情绪障碍与偏侧化的脑功能障碍有关,左侧为抑郁症,右侧为躁狂症。始终如一,皮质兴奋性的不对称,经颅磁刺激(TMS)测量已被报道。这里,我们回顾并总结了在情绪障碍中对这些措施进行双边评估的工作。
我们进行了系统评价并提取了数据,以对运动皮质兴奋性的半球间不对称进行荟萃分析,用TMS评估,跨越不同的情绪障碍和健康受试者。此外,探讨了半球间不对称的潜在预测因素。
健康志愿者静息运动阈值(MT)的不对称是显著的,相对于左半球的兴奋性,有利于右下角。MT在重度抑郁障碍(MDD)中也显着不对称,但是左半球的兴奋性较低,与右边相比,在康复患者中不再观察到。皮质内促进的结果相似。包括双相抑郁在内的少数试验揭示了类似的失衡趋势,但是右下半球的兴奋性,相对于左边。
在MDD中存在运动皮层兴奋性的半球间不对称,与右侧相比,左侧的兴奋性较低。半球间不对称,右下相对于左侧的兴奋性,被发现用于双相抑郁,也被建议用于健康志愿者,与MDD明显不同的模式。
情绪障碍表现出不对称的运动皮质兴奋性,这与健康志愿者的表现不同。支持在这些疾病中存在偏侧化的脑功能障碍。
Mood disorders have been associated with lateralized brain dysfunction, on the left-side for depression and right-side for mania. Consistently,
asymmetry of cortical excitability, as measured by transcranial magnetic stimulation (TMS) has been reported. Here, we reviewed and summarized work assessing such measures bilaterally in mood disorders.
We performed a systematic
review and extracted data to perform meta-analyses of interhemispheric
asymmetry of motor cortex excitability, assessed with TMS, across different mood disorders and in healthy subjects. Additionally, potential predictors of interhemispheric
asymmetry were explored.
Asymmetry of resting motor threshold (MT) among healthy volunteers was significant, favoring lower right relative to left-hemisphere excitability. MT was also significantly asymmetric in major depressive disorder (MDD), but with lower excitability of the left -hemisphere, when compared to the right, no longer observed in recovered patients. Findings on intracortical facilitation were similar. The few trials including bipolar depression revealed similar trends for imbalance, but with lower right hemisphere excitability, relative to the left.
There is interhemispheric asymmetry of motor cortical excitability in MDD, with lower excitability on left when compared to right-side. Interhemispheric asymmetry, with lower right relative to left-sided excitability, was found for bipolar depression and was also suggested for healthy volunteers, in a pattern that is clearly distinct from MDD.
Mood disorders display asymmetric motor cortical excitability that is distinct from that found in healthy volunteers, supporting the presence of lateralized brain dysfunction in these disorders.