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谷氨酸和γ-氨基丁酸系统在重度抑郁症病理生理学及对氯胺酮抗抑郁反应中的作用

Glutamate and Gamma-Aminobutyric Acid Systems in the Pathophysiology of Major Depression and Antidepressant Response to Ketamine.

作者信息

Lener Marc S, Niciu Mark J, Ballard Elizabeth D, Park Minkyung, Park Lawrence T, Nugent Allison C, Zarate Carlos A

机构信息

Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.

Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.

出版信息

Biol Psychiatry. 2017 May 15;81(10):886-897. doi: 10.1016/j.biopsych.2016.05.005. Epub 2016 May 12.

Abstract

In patients with major depressive disorder or bipolar disorder, abnormalities in excitatory and/or inhibitory neurotransmission and neuronal plasticity may lead to aberrant functional connectivity patterns within large brain networks. Network dysfunction in association with altered brain levels of glutamate and gamma-aminobutyric acid have been identified in both animal and human studies of depression. In addition, evidence of an antidepressant response to subanesthetic-dose ketamine has led to a collection of studies that have examined neurochemical (e.g., glutamatergic and gamma-aminobutyric acidergic) and functional imaging correlates associated with such an effect. Results from these studies suggest that an antidepressant response in association with ketamine occurs, in part, by reversing these neurochemical/physiological disturbances. Future studies in depression will require a combination of neuroimaging approaches from which more biologically homogeneous subgroups can be identified, particularly with respect to treatment response biomarkers of glutamatergic modulation.

摘要

在重度抑郁症或双相情感障碍患者中,兴奋性和/或抑制性神经传递及神经元可塑性异常可能导致大脑大型网络内出现异常的功能连接模式。在抑郁症的动物和人体研究中均已发现,与大脑中谷氨酸和γ-氨基丁酸水平改变相关的网络功能障碍。此外,亚麻醉剂量氯胺酮具有抗抑郁作用的证据引发了一系列研究,这些研究探讨了与此种效应相关的神经化学(如谷氨酸能和γ-氨基丁酸能)及功能成像相关性。这些研究结果表明,氯胺酮引发的抗抑郁反应部分是通过逆转这些神经化学/生理紊乱实现的。未来关于抑郁症的研究将需要结合多种神经成像方法,以便能够识别出生物学上更具同质性的亚组,尤其是在谷氨酸能调节的治疗反应生物标志物方面。

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