生理心理学心境障碍__培训课件.ppt

KEY POINTS: 这些数据均来自于未经治疗的抑郁症患者，发现这类患者病程越长，海马体积越小 Untreated time depressed was significantly inversely related to hippocampal volume, with longer periods of untreated depression correlated with lower total hippocampal volume BACKGROUND: 38位临床治愈的门诊女性复发性抑郁患者入选到本研究 受试者经筛选，排除有器质性疾病，尤其是有早期痴呆者 用DSM-IV标准判断既往的抑郁发作，同时排除其它精神性疾病 海马体积用核磁共振来测量 治疗的总时间没有发现与海马体积有相互关联性 REFERENCE: Sheline YI, Gado MH, Kraemer HC. Untreated depression and hippocampal volume loss. Am J Psychiatry 2003;160:1516-1518. KEY POINTS: 以前的教育认为人在出生以后，就不会有新的神经细胞生成了。但现在的研究表明，有些脑区有新神经元产生，比如哺乳动物(鼠、猴、人)的海马(齿状回) 。而神经营养因子与新神经元的生成、生长和发育密切相关。 海马对情绪和记忆有重要作用，因此对抑郁症很重要。 BDNF与情绪管理有关4，同时受应激和疼痛感知的影响5 抑郁患者的BDNF水平比健康对照者显著降低4，而抗抑郁剂治疗可以使BDNF水平恢复正常 5-HT和NE都可以调节BDNF1 BACKGROUND: Most neurons in the mammalian brain and spinal cord are generated during the pre- and perinatal periods of development. Nevertheless, neurons continue to be born throughout life in the olfactory bulb, which processes scents, and in the dentate gyrus of the hippocampus Most existing neurons in the adult brain cannot divide. Some progenitor cells, however, remain, and they retain the capability for further division into new neurons. Apparently, in most parts of the adult brain, something inhibits progenitor cells from dividing to produce new neurons. No one knows exactly why neurogenesis continues in some areas and not others The hippocampi appears to have important functions related to both cognition and mood. Components of the hippocampus that may be involved in mood include the dentate gyrus (where adult neurogenesis occurs), and an area known as CA3 In a study of 33 patients with MDD, patients who had not received antidepressant treatment (n=16) had significantly lower BDNF levels than treated patients (n=17) as well as control subjects (n=50)4 In an animal study, both stress as well as acute and chronic pain states significantly lowered levels of BDNF mRNA in the rat hippocampus5 REFERENCES: Duman RS, Heninger GR, Nestler EJ. A molecular and cellul