High Times for Painful Blues: The Endocannabinoid System in Pain-Depression Comorbidity.
High Times for Painful Blues: The Endocannabinoid System in Pain-Depression Comorbidity.
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DOI：
10.1093/ijnp/pyv095
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发表时间：
2015-09-05
期刊：
影响因子：
--
通讯作者：
Roche M
中科院分区：
文献类型：
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作者：
Fitzgibbon M;Finn DP;Roche M
抑郁症和疼痛是世界上两种最令人衰弱的疾病，估计同时发生率高达80%。这些疾病的合并症比单独的任何一种疾病都更难治疗，与严重的残疾和与健康相关的生活质量受损相关，导致巨大的社会和经济成本。几种神经底物已被确定为抑郁症和疼痛之间的关联的潜在介质，包括神经解剖重组，单胺和神经营养因子耗竭，下丘脑-垂体-肾上腺轴的失调，和神经炎症。然而，在过去的十年中，越来越多的证据支持内源性大麻素（endocannabinoid）系统在情感和伤害性处理中的作用，因此，该系统的改变可能在抑郁症和疼痛之间的相互作用中发挥关键作用。本文综述了支持抑郁症和疼痛之间相互作用的临床前证据，以及支持内源性大麻素系统在这种相互作用中发挥作用的证据。
Depression and pain are two of the most debilitating disorders worldwide and have an estimated cooccurrence of up to 80%. Comorbidity of these disorders is more difficult to treat, associated with significant disability and impaired health-related quality of life than either condition alone, resulting in enormous social and economic cost. Several neural substrates have been identified as potential mediators in the association between depression and pain, including neuroanatomical reorganization, monoamine and neurotrophin depletion, dysregulation of the hypothalamo-pituitary-adrenal axis, and neuroinflammation. However, the past decade has seen mounting evidence supporting a role for the endogenous cannabinoid (endocannabinoid) system in affective and nociceptive processing, and thus, alterations in this system may play a key role in reciprocal interactions between depression and pain. This review will provide an overview of the preclinical evidence supporting an interaction between depression and pain and the evidence supporting a role for the endocannabinoid system in this interaction.