抑郁对男女大脑的影响差异

皇后

Depression affects the brains of males and females differentlyJuly 11, 2017
When researchers in the UK exposed depressed adolescents to happy or sad words and imaged their brains, they found that depression has different effects on the brain activity of male and female patients in certain brain regions. The findings suggest that adolescent girls and boys might experience depression differently and that sex-specific treatments could be beneficial for adolescents.

Men and women appear to suffer from depression differently, and this is particularly striking in adolescents. By 15 years of age, girls are twice as likely to suffer from depression as boys. There are various possible reasons for this, including body image issues, hormonal fluctuations and genetic factors, where girls are more at risk of inheriting depression. However, differences between the sexes don't just involve the risk of experiencing depression, but also how the disorder manifests and its consequences.

"Men are more liable to suffer from persistent depression, whereas in women depression tends to be more episodic," explains Jie-Yu Chuang, a researcher at the University of Cambridge, and an author on the study, which was recently published in Frontiers in Psychiatry. "Compared with women, depressed men are also more likely to suffer serious consequences from their depression, such as substance abuse and suicide." Despite this, so far, most researchers have focused on depression in women, likely because it is more common.

This motivated Chuang and her colleagues to carry out this latest study to find differences between depressed men and women. They recruited adolescent volunteers for the study, who were aged between 11 and 18 years. This included 82 female and 24 male patients who suffered from depression, and 24 female and 10 male healthy volunteers. The researchers imaged the adolescents' brains using magnetic resonance imaging, while flashing happy, sad or neutral words on a screen in a specific order.

The volunteers pressed a button when certain types of words appeared and did not press the button when others appeared, and the researchers measured their brain activity throughout the experiment. When the researchers flashed certain combinations of words on the screen, they noticed that depression affects brain activity differently between boys and girls in brain regions such as the supramarginal gyrus and posterior cingulate.

So, what do these results mean? "Our finding suggests that early in adolescence, depression might affect the brain differently between boys and girls," explains Chuang. "Sex-specific treatment and prevention strategies for depression should be considered early in adolescence. Hopefully, these early interventions could alter the disease trajectory before things get worse."

The brain regions highlighted in the study have been previously linked to depression, but further work is needed to understand why they are affected differently in depressed boys, and if this is related to how boys experience and handle depression.

Because depression is more common in girls, the researchers were not able to recruit as many boys in this study, and future experiments should compare similar numbers of girlsand boys for more representative results. Chuang and her colleagues would like to explore this phenomenon further. "I think it would be great to conduct a large longitudinal study addressing sex differences in depression from adolescence to adulthood."

当英国研究者向抑郁青少年呈现幸福或者悲伤的词汇并对他们的大脑成像时，他们发现抑郁对男性和女性特定大脑区域的活动影响不同。这些发现表明青春期男孩和女孩可能经历了不同的抑郁，分性别的治疗可能对于青少年更好。这一成果已发表在精神病学前沿上。

男性和女性经受抑郁的方式似乎不同，在青少年中尤为显著。到15岁，女孩患上抑郁的可能性是男孩的2倍。这可能是多种因素引起的，包括身体问题，激素涨落和遗传因素等，其中女孩更可能继承抑郁。不过，性别差异并不仅仅包括经历抑郁的风险，还包括这种失调的症状和后果。

剑桥大学研究员、研究共同作者Jie-Yu Chuang解释道：“男性更可能患上顽固性的抑郁，而女性抑郁则倾向于是偶发性的。相比女性，抑郁男性更可能由于抑郁承受更严重的后果，比如药物滥用和自杀。”尽管如此，可能由于女性抑郁更为常见，大部分研究者都专注于女性的抑郁。

这就激发了Chuang和她的同事们进行这一项最新研究，来发现抑郁男性和女性之间的差异。他们为该研究招募了11岁到18岁的青少年志愿者，包括82名抑郁女性和24名抑郁男性，24名正常女性和10名正常男性。研究者在屏幕上以特定顺序放映高兴、悲伤或者中性词汇，并利用磁共振成像对青少年的脑部进行了显像。

当特定类型词语出现时，志愿者按下一个按钮，当其他类型出现时就不按这个按钮，研究者在整个实验中都测量他们的脑部活动。当研究者在屏幕上闪过特定组合词语时，他们注意到抑郁在男孩和女孩的特定脑部区域影响的活跃度不同，比如缘上回和后扣带回。

所以，这些结果意味着什么呢？Chuang解释道：“我们的发现表明早在青春期，抑郁可能对男孩和女孩的大脑有不同的影响。分性别的抑郁治疗和预防策略应该早在青春期就加以考虑了。希望这些早期的干预能在事情变得更糟糕之前改变疾病的轨迹。”

研究中强调的脑部区域先前就与抑郁有联系了，但还需要进一步的工作来理解为什么抑郁男孩的这个部位受到的影响不同，这是否与男孩经历和处理抑郁的方式有关。

由于抑郁在女孩中更为普遍，本研究无法招募那么多的抑郁男孩志愿者，为了得到更具代表性的结果，未来的实验应当比较近似数目的男孩和女孩。Chuang和她的同事们将会更深入地探索这一现象。“我认为进行从青少年到成年的抑郁性别差异的纵向研究将会很有意义。”

论文原文：DOI: 10.3389/fpsyt.2017.00119