此外,我们将超越对威胁模型的更多历史关注,并研究无序/改变的情绪状态和ANS处理如何影响姿势控制和评估。最后,本文将讨论对揭示情绪状态对姿势控制的调节作用非常重要的研究,包括可能会影响我们对无序控制的理解的联系,例如在患有帕金森氏病的个体中观察到的,并讨论了有可能促进对这种复杂关系的理解的方法学工具。
    Advances in our understanding of postural control have highlighted the need to examine the influence of higher brain centers in the modulation of this complex function. There is strong evidence of a link between emotional state, autonomic nervous system (ANS) activity and somatic nervous system (somatic NS) activity in postural control. For example, relationships have been demonstrated between postural threat, anxiety, fear of falling, balance confidence, and physiological arousal. Behaviorally, increased arousal has been associated with changes in velocity and amplitude of postural sway during quiet standing. The potential links between ANS and somatic NS, observed in control of posture, are associated with shared neuroanatomical connections within the central nervous system (CNS). The influence of emotional state on postural control likely reflects the important influence the limbic system has on these ANS/somatic NS control networks. This narrative review will highlight several examples of behaviors which routinely require coordination between the ANS and somatic NS, highlighting the importance of the neurofunctional link between these systems. Furthermore, we will extend beyond the more historical focus on threat models and examine how disordered/altered emotional state and ANS processing may influence postural control and assessment. Finally, this paper will discuss studies that have been important in uncovering the modulatory effect of emotional state on postural control including links that may inform our understanding of disordered control, such as that observed in individuals living with Parkinson\'s disease and discuss methodological tools that have the potential to advance understanding of this complex relationship.
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  • 文章类型: Journal Article
    海马是大脑内侧颞叶的一部分,位于皮质下。它属于边缘系统,有助于从短期记忆到长期记忆的信息收集和转移,以及每个哺乳动物大脑半球的空间方向。经过两个多世纪对大脑不对称的研究,海马在脑偏侧化研究中备受关注。海马在认知障碍中非常重要,与癫痫发作和痴呆有关,如癫痫和阿尔茨海默病。此外,由于健康人左右海马活动的不对称,研究海马的动机显着增加,以及它在一些神经系统疾病中的破坏。在全面回顾海马结构及其在相关疾病中的重要性后,在健康人的成长和成熟过程中,大脑中的不对称集中在海马上,以及患者在分子上产生的差异,功能,和生理水平进行了讨论。大多数先前的工作表明,海马体在健康人中被偏侧化。此外,不同水平的偏侧化在患者中发生显著变化,最复杂的认知障碍似乎是由一个新的显性不对称系统引起的。
    The hippocampus is a part of the brain\'s medial temporal lobe that is located under the cortex. It belongs to the limbic system and helps to collect and transfer information from short-term to long-term memory, as well as spatial orientation in each mammalian brain hemisphere. After more than two centuries of research in brain asymmetry, the hippocampus has attracted much attention in the study of brain lateralization. The hippocampus is very important in cognitive disorders, related to seizures and dementia, such as epilepsy and Alzheimer\'s disease. In addition, the motivation to study the hippocampus has increased significantly due to the asymmetry in the activity of the left and right hippocampi in healthy people, and its disruption during some neurological diseases. After a general review of the hippocampal structure and its importance in related diseases, the asymmetry in the brain with a focus on the hippocampus during the growth and maturation of healthy people, as well as the differences created in patients at the molecular, functional, and physiological levels are discussed. Most previous work indicates that the hippocampus is lateralized in healthy people. Also, lateralization at different levels remarkably changes in patients, and it appears that the most complex cognitive disorder is caused by a new dominant asymmetric system.
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  • 文章类型: Journal Article
    尽管尺寸小,乳头体在支持回忆记忆中起着重要作用。然而,在评估伴有记忆障碍的神经系统疾病时,它们通常被忽略。虽然有越来越多的证据表明,在成人的神经系统疾病中,对婴儿和儿童的关注很少。对PubMed和EMBASE进行了文献检索,以确定在儿童脑MR成像中描述乳头体病理学的文章。哺乳动物体病理学存在于儿科人群中的几种情况,由MR成像上的信号变化和/或萎缩指示。乳头体病理的主要原因是硫胺素缺乏,缺氧缺血,由于肿块或脑积水造成的直接损害,或由更宽的Papez电路内的病理学引起的失能。优化扫描方案和评估乳腺体状态作为标准程序是至关重要的,考虑到它们在内存进程中的作用。
    Despite their small size, the mammillary bodies play an important role in supporting recollective memory. However, they have typically been overlooked when assessing neurologic conditions that present with memory impairment. While there is increasing evidence of mammillary body involvement in a wide range of neurologic disorders in adults, very little attention has been given to infants and children. Literature searches of PubMed and EMBASE were performed to identify articles that describe mammillary body pathology on brain MR imaging in children. Mammillary body pathology is present in the pediatric population in several conditions, indicated by signal change and/or atrophy on MR imaging. The main causes of mammillary body pathology are thiamine deficiency, hypoxia-ischemia, direct damage due to masses or hydrocephalus, or deafferentation resulting from pathology within the wider Papez circuit. Optimizing scanning protocols and assessing mammillary body status as a standard procedure are critical, given their role in memory processes.
