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.