下丘脑异常与抑郁症

近年来的研究发现了抑郁模型动物或抑郁症病人下丘脑异常的大量证据, 诸如下丘脑体积及神经元数目的改变, 下丘脑-垂体-内分泌轴的改变, 下丘脑相关激素、受体及其基因、神经肽的改变, 下丘脑与其他脑区功能联系的改变等等。然而, 下丘脑与抑郁症关系的研究所获证据多来自动物实验、或临床间接指标(如病人外周血激素水平等), 或病人脑组织尸检, 缺乏来自病人活体下丘脑异常的直接证据。今后的研究可考虑运用影像学的手段更直接地探索抑郁症患者活体下丘脑的结构特征和功能特征, 以期发现抑郁症的生物学标记及其可靠性指标, 为抑郁症的客观诊断提供依据, 为揭示抑郁症病理机制提供线索。

Hypothalamic Abnormalities and Major Depressive Disorder

Recent studies of depression model animals or patients with major depressive disorders have found substantial evidence of hypothalamic abnormalities, such as changes in the hypothalamus volume and the number of neurons, dysfunctions in hypothalamic-pituitary-endocrine axis, hypothalamic-related hormone, receptors and their genes, neuropeptides, and alterations in the connectivity between hypothalamus and other brain regions. Most of this evidence, however, was obtained either from animal experiments, from indirect clinical indicators (such as peripheral blood hormone levels, etc.), or from brain autopsies of patients with depression. No direct evidence for abnormal hypothalamus in depressive disorders has been confirmed in vivo in humans. Future studies may use brain imaging methods to more directly explore the structural and functional characteristics of abnormal hypothalamus in depressed patients. The resulting biomarkers, along with measurements of their reliability, can provide the basis for objective diagnosis, and lead to a better understanding of the pathogenesis of depressive disorders.