Bewernick Bettina H, Schlaepfer Thomas E
Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany.
Dialogues Clin Neurosci. 2013 Mar;15(1):77-85. doi: 10.31887/DCNS.2013.15.1/bbewernick.
Conceptualizations of the underlying neurobiology of major depression have changed their focus from dysfunctions of neurotransmission to dysfunctions of neurogenesis and neuroprotection. The "neurogenesis hypothesis of depression" posits that changes in the rate of neurogenesis are the underlying mechanism in the pathology and treatment of major depression. Stress, neuroinflammation, dysfunctional insulin regulation, oxidative stress, and alterations in neurotrophic factors possibly contribute to the development of depression. The influence of antidepressant therapies, namely pharmacotherapy and neuroprotectants, on cellular plasticity are summarized. A dysfunction of complex neuronal networks as a consequence of neural degeneration in neuropsychiatric diseases has led to the application of deep brain stimulation. We discuss the way depression seen in the light of the neurogenesis hypothesis can be used as a model disease for cerebral aging. A common pathological mechanism in depression and cerebral aging-a dysfunction of neuroprotection and neurogenesis-is discussed. This has implications for new treatment methods.
对重度抑郁症潜在神经生物学的概念化理解已将重点从神经传递功能障碍转向神经发生和神经保护功能障碍。“抑郁症的神经发生假说”认为,神经发生速率的变化是重度抑郁症病理和治疗的潜在机制。压力、神经炎症、胰岛素调节功能障碍、氧化应激以及神经营养因子的改变可能导致抑郁症的发生。本文总结了抗抑郁疗法(即药物疗法和神经保护剂)对细胞可塑性的影响。神经精神疾病中神经退行性变导致的复杂神经网络功能障碍促使了深部脑刺激的应用。我们讨论了如何将基于神经发生假说所理解的抑郁症用作大脑衰老的模型疾病。文中探讨了抑郁症和大脑衰老的共同病理机制——神经保护和神经发生功能障碍。这对新的治疗方法具有启示意义。