Ruiz Norma A Labra, Del Ángel Daniel Santamaría, Olguín Hugo Juárez, Silva Miroslava Lindoro
Laboratory of Neurosciences, Instituto Nacional de Pediatria (INP), Mexico City, Mexico.
Laboratory of Pharmacology, Instituto Nacional de Pediatría (INP), Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
Neuropsychiatr Dis Treat. 2018 Oct 30;14:2837-2845. doi: 10.2147/NDT.S177973. eCollection 2018.
For many years, depressive disorder (DD) was considered a transient and natural disease of people's mood. Its etiology had been attributed mainly to biochemical alterations of the monoamines and their receptors. Nevertheless, its prevalence and considerable impact on the family and social environment of those afflicted by it have placed the disease as a global public health problem. Neuroprogression is the term used to describe the changes in several psychiatric conditions evidenced and observed in the clinical manifestations, biochemical markers, and cerebral structures of the patients with major depressive disorder (MDD), which frequently overlap with neurodegenerative disorders. DD is considered a potentially aggressive state of neuronal deterioration involving apoptosis, reduced neurogenesis, decreased neuronal plasticity, and increased immune response. Clinically, it encompasses a poor response to treatment and an increase in depressive episodes, both of which bring about vulnerability and decline of functions associated with structural changes in the brain. The interest of this work is to review the metabolic processes involved in the morphologic alterations in the limbic system reported in patients with MDD, as well as the neurologic bases of this complex pathology that include environmental stress, genetic vulnerability, alterations in the neurotransmission, and changes in the neuroplasticity, all of which today bring into limelight a mechanism of progressive neuronal damage.
多年来，抑郁症（DD）被认为是一种人类情绪的短暂性自然疾病。其病因主要归因于单胺及其受体的生化改变。然而，它的患病率以及对患者家庭和社会环境的重大影响已将该疾病列为一个全球公共卫生问题。神经进展是用于描述在重度抑郁症（MDD）患者的临床表现、生化标志物和脑结构中所证实和观察到的几种精神疾病变化的术语，这些变化常常与神经退行性疾病重叠。抑郁症被认为是一种潜在的侵袭性神经元退化状态，涉及细胞凋亡、神经发生减少、神经元可塑性降低以及免疫反应增强。临床上，它包括对治疗反应不佳以及抑郁发作增加，这两者都会导致与大脑结构变化相关的功能脆弱性和衰退。这项工作的关注点是回顾MDD患者中所报道的边缘系统形态学改变所涉及的代谢过程，以及这种复杂病理学的神经学基础，包括环境应激、遗传易感性、神经传递改变和神经可塑性变化，所有这些如今都凸显了一种进行性神经元损伤机制。
