1、1.抑郁症概念2.抑郁症病因探究3.抑郁症的影像遗传学研究4.小结抑郁症抑郁症心灵杀手心灵杀手一种常见的心境障碍，典型症状：情绪低落 思维迟缓 意志活动减退认知障碍全球抑郁症患者：3.5亿WHO预计：2020年，人类第二大疾患(13)为什么会得抑郁症？为什么会得抑郁症？生物生物神神经经行行为为环境环境影影像像心理心理遗传遗传Mattay et al Biol Psychol 2019研究局限性研究局限性遗传学研究:人格问卷临床评估神经电生理测验(7)关联性背后的机制？关联性背后的机制？Mattay et al Biol Psychol 2019影像学研究：海马（认知记忆）杏仁核（负性信息调节）
2、扣带回前部（情感整合）前额叶皮层（信息加工）（811）受试者的遗传背景？受试者的遗传背景？研究局限性研究局限性影像遗传学影像遗传学神经科学神经科学遗传学遗传学信息信息/工程学科工程学科影像学影像学放射科医生放射科医生精神神经科医生精神神经科医生计算机图像处理专家计算机图像处理专家遗传学专家遗传学专家统计学专家统计学专家新思路新思路影像遗传学影像遗传学Mattay et al Biol Psychol 2019抑郁症影像遗传学的主要发现抑郁症影像遗传学的主要发现5-HT相关的基因（色氨酸羟化酶(TPH)基因、5-HTT基因、5-HTTLPR、5-HT受体基因和单胺氧化酶基因等）儿茶酚氧位甲基转移
3、酶（COMT）基因脑源性神经营养因子(BDNF)基因精神分裂症断裂-l型(DISC1)基因载脂蛋白E（APOE）基因大麻素受体1(CNRl)基因（7）抑郁症影像遗传学的主要发现抑郁症影像遗传学的主要发现(Frodl，et,al.Acta Psychiatry,2019)5-HTTLPR5-HTTLPR5-羟色胺转运基因启动序列羟色胺转运基因启动序列5-HT：生理和行为的调控因子5-HTT：重摄取突触间隙的5-HT5-HTTLPR：短等位基因(S)，长等位基因(L)5-HT 5-HTT 5-HTTLPR（1）结构影像：Hickie等:携带S等位基因-尾状核、扣带回、杏仁核体积减小(1214)Fr
4、odl等:纯合L等位基因-灰质体积明显减小如背侧额前叶皮质、前扣带回皮质、杏仁核、海马前部等(15)Taylor等:海马体积减小 早发(发病年 龄55岁)-S等位基因 抑郁症晚期发作的年龄-L等位基因(12)Hariri(16),Heinz(17)等:负性刺激 S等位基因携带者杏仁核的活性更高,杏仁核与腹内侧前额皮质联系增强5-HTTLPR基因多态性可能是情绪障碍的典型易患因素.Hariri,et al.Science,2019（2）功能影像：选择性5-羟色胺再摄取抑制剂(SSRIs)：药物对5-HTT的占有率在 LL等位基因携带者中较高，从而对抗抑郁剂治疗反应较好（18）抑郁症抑郁症个体化个
5、体化治疗提治疗提供依据供依据（2）药物治疗反应：小结小结 1抑郁症严重危害人类的身心健康，抑郁症严重危害人类的身心健康，3.5亿患亿患者只是冰山一角；者只是冰山一角；抑郁症的影像遗传学研究尚处于初步阶段；抑郁症的影像遗传学研究尚处于初步阶段；抑郁症发病与大脑改变的因果关系；抑郁症发病与大脑改变的因果关系；候选基因选择，研究结论各异。候选基因选择，研究结论各异。小结小结 21.Nestler EJ,M Barrot,RJ DiLeone,et al.Neurobiology of depression.Neuron,2019,34(1):13-25.2.Belmaer R H,Agam G.Ma
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