Why Are Teenagers So Vulnerable to Mental Illness?為何青少年易患精神疾病

約翰·埃爾德/文 李婧萍/譯

Cambridge scientists have found that the adolescent brain undergoes a “disruptive” form of remodelling—during which new networks come online—allowing teenagers to develop more complex adult social skills.

But this disruptive phase， which sees a somewhat radical shift in the strengthening and weakening of certain neural connections， may explain why young people have an increased risk of mental illness.

This discovery was part of a big-picture finding that the functional connectivity of the human brain—how different regions of the brain communicate with each other—changes in two main ways during adolescence.

According to a statement from Cambridge， the study collected functional magnetic resonance imaging （fMRI） data on brain activity from 298 healthy young people， aged 14 to 25 years， each scanned on one to three occasions about six to 12 months apart.

As the participants were bid to lie still and as quietly as possible， the researchers analysed the pattern of connections between different brain regions while the brain was in a resting state.

Please dont move， dont talk

Measuring functional connectivity in the brain presented particular challenges， said Dr Franti?ek Vá?a， who led the study.

“Studying brain functional connectivity with fMRI is tricky as even the slightest head movement can corrupt the data—this is especially problematic when studying adolescent development as younger people find it harder to keep still during the scan，” said Dr Vasa， in a prepared statement.

“Here， we used three different approaches for removing signatures of head movement from the data， and obtained consistent results， which made us confident that our conclusions are not related to head movement， but to developmental changes in the adolescent brain.”

What the scientists found

The scans revealed that “the brain regions that are important for vision， movement， and other basic faculties were strongly connected at the age of 14 and became even more strongly connected by the age of 25”.

The scientists called this a “conservative” pattern of change， as areas of the brain that were rich in connections at the start of adolescence become even richer during the transition to adulthood.

In other words， the changes were of a consolidating character—and perhaps not so surprising.

However， the scans showed “the brain regions that are important for more advanced social skills， such as being able to imagine how someone else is thinking or feeling （so-called theory of mind）， underwent a more ‘disruptive pattern of change”.

In these regions—mainly in whats known as the association cortex—connections were redistributed over the course of adolescence： Connections that were initially weak became stronger， and connections that were initially strong became weaker.

By comparing the fMRI results to other data on the brain， the researchers found the network of regions that showed the disruptive pattern of change during adolescence had high levels of metabolic activity typically associated with active remodelling of connections between nerve cells.

The mystery of adolescent mental illness

Professor Ed Bullmore， joint senior author of the paper and head of the Department of Psychiatry at Cambridge， said： “We know that depression， anxiety and other mental health disorders often occur for the first time in adolescence—but we dont know why”.

“These results show us that active remodelling of brain networks is ongoing during the teenage years and deeper understanding of brain development could lead to deeper understanding of the causes of mental illness in young people.”

The new study appears to build on a 2016 Cambridge experiment that used magnetic resonance imaging （MRI） to study the brain structure of almost 300 individuals aged 14 to 24 years old.

By comparing the brain structure of teenagers of different ages， they found that during adolescence， the outer regions of the brain， the cortex， shrink in size， becoming thinner.

However as this happens， levels of myelin—the sheath that insulates nerve fibres， allowing them to communicate efficiently—increase within the cortex.

According to a statement from the university， myelin was thought mainly to reside in the so-called “white matter”， the brain tissue that connects areas of the brain and allows for information to be communicated between brain regions.

However， the researchers show that it can also be found within the cortex， the “grey matter” of the brain， and that levels increase during teenage years.

In particular， the myelin increase occurs in the association cortical areas—the areas of the brain shown to undergo disruptive changes in the more recent study.

These are regions of the brain that act as hubs， the major connection points between different regions of the brain network.

The researchers compared their MRI results with Allen Brain Atlas， which maps regions of the brain by gene expression—the genes that are switched on in particular regions.

They found that “those brain regions that exhibited the greatest MRI changes during the teenage years were those in which genes linked to schizophrenia risk were most strongly expressed”.

劍橋大學(xué)的科學(xué)家們發(fā)現(xiàn)，青少年的大腦會(huì)經(jīng)歷一種“破壞性”重塑——在此期間，新的神經(jīng)網(wǎng)絡(luò)出現(xiàn)——使青少年發(fā)展出更復(fù)雜的成人社交技能。

但這個(gè)破壞性階段或許能夠解釋為什么年輕人患上精神疾病的風(fēng)險(xiǎn)會(huì)加大。在這一階段，某些神經(jīng)連接增強(qiáng)和減弱時(shí)的變化有些劇烈。

這項(xiàng)發(fā)現(xiàn)是一個(gè)宏觀研究結(jié)果的一部分，該研究發(fā)現(xiàn)：人類大腦的功能連接（大腦不同區(qū)域之間的相互交流）在青春期主要以兩種方式發(fā)生變化。

劍橋大學(xué)的報(bào)告稱，這項(xiàng)研究共收集了298名受試者大腦活動(dòng)的功能磁共振成像數(shù)據(jù)，他們身體健康，年齡處于14到25歲之間，各掃描1到3次，每次間隔6到12個(gè)月。

