Marinescu Ileana P, Predescu Anca, Udriştoiu T, Marinescu D
Department of Psychiatry, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Rom J Morphol Embryol. 2012;53(2):397-400.
The neurobiological model of depressive disorder may be correlated with the animal model on rat, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, the increase of cortisol level being specific to the model of depression in women. The neurobiological model of depression in women presents vulnerabilities for some cerebral structures (hippocampus, frontal cortex, cerebral amygdala). A decrease of frontal cortex and hippocampus volumes are recognized in depressive disorder in women, depending on duration of disease and antidepressant therapy. Neurobiological vulnerability may be pronounced through cholinergic blockade. The purpose of the study was to highlight the cytoarchitectural changes in the frontal cortex and hippocampus by comparing two antidepressant substances: amitriptyline with a strong anticholinergic effect and trazodone, without anticholinergic effect. The superior neuroprotective qualities of trazodone for the frontal cortex, hippocampus and dentate gyrus are revealed. The particular neurobiological vulnerability of depression in women requires a differentiated therapeutic approach, avoiding the use of antidepressants with anticholinergic action.
抑郁症的神经生物学模型可能与大鼠动物模型相关,下丘脑 - 垂体 - 肾上腺(HPA)轴功能亢进,皮质醇水平升高是女性抑郁症模型的特异性表现。女性抑郁症的神经生物学模型显示出某些脑结构(海马体、额叶皮质、脑杏仁核)存在易损性。在女性抑郁症中,额叶皮质和海马体体积减小,这取决于疾病持续时间和抗抑郁治疗。神经生物学易损性可能通过胆碱能阻断而加剧。该研究的目的是通过比较两种抗抑郁药物来突出额叶皮质和海马体的细胞结构变化:具有强烈抗胆碱能作用的阿米替林和无抗胆碱能作用的曲唑酮。结果显示曲唑酮对额叶皮质、海马体和齿状回具有更好的神经保护作用。女性抑郁症特殊的神经生物学易损性需要采用差异化的治疗方法,避免使用具有抗胆碱能作用的抗抑郁药。