Campell Family Mental Health Research Institute of Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Department of Psychiatry, Yale University, New Haven, Connecticut.
Biol Psychiatry. 2021 Jul 15;90(2):118-127. doi: 10.1016/j.biopsych.2021.04.004. Epub 2021 Apr 16.
Major depressive disorder (MDD) is a stress-related disorder associated with many cytoarchitectural and neurochemical changes. However, the majority of these changes cannot be reliably detected in the living brain. The examination of animal stress models and postmortem human brain tissue has significantly contributed to our understanding of the pathophysiology of MDD. Ronald Duman's work in humans and in rodent models was critical to the investigation of the contribution of synaptic deficits to MDD and chronic stress pathology, their role in the development and expression of depressive-like behavior, and reversal by novel drugs. Here, we review evidence from magnetic resonance imaging in humans and animals that suggests that corticolimbic alterations are associated with depression symptomatology. We also discuss evidence of cytoarchitectural alterations affecting neurons, astroglia, and synapses in MDD and highlight how similar changes are described in rodent chronic stress models and are linked to the emotion-related behavioral deficits. Finally, we report on the latest approaches developed to measure the synaptic and astroglial alterations in vivo, using positron emission tomography, and how it can inform on the contribution of MDD-associated cytoarchitectural alterations to the symptomatology and the treatment of stress-related disorders.
重度抑郁症(MDD)是一种与多种细胞结构和神经化学变化相关的应激相关障碍。然而,这些变化中的大多数在活体大脑中无法可靠地检测到。对动物应激模型和人死后脑组织的研究极大地促进了我们对 MDD 病理生理学的理解。罗纳德·杜曼(Ronald Duman)在人类和啮齿动物模型中的工作对于研究突触缺陷对 MDD 和慢性应激病理的贡献、它们在抑郁样行为的发展和表达中的作用以及新型药物的逆转至关重要。在这里,我们回顾了来自人类和动物的磁共振成像证据,这些证据表明皮质边缘改变与抑郁症状有关。我们还讨论了影响 MDD 中神经元、星形胶质细胞和突触的细胞结构改变的证据,并强调了在慢性应激啮齿动物模型中描述的类似变化以及与情绪相关的行为缺陷之间的联系。最后,我们报告了使用正电子发射断层扫描在体内测量突触和星形胶质细胞改变的最新方法,以及它如何为与 MDD 相关的细胞结构改变对症状和应激相关障碍的治疗的贡献提供信息。