Electroconvulsive therapy in melancholia: the role of hippocampal neurogenesis
Electroconvulsive therapy in melancholia: the role of hippocampal neurogenesis
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DOI：
10.1111/j.1600-0447.2007.00971.x
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发表时间：
2007-01-01
影响因子：
6.7
通讯作者：
Madsen, T. M.
中科院分区：
文献类型：
--
作者：
Bolwig, T. G.;Madsen, T. M.
目的：阐明在治疗忧郁抑郁症时电休克治疗（ECT）对海马解剖和功能的影响与接受电休克癫痫（ECS）实验动物海马神经发生增加的临床前观察之间的关系。我们强癫痫发作优于抗抑郁药物。起效不仅更快而且持续。发现新生细胞具有功能。皮质酮长期治疗对神经发生的抑制与类抑郁症的生物学和行为有关，与人类抑郁症及其对 ECT 的反应进行比较有关。结论：我们假设，根据下丘脑-垂体-肾上腺轴的调节以及其他调节因素对神经可塑性的强大控制，可以理解诱发癫痫发作的卓越抗忧郁作用。
Objective: To elucidate the relationship between the effects of electroconvulsive therapy (ECT) on hippocampal anatomy and function in the therapy of melancholic depression and preclinical observations of increased neurogenesis in the hippocampus of experimental animals receiving electroconvulsive seizures (ECS). We emphasize the role of hypercortisolaemia in melancholic depression and in experimental hippocampal neurogenesis.Method: Our statements are based on a variety of studies pointing to i) ECT being superior to all other treatment modalities in the therapy of melancholia, ii) melancholia being associated with hypercortisolaemia and iii) evidence of hippocampal neurogenesis being relevant for understanding both melancholia and ECT.Results: The increased neurogenesis found in animal studies shows stronger effect of seizures than of antidepressant drugs. The onset of effect is not only faster but is also sustained. Newborn cells are found to be functional. Suppression of neurogenesis by chronic treatment with corticosterone is associated with depression-like biology and behaviour making comparison with human depression and its response to ECT relevant.Conclusion: We hypothesize that the superior antimelancholic effect of induced seizures may be understood in the light of the powerful control of neural plasticity exerted by the regulation of the hypothalamic-pituitary-adrenal axis and, perhaps, other regulatory factors.