New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity.
New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity.
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DOI：
10.1155/2017/4605971
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发表时间：
2017
影响因子：
3.1
通讯作者：
Lin CH
中科院分区：
文献类型：
--
作者：
Huang YJ;Lane HY;Lin CH
重度抑郁症是一种严重而复杂的精神障碍。神经传递受损和信号通路中断可能影响神经可塑性，这与抑郁症的脑功能障碍有关。传统的抑郁症神经生物学理论，如单胺假说，不能完全解释抑郁症的全貌。本文就谷氨酸系统调节和无创脑刺激等治疗抑郁症的新方向进行了综述。谷氨酸神经传递障碍在抑郁症的病理生理中起着重要作用。氯胺酮是一种n -甲基- d -天冬氨酸（NMDA）受体拮抗剂，在以往的研究中具有快速和持久的抗抑郁作用。除氯胺酮外，其他谷氨酸调节剂，如肌氨酸，在动物模型或临床试验中也显示出潜在的抗抑郁作用。非侵入性脑刺激是药物治疗之外的另一种新的治疗策略。越来越多的证据表明，浅表脑刺激，如经颅磁刺激、经颅直流电刺激、颅电刺激和磁癫痫治疗，可以改善抑郁症状。这些大脑刺激的抗抑郁作用可能是通过调节神经可塑性来实现的。综上所述，通过NMDA受体调节神经传递和无创脑刺激的药物可能为抑郁症的治疗提供新的方向。此外，探索潜在的机制将有助于在未来开发新的治疗抑郁症的方法。
Major depressive disorder is a severe and complex mental disorder. Impaired neurotransmission and disrupted signalling pathways may influence neuroplasticity, which is involved in the brain dysfunction in depression. Traditional neurobiological theories of depression, such as monoamine hypothesis, cannot fully explain the whole picture of depressive disorders. In this review, we discussed new treatment directions of depression, including modulation of glutamatergic system and noninvasive brain stimulation. Dysfunction of glutamatergic neurotransmission plays an important role in the pathophysiology of depression. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has rapid and lasting antidepressive effects in previous studies. In addition to ketamine, other glutamatergic modulators, such as sarcosine, also show potential antidepressant effect in animal models or clinical trials. Noninvasive brain stimulation is another new treatment strategy beyond pharmacotherapy. Growing evidence has demonstrated that superficial brain stimulations, such as transcranial magnetic stimulation, transcranial direct current stimulation, cranial electrotherapy stimulation, and magnetic seizure therapy, can improve depressive symptoms. The antidepressive effect of these brain stimulations may be through modulating neuroplasticity. In conclusion, drugs that modulate neurotransmission via NMDA receptor and noninvasive brain stimulation may provide new directions of treatment for depression. Furthermore, exploring the underlying mechanisms will help in developing novel therapies for depression in the future.