Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417 United States.
Neurosci Biobehav Rev. 2018 Jul;90:212-220. doi: 10.1016/j.neubiorev.2018.04.002. Epub 2018 Apr 12.
Disruptions of bioenergetic signaling and neurogenesis are hallmarks of depression physiology and are often the product of dysregulation of the inflammatory, stress-response, and metabolic systems. These systems are extensively interrelated at the physiological level, yet the bulk of the literature to date addresses pathophysiological mechanisms in isolation. A more integrated understanding of the etiology, progression, and treatment response profiles of depression is possible through wider consideration of relevant preclinical and clinical studies that examine the result of disruptions in these systems. Here, we review recent data demonstrating the critical effects of bioenergetic disruption on neuroplasticity and the development and progression of depressive illness. We further highlight the interactive and dynamic nature of the inflammatory and stress response systems and how disruption of these systems influences bioenergetic signaling pathways critical to treatment outcomes. In so doing, we underscore the pressing need to reconsider the implications of treatment resistance and present a framework for developing novel, personalized treatment approaches for depression.
生物能量信号和神经发生的紊乱是抑郁症生理学的标志，通常是炎症、应激反应和代谢系统失调的产物。这些系统在生理水平上广泛相互关联，但迄今为止，大量文献都孤立地探讨了病理生理学机制。通过更广泛地考虑相关的临床前和临床研究，这些研究检查了这些系统中断的结果，就有可能对抑郁症的病因、进展和治疗反应特征有更综合的了解。在这里，我们回顾了最近的数据，这些数据表明生物能量紊乱对神经可塑性以及抑郁发作的发展和进展的关键影响。我们进一步强调了炎症和应激反应系统的交互和动态性质，以及这些系统的中断如何影响对治疗结果至关重要的生物能量信号通路。这样，我们强调了重新考虑治疗抵抗的意义的紧迫性，并提出了一个针对抑郁症的新的、个性化的治疗方法的框架。
