Abstract:
:Major depression (MDD) is a chronic psychiatric condition in which patients often show increasing cognitive impairment with recurring episodes. Neurodegeneration may play an important component in the pathogenesis of MDD associated with cognitive complaints. In agreement with this, patients with MDD show decreased brain volumes in areas implicated in emotional regulation and cognition, neuronal and glial cell death as well as activation of various pathways that can contribute to cell death. Therefore, the aim of this review is to provide an integrative overview of potential contributing factors to neurodegeneration in MDD. Studies have reported increased neuronal and glial cell death in the frontal cortex, amygdala, and hippocampus of patients with MDD. This may be due to decreased neurogenesis from lower levels of brain-derived neurotrophic factor (BDNF), excitotoxicity from increased glutamate signaling, and lower levels of gamma-aminobutyric acid (GABA) signaling. In addition, mitochondrial dysfunction and oxidative stress are found in similar brain areas where evidence of excitotoxicity has been reported. Also, levels of antioxidant enzymes were reported to be increased in patients with MDD. Inflammation may also be a contributing factor, as levels of inflammatory cytokines were reported to be increased in the prefrontal cortex of patients with MDD. While preliminary, studies have also reported neuropathological alterations in patients with MDD. Together, these studies suggest that lower BDNF levels, mitochondrial dysfunction, oxidative stress, inflammation and excitotoxicity may be contributing to neuronal and glial cell death in MDD, leading to decreased brain volume and cognitive dysfunction with multiple recurrent episodes. This highlights the need to identify specific pathways involved in neurodegeneration in MDD, which may elucidate targets that can be treated to ameliorate the effects of disease progression in this disorder.
journal_name
Prog Neuropsychopharmacol Biol Psychiatryauthors
Kim HK,Nunes PV,Oliveira KC,Young LT,Lafer Bdoi
10.1016/j.pnpbp.2016.01.008subject
Has Abstractpub_date
2016-06-03 00:00:00pages
51-7eissn
0278-5846issn
1878-4216pii
S0278-5846(16)30007-0journal_volume
67pub_type
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journal_title:Progress in neuro-psychopharmacology & biological psychiatry
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doi:10.1016/j.pnpbp.2012.12.006
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journal_title:Progress in neuro-psychopharmacology & biological psychiatry
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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