神经病学与神经康复学杂志2025，Vol.21Issue(5)：407-413,7.DOI:10.12022/jnnr.2025-0168
老年抑郁症的神经脑机制及无创脑神经调控技术研究进展
Research progress on the neuro-brain mechanism of late-life depression and non-invasive brain neuroregulation techniques
曾玲芸 1吴东辉 2翟伟光 3王继军4
作者信息
- 1. 深圳市精神卫生中心(深圳市康宁医院)脑调控与精神康复研究室,广东 深圳 580000
- 2. 深圳市精神卫生中心(深圳市康宁医院)老年精神科,广东 深圳 580000
- 3. 深圳市精神卫生中心(深圳市康宁医院)门诊部,广东 深圳 580000
- 4. 上海交通大学医学院附属精神卫生中心脑电影像眼动研究室,上海 200030
- 折叠
摘要
Abstract
The prevalence of late-life depression(LLD)among people over 60 years old worldwide is as high as 28.4%,and the incidence rate of LLD in China is 31.21%.Its clinical manifestations are mainly physical symptoms and cognitive impairment,which are easily misdiagnosed as physical diseases.Neuroimaging studies have revealed that the pathological mechanism of LLD is closely related to abnormal brain structure and function,including reduced gray matter volume in brain regions such as the prefrontal lobe and hippocampus,excessive activation of the default mode network(DMN),and weakened connections of the executive control network.These findings provide targets for neuroregulation therapy.The response rate of traditional antidepressant drugs is only 50%,and some have cardiovascular and cognitive risks.However,non-invasive neuroregulation techniques have shown significant potential.Electroconvulsive therapy(ECT)has a remission rate of over 50%for severe patients,but it has obvious cognitive side effects.Magnetic seizure therapy achieves focal epileptic seizures through precise magnetic field stimulation,with efficacy comparable to that of ECT and less cognitive impact.Bilateral repetitive transcranial magnetic stimulation(TMS)and deep TMS(dTMS)are recommended as first-line regimens.Transcranial direct current stimulation is suitable for patients with mild to moderate conditions due to its high safety.In the future,it is necessary to optimize individualized parameters by integrating multi-modal assessment,explore combined therapies and telemedicine applications,in order to improve the diagnosis and treatment effect of LLD.关键词
老年抑郁症/经颅磁刺激/经颅直流电刺激/电休克疗法/磁抽搐疗法Key words
Late-life depression/Transcranial magnetic stimulation/Transcranial direct current stimulation/Electroconvulsive therapy/Magnetic seizure therapy引用本文复制引用
曾玲芸,吴东辉,翟伟光,王继军..老年抑郁症的神经脑机制及无创脑神经调控技术研究进展[J].神经病学与神经康复学杂志,2025,21(5):407-413,7.
