1] School of Psychiatry, University of New South Wales, Sydney, NSW, Australia [2] Black Dog Institute, Sydney, NSW, Australia.
Neuropsychopharmacology. 2013 Oct;38(11):2101-8. doi: 10.1038/npp.2013.126. Epub 2013 May 16.
Several lines of evidence suggest that neuroplasticity is impaired in depression. This study aimed to compare neuroplasticity in 23 subjects with DSM-IV major depressive episode and 23 age- and gender-matched healthy controls, using an objective test that is independent of subject effort and motivation. Neuroplasticity was assessed in the motor cortex using a brain stimulation paradigm known as paired associative stimulation (PAS), which induces transient changes in motor cortical function. Motor cortical excitability was assessed before and after PAS using single-pulse transcranial magnetic stimulation (TMS) to induce motor evoked potentials (MEPs) in a hand muscle. After PAS, MEP amplitudes significantly increased in healthy controls compared with depressed subjects (P=0.002). The functional significance of motor cortical changes was assessed using a motor learning task-a computerized version of the rotor pursuit task. Healthy controls also performed better on motor learning (P=0.02). BDNF blood levels and genotype were assayed to determine any relationship with motor cortical plasticity. However, PAS results did not correlate with motor learning, nor appear to be related to BDNF measures. The significance of these findings is that it provides one of the first direct demonstrations of reduced neuroplasticity in depressed subjects, using an objective test.
有几条证据表明,抑郁症患者的神经可塑性受到损害。本研究旨在使用一种客观的测试方法来比较 23 名符合 DSM-IV 重性抑郁发作的患者和 23 名年龄和性别匹配的健康对照者的神经可塑性,这种测试方法独立于被试的努力和动机。通过一种称为配对关联刺激(PAS)的脑刺激范式来评估运动皮层的神经可塑性,该范式可引起运动皮层功能的短暂变化。使用单脉冲经颅磁刺激(TMS)在手肌肉中诱发运动诱发电位(MEPs),在 PAS 之前和之后评估运动皮层兴奋性。与抑郁患者相比,健康对照组在 PAS 后 MEP 幅度明显增加(P=0.002)。使用运动学习任务(转子追踪任务的计算机版本)评估运动皮层变化的功能意义。健康对照组在运动学习方面也表现更好(P=0.02)。测定了 BDNF 血液水平和基因型,以确定其与运动皮层可塑性的任何关系。然而,PAS 的结果与运动学习无关,也似乎与 BDNF 测量无关。这些发现的意义在于,它提供了使用客观测试方法首次直接证明抑郁患者神经可塑性降低的证据之一。