瑜伽的心理神经免疫学对抑郁症的精神病理学有何启示?

IF 3.7 Q2 IMMUNOLOGY
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引用次数: 0

摘要

抑郁症是最常见的精神疾病,但仍有 30% 以上的患者未得到治疗。这组患者表现为亚临床炎症。试用抗炎药物的研究结果喜忧参半。效果不佳的原因可能是炎症的复杂性以及只针对抑郁症的少数异常途径。身心疗法的生物学和神经影像学研究为抑郁症的病理心理提供了宝贵的见解。有趣的是,身心疗法(如瑜伽)能逆转抑郁症的异常通路。这些畸变通路包括认知功能下降、互感、神经可塑性、显著性和默认模式网络连接、副交感神经张力、下丘脑-垂体-肾上腺(HPA)轴活动增加以及代谢亢进/功能低下。大量证据表明,瑜伽技巧可以改善不同人群自我报告的抑郁症状。瑜伽与药物疗法和认知疗法相结合,可能会更有效地治疗抑郁症。瑜伽的心理神经免疫学告诉我们,减少异位负荷对改善抑郁症状至关重要。心身疗法可促进副交感神经张力、下调 HPA 轴、减少炎症和提高免疫力。炎症的减轻可促进神经可塑性,进而促进神经发生。改善相互感知可解决代谢需求预测错误,恢复平衡。此外,通过改善显著性网络内的功能连接,它们还能恢复默认模式和中央执行网络之间的动态切换,减少反刍和思维游离。未来的研究应针对上述机制设计疗法。建立多学科医疗团队,提供药物、基因、神经反馈、行为、身心和心理疗法的组合,可以治疗耐药性抑郁症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What can the psychoneuroimmunology of yoga teach us about depression's psychopathology?
Depression, the most prevailing mental health condition, remains untreated in over 30% of patients. This cluster presents with sub-clinical inflammation. Investigations trialling anti-inflammatory medications had mixed results. The lack of results may result from inflammation's complexity and targeting only a few of depression's abnormal pathways. Mind-body therapies' biological and neuro-imaging studies offer valuable insights into depression psychopathology. Interestingly, mind-body therapies, like yoga, reverse the aberrant pathways in depression. These aberrant pathways include decreased cognitive function, interoception, neuroplasticity, salience and default mode networks connectivity, parasympathetic tone, increased hypothalamic-pituitary-adrenal (HPA) axis activity, and metabolic hyper/hypofunction. Abundant evidence found yogic techniques improving self-reported depressive symptoms across various populations. Yoga may be more effective in treating depression in conjunction with pharmacological and cognitive therapies. Yoga's psychoneuroimmunology teaches us that reducing allostatic load is crucial in improving depressive symptoms. Mind-body therapies promote parasympathetic tone, downregulate the HPA axis, reduce inflammation and boost immunity. The reduced inflammation promotes neuroplasticity and, subsequently, neurogenesis. Improving interoception resolves the metabolic needs prediction error and restores homeostasis. Additionally, by improving functional connectivity within the salience network, they restore the dynamic switching between the default mode and central executive networks, reducing rumination and mind-wandering. Future investigations should engineer therapies targeting the mechanisms mentioned above. The creation of multi-disciplinary health teams offering a combination of pharmacological, gene, neurofeedback, behavioural, mind-body and psychological therapies may treat treatment-resistant depression.
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来源期刊
Brain, behavior, & immunity - health
Brain, behavior, & immunity - health Biological Psychiatry, Behavioral Neuroscience
CiteScore
8.50
自引率
0.00%
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审稿时长
97 days
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