[神经元可塑性和神经元负荷对心境障碍病理生理及临床药物治疗机制的多轴评价]。

Naoto Omata, Tomoyuki Mizuno, Hironori Mitsuya, Yuji Wada
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引用次数: 0

摘要

神经可塑性损伤在心境障碍的病理生理中具有重要意义。缺锌和社会隔离都会损害神经元的可塑性。两者都会导致抑郁状态。然而,在动物实验中,它们的联合负荷引起了躁狂样行为。因此,我们推断,中度的神经元可塑性损伤可诱发抑郁状态,而进一步的神经元可塑性损伤可诱发躁狂状态。然而,某种通过神经传递对神经元功能的负荷可以影响情绪障碍症状,但不直接影响神经元的可塑性。我们从神经元可塑性的角度提出躁狂是抑郁的加重,通过神经可塑性和神经负荷通过神经传递进行多轴评价有助于理解心境障碍的病理生理。在心境障碍中有许多临床方面难以解释:为什么心境稳定剂或电痉挛疗法对躁狂症和抑郁症都有用?混合状态的病理生理是怎样的?为什么抗抑郁药会导致躁狂转换?我们的假设有助于理解这些方面,并利用这一假设,预期情绪障碍的病理生理学和情绪稳定剂和抗抑郁药的临床机制现在可以被理解为一个完整的故事。
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[Multiaxial evaluation of the pathophysiology of mood disorder and therapeutic mechanisms of clinical drugs by neuronal plasticity and neuronal load].

Impairment of neuronal plasticity is important in the pathophysiology of mood disorder. Both zinc deficiency and social isolation impair neuronal plasticity. Both cause a depressive state. However, in experiments using animals, their combined loading induced manic-like behavior. Therefore, it was inferred that moderate impairment of neuronal plasticity induces a depressive state, and that further impairment of neuronal plasticity induces a manic state. However, some kind of load toward neuronal function through neural transmission can influence mood disorder symptoms without direct effects on neuronal plasticity. Our hypothesis is that mania is an aggravation of depression from the perspective of neuronal plasticity, and that multiaxial evaluation by neuronal plasticity and neuronal load through neural transmission is useful for understanding the pathophysiology of mood disorder. There are many clinical aspects that have been difficult to interpret in mood disorder: Why is a mood stabilizer or electric convulsive therapy useful for both mania and depression? What is the pathophysiology of the mixed state? Why does manic switching by an antidepressant occur or not? Our hypothesis is useful to understand these aspects, and using this hypothesis, it is expected that the pathophysiology of mood disorder and clinical mechanism of mood stabilizers and antidepressants can now be understood as an integrated story.

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