摘要
抑郁症(major depressive disorder,MDD)是最常见的精神疾病之一,其特征是显著而持久的心境低落和意志行为改变,并且自杀风险高,常导致严重的残疾和疾病负担.研究发现MDD患者急性期和缓解期均存在认知功能损伤,并严重影响患者的预后.视觉认知功能损伤极大影响MDD患者的社会功能.研究表明,MDD患者视觉认知功能损伤与脑内功能连接和异常激活密切相关,患者额叶、枕叶、颞叶、顶叶等脑区均存在不同程度的神经影像学改变. MDD患者视觉认知功能的改变主要受额叶及枕叶的影响,这可能与这两个脑区在解剖结构上包含大量的视觉皮层有关.额叶的激活可能与患者视觉认知损伤呈正相关;枕叶活动的减少对视觉处理产生影响,并且可能是认知功能损伤的起始因素.颞叶在表情识别中起着调节作用;顶叶区域的活动增强对视觉短期记忆也起着重要的作用.除此之外,颞顶交界也被发现参与视觉图像和工作记忆的处理,并且能够观察到顶叶及颞叶的激活.本综述通过梳理分析国内外最新研究,以期揭示MDD视觉认知功能损伤的脑影像机制.
Major depressive disorder (MDD) is one of the most common psychiatric disorders. It is characterized by emotional,cognitive,and physical symptoms which can also cause severe disability and dis-ease burden. The current study found that patients with MDD have cognitive impairment in both acute and remission phases,which seriously affect the prognosis of patients. The impairment of visual cognitive function greatly affects the social function of MDD patients and the current researches showed that visual cognitive im-pairment of MDD patients is closely related to the functional connection in the brain,which can be reflected by different degrees of neuroimaging changes in the frontal, occipital, temporal, and parietal regions. The change of visual cognitive function in patients with MDD is mainly influenced by the frontal lobe and the oc-cipital lobe,which may be related to the large number of visual cortex in the anatomy of the two brain re-gions. The activation of the frontal lobe may be positively related to the patient's visual cognitive impairment;the reduction of the occipital lobe activity may have an impact on the visual process and may be the starting factor for cognitive impairment. The active enhancement of the parietal region plays an important role in the visual short-term memory. In addition,the temporo-parietal junction is also found to be involved in the pro-cessing of visual and working memory,and the activation of temporal lobe and parietal lobe can be observed. This review summarizes recent researches at home and abroad and reveals the visual perception of MDD pa-tients in different ways in each different brain regions.
作者
张一靓
钟舒明
赖顺凯
贾艳滨
Zhang Yiliang;Zhong Shuming;Lai Shunkai;Jia Yanbin(Department of Psychiatry,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2019年第10期951-955,共5页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家自然科学基金项目(81671351)。
关键词
抑郁症
视觉认知
脑影像
Major depressive disorder
Visual cognitive
Brain imaging
