Shirayama Yukihiko, Chaki Shigeyuki
Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago, Japan.
Curr Neuropharmacol. 2006 Oct;4(4):277-91. doi: 10.2174/157015906778520773.
There is accumulating evidence that the nucleus accumbens (NAc) plays an important role in the pathophysiology of depression. Given that clinical depression is marked by anhedonia (diminished interest or pleasure), dysfunction of the brain reward pathway has been suggested as contributing to the pathophysiology of depression.Since the NAc is the center of reward and learning, it is hypothesized that anhedonia might be produced by hampering the function of the NAc. Indeed, it has been reported that stress, drug exposure and drug withdrawal, all of which produce a depressive-phenotype, alter various functions within the NAc, leading to inhibited dopaminergic activity in the NAc.In this review, we describe various factors as possible candidates within the NAc for the initiation of depressive symptoms. First, we discuss the roles of several neurotransmitters and neuropeptides in the functioning of the NAc, including dopamine, glutamate, gamma-aminobutyric acid (GABA), acetylcholine, serotonin, dynorphin, enkephaline, brain-derived neurotrophic factor (BDNF), cAMP response element-binding protein (CREB), melanin-concentrating hormone (MCH) and cocaine- and amphetamine-regulated transcript (CART). Second, based on previous studies, we propose hypothetical relationships among these substances and the shell and core subregions of the NAc.
越来越多的证据表明,伏隔核(NAc)在抑郁症的病理生理学中起着重要作用。鉴于临床抑郁症的特征是快感缺失(兴趣或愉悦感减退),大脑奖赏通路功能障碍被认为是导致抑郁症病理生理的原因之一。由于伏隔核是奖赏和学习的中心,因此推测快感缺失可能是由伏隔核功能受阻所致。事实上,已有报道称,压力、药物暴露和药物戒断都会产生抑郁表型,它们会改变伏隔核内的各种功能,导致伏隔核内多巴胺能活性受到抑制。在本综述中,我们描述了伏隔核内可能引发抑郁症状的各种因素。首先,我们讨论了几种神经递质和神经肽在伏隔核功能中的作用,包括多巴胺、谷氨酸、γ-氨基丁酸(GABA)、乙酰胆碱、5-羟色胺、强啡肽、脑啡肽、脑源性神经营养因子(BDNF)、环磷酸腺苷反应元件结合蛋白(CREB)、促黑素(MCH)和可卡因及苯丙胺调节转录肽(CART)。其次,基于先前的研究,我们提出了这些物质与伏隔核壳部和核心亚区之间的假设关系。