Neuropsychopharmacology：发现大脑中4个与抑郁症相关的区域关联-生物...

8月26日,德国波恩大学发表公报说，该校与美国科学家最新研究发现，大脑中4个与抑郁症相关的区域间互有关联。这一成果有助于改善抑郁症的治疗方法。

20世纪80年代末治疗抑郁症的手段之一是脑部手术，研究人员分析了大量此类历史病例。当时的研究发现了4个与抑郁症有关的脑部区域，如果手术中有意“破坏”这些区域，术后70%的患者病情都有明显改善。

德美研究人员在此次研究中发现，这4个区域都由内侧前脑束相互连接在一起，形成一个与抑郁症有关的脑区域群。此前研究仅发现这4个区域对情感处理有不同作用，但并不知道它们之间有联系。德美研究人员认为，由于学界已知刺激内侧前脑束能给抑郁症患者带来好心情，有针对性地刺激上述脑区域群很可能为抑郁症的治疗带来突破。

此外，研究人员用核磁共振扫描为50名抑郁症患者进行了检查，并结合电脑模拟手术对这一成果进行实践分析。研究人员认为，在该研究成果的基础上，利用立体定向手术在患者脑部特定区域植入电极将有望改善抑郁症症状。

这一成果发表在最新一期的《神经心理药物学》（Neuropsychopharmacology）杂志上。（生物谷Bioon.com）

生物谷推荐原文出处：

Neuropsychopharmacology doi: 10.1038/npp.2010.132

Tractographic Analysis of Historical Lesion Surgery for Depression
Jan-Christoph Schoene-Bake1,2,6, Yaroslav Parpaley3,6, Bernd Weber1,2, Jaak Panksepp4, Trevor A Hurwitz5 and Volker A Coenen3

1Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
2Department of NeuroCognition/Imaging, Life & Brain Center, Bonn, Germany
3Stereotaxy and MR based OR Techniques/Department of Neurosurgery, University of Bonn Medical Center, Bonn, Germany
4Department of VCAPP, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
5Department of Psychiatry, University of British Columbia, Vancouver, CA, USA

Various surgical brain ablation procedures for the treatment of refractory depression were developed in the twentieth century. Most notably, key target sites were (i) the anterior cingulum, (ii) the anterior limb of the internal capsule, and (iii) the subcaudate white matter, which were regarded as effective targets. Long-term symptom remissions were better following lesions of the anterior internal capsule and subcaudate white matter than of the cingulum. It is possible that the observed clinical improvements of these various surgical procedures may reflect shared influences on presently unspecified brain affect-regulating networks. Such possibilities can now be analyzed using modern brain connectivity procedures such as diffusion tensor imaging (DTI) tractography. We determined whether the shared connectivities of the above lesion sites in healthy volunteers might explain the therapeutic effects of the various surgical approaches. Accordingly, modestly sized historical lesions, especially of the anatomical overlap areas, were ‘implanted’ in brain-MRI scans of 53 healthy subjects. These were entered as seed regions for probabilistic DTI connectivity reconstructions. We analyzed for the shared connectivities of bilateral anterior capsulotomy, anterior cingulotomy, subcaudate tractotomy, and stereotactic limbic leucotomy (a combination of the last two lesion sites). Shared connectivities between the four surgical approaches mapped onto the most mediobasal aspects of bilateral frontal lobe fibers, including the forceps minor and the anterior thalamic radiations that contacted subgenual cingulate regions. Anatomically, convergence of these shared connectivities may derive from the superolateral branch of the medial forebrain bundle (MFB), a structure that connects these frontal areas to the origin of the mesolimbic dopaminergic ‘reward’ system in the midbrain ventral tegmental area. Thus, all four surgical anti-depressant approaches may be promoting positive affect by converging influences onto the MFB.