摘要
重度抑郁障碍(major depressive disorder,MDD)是一种常见的精神疾病,伴随大脑结构和功能连接的改变,严重影响患者的身心健康和社会功能。重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)是一种基于电磁感应的非侵入性神经调节技术,在MDD治疗中已表现出显著疗效,但其通过调节大脑结构和功能来发挥抗抑郁作用的具体机制仍不明确。尽管多模态MRI为揭示rTMS的神经调控机制提供了重要手段,但现有综述多侧重于独立分析大脑结构或功能的变化,未能系统整合和充分探讨rTMS对大脑结构-功能耦合关系的影响。因此,本综述将基于结构-功能MRI,系统梳理rTMS在治疗MDD过程中对大脑结构-功能耦合关系变化的研究进展,从而为优化刺激靶点选择提供新视角,并为实现rTMS干预效果的多尺度客观评估提供方法论建议。本文认为,深入理解rTMS对大脑结构-功能耦合的调控机制,是推动其实现MDD治疗精准化和疗效评估客观化的关键路径。
Major depressive disorder(MDD)is a prevalent psychiatric condition associated with alterations in brain structural and functional connectivity,which significantly affects physical,psychological,and social functioning.Repetitive transcranial magnetic stimulation(rTMS),a non-invasive neuromodulation technique that applies magnetic pulses to the cortical regions,has shown significant efficacy in the treatment of MDD.However,the specific mechanisms by which it exerts its antidepressant effects through regulating brain structure and function remain unclear.Although multimodal MRI has provided valuable tools for revealing the neuroregulatory mechanisms of rTMS,existing reviews mostly focus on separate analyses of structural or functional changes,without systematically integrating how rTMS affects the structural-functional coupling of the brain.Therefore,we systematically summarize the research progress on rTMS-induced changes in the brain's structure-function coupling during MDD treatment,based on structural-functional MRI.It aims to provide new perspectives for optimizing the selection of stimulation targets and offers methodological suggestions for the multi-scale objective evaluation of rTMS intervention effects.We propose that a deeper understanding of the regulatory mechanisms of rTMS on brain structure-function coupling is a core to achieving precision in MDD treatment and objectivity in efficacy evaluation.
作者
刘靖雯
胡良波
LIU Jingwen;HU Liangbo(Department of Radiology,the Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)
出处
《磁共振成像》
北大核心
2025年第7期102-108,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
重庆市自然科学基金面上项目(编号:CSTB2022NSCQ-MSX1035)
重庆市科卫联合医学科研项目(编号:2024ZDXM013)。
关键词
重度抑郁障碍
磁共振成像
多模态
重复经颅磁刺激
机制
major depressive disorder
magnetic resonance imaging
multimodal
repetitive transcranial magnetic stimulation
mechanism