受試者按要求盡量安靜平躺且保持不動(dòng)，研究人員在其大腦處于休息狀態(tài)時(shí)分析不同腦區(qū)的連接模式。

請勿動(dòng)勿言

測量大腦的功能連接頗具挑戰(zhàn)性，領(lǐng)導(dǎo)這項(xiàng)研究的弗朗齊歇克·瓦沙博士如是說。

瓦沙博士在一份預(yù)先準(zhǔn)備好的聲明中提到：“用功能磁共振成像技術(shù)研究大腦的功能連接并不太好把握，因?yàn)榧词故亲钶p微的頭部運(yùn)動(dòng)也會(huì)破壞數(shù)據(jù)——而這在研究青春期發(fā)育時(shí)尤其棘手，畢竟年齡越小越難在掃描過程中保持不動(dòng)。

“研究中，我們分別用了三種不同的方法從數(shù)據(jù)中剔除頭部運(yùn)動(dòng)產(chǎn)生的影響，三種方法得到的結(jié)果一致，因此我們確信最終的結(jié)論與頭部運(yùn)動(dòng)無關(guān)，而與青少年大腦的發(fā)育變化有關(guān)。”

科學(xué)家們的發(fā)現(xiàn)

掃描結(jié)果顯示，“14歲時(shí)，大腦中關(guān)乎視覺、運(yùn)動(dòng)和其他基本能力的重要區(qū)域彼此緊密關(guān)聯(lián)，到25歲這種關(guān)聯(lián)變得更加緊密”。

科學(xué)家們稱此為“保守的”變化模式，因?yàn)樵缭谇啻浩诔跗诰陀芯o密連接的大腦區(qū)域，只不過在向成年過渡的過程中變得連接更加緊密。

換言之，這些變化具有的是增強(qiáng)鞏固的性質(zhì)，或許并沒有那么新奇。

然而，掃描結(jié)果顯示，“大腦中那些牽涉高級社交技能——比如能夠想象他人想法或感受（所謂的心理推測能力）——的重要區(qū)域，經(jīng)歷了相對更具‘破壞性 的變化?！?/p>

在這些區(qū)域（主要是所謂的聯(lián)絡(luò)皮質(zhì)）中，各種連接在整個(gè)青少年時(shí)期被重新分配：最初較弱的連接變強(qiáng)，而最初較強(qiáng)的連接變?nèi)酢?/p>

通過比較功能磁共振成像結(jié)果與其他大腦數(shù)據(jù)，研究人員發(fā)現(xiàn)，青春期呈現(xiàn)破壞性變化模式的大腦區(qū)域網(wǎng)絡(luò)代謝活動(dòng)旺盛，這通常與神經(jīng)細(xì)胞之間連接發(fā)生活躍的重構(gòu)息息相關(guān)。

探秘青春期精神疾病

該論文資深的共同作者、劍橋大學(xué)精神病學(xué)系主任埃德·布爾莫教授說：“我們知道，抑郁、焦慮和其他精神健康障礙首次出現(xiàn)常常是在青春期，但我們不了解原因。

“這些結(jié)果告訴我們，青少年時(shí)期大腦網(wǎng)絡(luò)重構(gòu)活躍，隨著對大腦發(fā)育的深入了解，我們有可能進(jìn)一步了解年輕人罹患精神疾病的種種誘因。”

這項(xiàng)新研究似是基于2016年劍橋大學(xué)的一項(xiàng)實(shí)驗(yàn)進(jìn)行的，該實(shí)驗(yàn)使用磁共振成像研究了近300名14歲至24歲受試者的大腦結(jié)構(gòu)。

他們通過對比不同年齡青少年的大腦結(jié)構(gòu)發(fā)現(xiàn)：在青春期，大腦外部區(qū)域（即皮層）會(huì)縮小且變薄。

但與此同時(shí)，皮層內(nèi)的髓鞘數(shù)量增加。髓鞘可隔離神經(jīng)纖維，使其有效交流。

根據(jù)劍橋大學(xué)的報(bào)告，髓鞘被認(rèn)為主要存在于所謂的“白質(zhì)”中——“白質(zhì)”是連接大腦各區(qū)域的組織，能讓大腦各區(qū)域進(jìn)行信息交流。

不過研究人員也證明，髓鞘可能還存在于大腦皮層（即大腦的“灰質(zhì)”）中，而且其數(shù)量在青少年時(shí)期會(huì)有所增加。

尤其是，髓鞘的增加發(fā)生在聯(lián)絡(luò)皮質(zhì)區(qū)域——近期這項(xiàng)研究顯示，恰是這些區(qū)域發(fā)生了破壞性變化。

大腦的這些區(qū)域起到樞紐作用，是大腦網(wǎng)絡(luò)不同區(qū)域之間的主要連接點(diǎn)。

研究人員將受試者的核磁共振成像結(jié)果與艾倫腦圖譜進(jìn)行了比較，艾倫腦圖譜是通過基因表達(dá)（在特定區(qū)域被激活的基因）繪制出的大腦區(qū)域圖。

他們發(fā)現(xiàn)，“青少年時(shí)期核磁共振變化最大的那些腦區(qū)，是與罹患精神分裂癥相關(guān)的基因表達(dá)最強(qiáng)烈的那些區(qū)域”。

（譯者單位：北京外國語大學(xué)）