抑郁癥有望通過大腦掃描確診

　　6月15日BBC聽力：煩悶癥有望經由過程大腦掃描確診

　　Psychiatrists have struggled with their diagnoses of depression; patients often present withoverlapping symptoms. But researchers have made a breakthrough. In a new study publishedin Psychological Medicine, discovery which shows a distinct differences in the brain scans ofpeople suffering different types of depression. Nance Haxton has more. At least one in fiveaustralians will be affected by a major depressive disorder at some time in their lives. It's acomplex condition to identify，but researchers are now a step closer using medical imagingtechniques commonly known as MRIs. Black Dog Institute professor Gordon Parker says it's asignificant breakthrough. The study I think is more distinctly informative in telling us thatthere at least two key types of depression. One is the very biological depression which we call'melancholia', and where we do need to be able to identify this condition so that people with itcan be properly treated. I suppose another analogy would be looking at diabetes;for type onediabetes we know that most people are going to need insulin，for type two diabetes youprobably use a non-drug strategy diet and exercise and loss of weight. And therefore we needbetter ways of separating out the biological type of depression, melancholia, from the otherconditions. And particularly when we know the cause and the regions of the brain that affectit，this is an opportunity for developing a more appropriate treatments. I think it builds anincreasingly clearer story in terms of where the problems lie in the brain when people go into the'black dog' melancholic depression.

　　Researchers for this study conducted MRI scans on people diagnosed with depression whilethey watched happy and sad movies. What they discovered is that there are very distinctneurobiological changes in different parts of their brains，depending on which type ofdepression they had. Neuroscientist and study leader Dr.Christine Guo says it's hoped theirfindings will lead to better diagnostic tests. If can better diagnosing people for this underlyingcause of their depression symptoms，we should be better treat them in the future. Andhopefully that the treatment will be more successful? Exactly yeah,because it would be moretargeted，or you could call it personalised medicine for a psychiatrist. And this is the start ofthat new approach I suppose? Yeah exactly，yeah，yeah. To sort of shift away from asymptom-based diagnosis in psychiatry，which you know has been in the field forever.

　　Group leader Dr Micheal Breakspear says the findings will help doctors break through the

　　often overlapping symptoms that people with depression present. They range from sadmood，low energy to poor sleep. Each one is a potential clue that can lead to doctorsidentifying the underlying cause of their illness. A number of our recent brain imaging studieshave found distinct sub-types of patterns of activity in the brain for people with depression.Depression is really a symptom;it's a symptom of low mood，loss of interest，there is othersymptoms，and what have been doing in psychiatry is just classifying people into disordersbased on their symptoms. But as imaging technology has advanced, we are now at the pointwhere we can find distinct underlying differences in the brains of people，that we know fromother studies respond differently to different types of medication.

　　The joint study published in Psychological Medicine was carried out by QIMR Berghofer MedicalResearch Institute，the university of New South Wales and the Black Dog Institute. while it maystill be years before the diagnostic tools are ready for more general use. Professor Parker saysthese findings are an important step towards more effective treatment of depression. It sortof advances are clinical observation that we've long known for over 2,000 years that therewas this depression called melancholia or the black dog. But its origins have been debated foryears，a long period of time. It was thought to be certain neuro-transmitters and there havebeen multiple other causes that have been suggested. But neuroscience,in the last decade inparticular，is moving to a model of looking at parts of the brain that are no longer connected,or they become disconnected during episodes of illness，and this study not only shows thatpeople with melancholia have certain disconnections in the brain that people with non-melancholic depression and normal people don't show，even when depressed，it points atthe areas of the brain that are involved and tells us something as to the actual causal processwhere things go wrong when people are in episode. And ideally that will lead to bettertreatment.

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