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  • 文章类型: Journal Article
    重度抑郁症(MDD)和焦虑症(ANX)具有共同的核心症状,例如负面影响,并且经常共存。磁共振成像(MRI)研究表明共同的神经解剖学/神经功能基础。到目前为止,考虑到MDD和ANX的跨诊断性和特定于疾病的神经改变以及合并症(COM)的研究尚未进行系统审查。
    遵循PRISMA准则,根据PICOS标准筛选了文献,并检查了N=247篇文章:MRI研究调查诊断(跨MDD,ANX,与健康对照相比,COM和/或疾病特异性(MDD,ANX,COM)神经改变。N=35,其中n=13个结构MRI和扩散张量成像研究,n=22个功能MRI研究调查情绪,纳入认知缺陷和静息状态,并对质量进行编码.
    结果表明眶额叶皮质/中额叶皮质和边缘区域(杏仁核,扣带,海马体)。报道了很少且不一致的疾病特异性改变。然而,据报道,在情绪任务期间,额下回和背外侧前额叶皮层的抑郁症特异性功能改变,和边缘区域在休息。在情绪任务期间,在脑岛和额叶区域发现了焦虑特异性功能改变的初步结果,在下顶叶小叶,认知任务期间的额上回和颞上回,和(段落)静止时的边缘改变。
    这篇综述提供了支持MDD和ANX中现有的经诊断性前边缘神经模型的证据。在上面,它扩展了现有的知识,同时考虑了合并症并将MDD与ANX进行了比较。疾病特异性改变存在异质性证据。专注于ANX亚型的研究,和COM的考虑将有助于更好地理解基本的神经基础。
    Major depressive disorder (MDD) and anxiety disorders (ANX) share core symptoms such as negative affect and often co-exist. Magnetic-resonance imaging (MRI) research suggests shared neuroanatomical/neurofunctional underpinnings. So far, studies considering transdiagnostic and disorder-specific neural alterations in MDD and ANX as well as the comorbid condition (COM) have not been reviewed systematically.
    Following PRISMA guidelines, the literature was screened and N = 247 articles were checked according to the PICOS criteria: MRI studies investigating transdiagnostic (across MDD, ANX, COM compared to healthy controls) and/or disorder-specific (between MDD, ANX, COM) neural alterations. N = 35, thereof n = 13 structural MRI and diffusion-tensor imaging studies and n = 22 functional MRI studies investigating emotional, cognitive deficits and resting state were included and quality coded.
    Results indicated transdiagnostic structural/functional alterations in the orbitofrontal cortex/middle frontal cortex and in limbic regions (amygdala, cingulum, hippocampus). Few and inconsistent disorder-specific alterations were reported. However, depression-specific functional alterations were reported for the inferior frontal gyrus and dorsolateral prefrontal cortex during emotional tasks, and limbic regions at rest. Preliminary results for anxiety-specific functional alterations were found in the insula and frontal regions during emotional tasks, in the inferior parietal lobule, superior frontal gyrus and superior temporal gyrus during cognitive tasks, and (para)limbic alterations at rest.
    This review provides evidence to support existing transdiagnostic fronto-limbic neural models in MDD and ANX. On top, it expands existing knowledge taking into account comorbidity and comparing MDD with ANX. Heterogeneous evidence exists for disorder-specific alterations. Research focusing on ANX sub-types, and the consideration of COM would contribute to a better understanding of basic neural underpinnings.
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  • 文章类型: Journal Article
    这篇综述详细阐述了病因,诊断,和治疗颞下颌(TMD)肌筋膜疼痛综合征(MPS)调节的心理社会因素。MPS由于伴随的疼痛而损害社会功能。定向和自我定向的生物心理社会概况调节在MPS的治疗中可能是有益的。此外,营养也是肌肉骨骼系统健康的相当一部分。水果和蔬菜饮食由于其抗炎作用而有助于降低慢性疼痛强度。大麻二酚(CBD)油也可以用于治疗,因为它们可以减轻压力和焦虑。一种有希望的替代治疗方法可能是颅骨疗法,该疗法使用温和的筋膜触诊技术,通过调节身体节律并释放颅骨和骶骨之间的筋膜限制来减少交感神经唤醒。MPS受到边缘的综合作用的影响,自主性,内分泌,躯体,伤害性,和免疫系统。因此,MPS的治疗应该从整体上考虑,因为它是一种复杂的疾病.
    This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.
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  • 文章类型: Journal Article
    Emotions are valenced mental responses and associated physiological reactions that occur spontaneously and automatically in response to internal or external stimuli, and can influence our behavior, and can themselves be modulated to a certain degree voluntarily or by external stimuli. They are subserved by large-scale integrated neuronal networks with epicenters in the amygdala and the hippocampus, and which overlap in the anterior cingulate cortex. Although emotion processing is accepted as being lateralized, the specific role of each hemisphere remains an issue of controversy, and two major hypotheses have been proposed. In the right-hemispheric dominance hypothesis, all emotions are thought to be processed in the right hemisphere, independent of their valence or of the emotional feeling being processed. In the valence lateralization hypothesis, the left is thought to be dominant for the processing of positively valenced stimuli, or of stimuli inducing approach behaviors, whereas negatively valenced stimuli, or stimuli inducing withdrawal behaviors, would be processed in the right hemisphere. More recent research points at the existence of multiple interrelated networks, each associated with the processing of a specific component of emotion generation, i.e., its generation, perception, and regulation. It has thus been proposed to move from hypotheses supporting an overall hemispheric specialization for emotion processing toward dynamic models incorporating multiple interrelated networks which do not necessarily share the same lateralization patterns.
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