8月26日,德國波恩大學(xué)發(fā)表公報(bào)說，該校與美國科學(xué)家最新研究發(fā)現(xiàn),，大腦中4個(gè)與抑郁癥相關(guān)的區(qū)域間互有關(guān)聯(lián),。這一成果有助于改善抑郁癥的治療方法。
20世紀(jì)80年代末治療抑郁癥的手段之一是腦部手術(shù),，研究人員分析了大量此類歷史病例,。當(dāng)時(shí)的研究發(fā)現(xiàn)了4個(gè)與抑郁癥有關(guān)的腦部區(qū)域，如果手術(shù)中有意“破壞”這些區(qū)域,，術(shù)后70%的患者病情都有明顯改善,。
德美研究人員在此次研究中發(fā)現(xiàn)，這4個(gè)區(qū)域都由內(nèi)側(cè)前腦束相互連接在一起,，形成一個(gè)與抑郁癥有關(guān)的腦區(qū)域群,。此前研究僅發(fā)現(xiàn)這4個(gè)區(qū)域?qū)η楦刑幚碛胁煌饔茫⒉恢浪鼈冎g有聯(lián)系,。德美研究人員認(rèn)為,，由于學(xué)界已知刺激內(nèi)側(cè)前腦束能給抑郁癥患者帶來好心情，有針對性地刺激上述腦區(qū)域群很可能為抑郁癥的治療帶來突破,。
此外,，研究人員用核磁共振掃描為50名抑郁癥患者進(jìn)行了檢查，并結(jié)合電腦模擬手術(shù)對這一成果進(jìn)行實(shí)踐分析,。研究人員認(rèn)為,，在該研究成果的基礎(chǔ)上，利用立體定向手術(shù)在患者腦部特定區(qū)域植入電極將有望改善抑郁癥癥狀,。
這一成果發(fā)表在最新一期的《神經(jīng)心理藥物學(xué)》（Neuropsychopharmacology）雜志上,。（生物谷Bioon.com）
生物谷推薦原文出處：
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.
