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摘要
背景:越来越多的临床前证据表明锂(Li)可以保护神经元免受一系列的神经毒性的损害,因此起到神经保护作用。锂在人类受试者也有类似的影响吗?方法:回顾了锂治疗与脑结构的关联的神经影像学文献。结果:有I级证据表明锂治疗与脑灰质体积呈正相关,这是最多可重复的神经影像学研究之一。这在大多数的横断面现况研究有报道,所有8个前瞻性研究,包括1个随机对照试验和2个元分析和1个分子进化遗传分析(mega)。无论是情绪状态,诊断亚型,有或无联合药物的情况下, 锂治疗和灰质体积有关联。这在多个脑区被记录,包括海马体、杏仁核、前扣带回、膝下扣带回、额下回、中央后回、缰核。结论:尽管一些方法上和临床的问题使研究结果的解释复杂化,仍有坚实的可高度重复的I级证据表明锂治疗和灰质体积呈正相关。即使在健康受试者中,这种锂的“神经保护”效应也表现出独立于预防性的治疗反应。因此,锂有助于维持大脑的健康甚至对没有双相障碍的患者也有效,可能证明其在神经退行性疾病中改善病情的特点。
关键词: 杏仁核,大脑皮质,海马,锂,磁共振成像,神经保护,神经退行性变。
Current Alzheimer Research
Title:Neuroprotective Effects of Lithium in Human Brain? Food for Thought
Volume: 13 Issue: 8
Author(s): Tomas Hajek, Michael W. Weiner
Affiliation:
关键词: 杏仁核,大脑皮质,海马,锂,磁共振成像,神经保护,神经退行性变。
摘要: Background: There is a growing body of pre-clinical evidence suggesting that lithium (Li) may protect neurons from a range of neurotoxic insults, hence the term neuroprotective effects. Does Li have similar effects also in human subjects? Methods: We reviewed the neuroimaging literature investigating the association between Li treatment and brain structure. Results: There is level I evidence for positive association between Li treatment and brain grey matter volume, which is one of the most replicated neuroimaging findings. It has been reported in the majority of cross sectional studies, all 8 prospective studies, including a randomized controlled trial as well as in 2 meta-analyses and one mega-analysis. The association between Li treatment and grey matter volume occurs regardless of mood state, diagnostic subtype, presence or absence of concomitant medications. It was documented in multiple brain regions, including hippocampus, amygdala, anterior cingulate, subgenual cingulate, inferior frontal gyrus, postcentral gyrus, habenula. Conclusion: Although some methodological and clinical issues complicate the interpretation of findings, there is robust and highly replicated level 1 evidence for positive association between Li treatment and grey matter volumes. These "neuroprotective" effects of Li have been shown even in healthy subjects and appear independent of prophylactic treatment response. Consequently, Li might help maintain brain health even in patients without bipolar disorders and could possibly demonstrate diseasemodifying properties in neurodegenerative disorders.
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Cite this article as:
Tomas Hajek, Michael W. Weiner , Neuroprotective Effects of Lithium in Human Brain? Food for Thought, Current Alzheimer Research 2016; 13 (8) . https://dx.doi.org/10.2174/1567205013666160219112712
DOI https://dx.doi.org/10.2174/1567205013666160219112712 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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