Cortical Plasticity in Depression.
Cortical Plasticity in Depression.
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DOI：
10.1177/1759091417711512
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发表时间：
2017-05
期刊：
影响因子：
4.7
通讯作者：
Bella R
中科院分区：
文献类型：
--
作者：
Cantone M;Bramanti A;Lanza G;Pennisi M;Bramanti P;Pennisi G;Bella R
神经可塑性被认为是学习和记忆的神经生理学关联，尽管一些研究也注意到它在许多神经和精神疾病中起着至关重要的作用。事实上，大脑可塑性受损可能是导致认知能力下降和重度抑郁症的病理生理机制之一。此外，在情绪障碍的临床谱系中，经常观察到一定程度的认知障碍，抑郁和认知之间的关系往往是双向的。然而，大多数关于抑郁症的神经可塑性功能障碍的证据都是间接的。经颅磁刺激已成为一种非侵入性的工具，用于研究皮层兴奋性的几个参数，目的是探索不同神经传递途径的功能，并探测健康人类和病理条件下的体内可塑性。特别是，抑郁症患者在运动皮质兴奋性方面表现出显著的半球间差异，皮层内抑制性或兴奋性神经化学回路不平衡，运动后促进功能降低，对配对联合经颅磁刺激的长期增强样反应受损，这些症状可能表明可塑性被破坏。神经可塑性在导致抑郁的病理过程中发挥作用的机制和评估调节神经可塑性的作用是该领域促进更强大的转化研究和确定新的治疗靶点所需要的研究。
Neural plasticity is considered the neurophysiological correlate of learning and memory, although several studies have also noted that it plays crucial roles in a number of neurological and psychiatric diseases. Indeed, impaired brain plasticity may be one of the pathophysiological mechanisms that underlies both cognitive decline and major depression. Moreover, a degree of cognitive impairment is frequently observed throughout the clinical spectrum of mood disorders, and the relationship between depression and cognition is often bidirectional. However, most evidence for dysfunctional neural plasticity in depression has been indirect. Transcranial magnetic stimulation has emerged as a noninvasive tool for investigating several parameters of cortical excitability with the aim of exploring the functions of different neurotransmission pathways and for probing in vivo plasticity in both healthy humans and those with pathological conditions. In particular, depressed patients exhibit a significant interhemispheric difference in motor cortex excitability, an imbalanced inhibitory or excitatory intracortical neurochemical circuitry, reduced postexercise facilitation, and an impaired long-term potentiation-like response to paired-associative transcranial magnetic stimulation, and these symptoms may indicate disrupted plasticity. Research aimed at disentangling the mechanism by which neuroplasticity plays a role in the pathological processes that lead to depression and evaluating the effects of modulating neuroplasticity are needed for the field to facilitate more powerful translational research studies and identify novel therapeutic targets.