PDF herunterladen
Nervenheilkunde 2005; 24(07): 603-610
DOI: 10.1055/s-0038-1629995
Originaler Artikel
Schattauer GmbH

Neurofunktionelle Grundlagen unipolarer depressiver Störungen

Die Rolle limbisch-kortikaler Netzwerke in der Diagnostik und TherapieNeurofunctional mechanisms of unipolar depressive disordersThe role of limbic-cortical networks in diagnostic and therapy
N. Vasic
1   Abteilung Psychiatrie III der Universitätsklinik Ulm (Ärztlicher Direktor: Prof. Dr. Dr. M. Spitzer)
,
R. C. Wolf
1   Abteilung Psychiatrie III der Universitätsklinik Ulm (Ärztlicher Direktor: Prof. Dr. Dr. M. Spitzer)
,
H. Walter
1   Abteilung Psychiatrie III der Universitätsklinik Ulm (Ärztlicher Direktor: Prof. Dr. Dr. M. Spitzer)
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
25. Januar 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Depressive Erkrankungen gehören zu den wichtigsten psychiatrischen Störungsbildern und entwickeln sich zu einem gravierenden gesundheitlichen Problemen in der Gesellschaft. Verfahren der strukturellen und funktionellen Bildgebung erlauben es, neuronale Korrelate depressiver Symptome objektiv zu messen. Die Ergebnisse können dabei helfen, die neuronalen Mechanismen depressiver Störungen aufzuklären und können prinzipiell auch eingesetzt werden, um die Effekte therapeutischer Maßnahmen zu objektivieren. In diesem Beitrag werden neue Ergebnisse funktioneller Studien dargestellt und in gegenwärtige neurofunktionelle Modelle der Depression eingeordnet.

Summary

Depressive disorders are one of the most important disorders in psychiatry and become one of the most relevant health problems in our society. Structural and functional neuroimaging provide means to measure neural correlates of depression objectively and to use those measures to uncover neural mechanisms underlying depressive disorders or to evaluate the effects of therapy. In this article, we give a review of some of the latest neuroimaging findings and integrate them into recently proposed neurofunctional models of depression.

Schlüsselwörter

Unipolare Depression - funktionelle Bildgebung - limbischkortikale Netzwerke - Therapieoptimierung

Key words

Unipolar depression - functional imaging - limbic-cortical networks - therapy improvement
 

  • Literatur

  • 1 Alexander GE. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Reviews in Neuroscience 1986; 9: 357-81.
    CrossrefSuche in Google Scholar
  • 2 Alexander GE, Crutcher MD, DeLong MR. Basal ganglia-thalamocortical circuits: Parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions. Progress in Brain Research 1990; 85: 119-46.
    Suche in Google Scholar
  • 3 Altshuler LL. et al. Amygdala enlargement in bipolar disorder and hippocampal reduction in schizophrenia: an MRI study demonstrating neuroanatomic specificity. Arch Gen Psychiatry 1998; 55: 663-4.
    Suche in Google Scholar
  • 4 Bagby RM, Joffe RT, Parker JDA. Major depression and the five-factor model of personality. J Personal Disord 1995; 9: 224-34.
    CrossrefSuche in Google Scholar
  • 5 Bench CJ. et al. The anatomy of melancholia - focal abnormalities of cerebral blood flow in major depression. Psychol Med. 1992; 22: 607-15.
    CrossrefSuche in Google Scholar
  • 6 Bench CJ. et al. Investigations of the functional anatomy of attention using the Stroop test. Neuropsychologia 1993; 31: 907-22.
    CrossrefSuche in Google Scholar
  • 7 Berman KF. et al. Is the mechanism of prefrontal hypofunction in depression the same as in schizophrenia? Regional cerebral blood flow during cognitive activation. Br J Psychiatry 1993; 162: 183-92.
    CrossrefSuche in Google Scholar
  • 8 Bhagwagar Z. et al. Persistent reduction in brain serotonin1A receptor binding in recovered depressed men measured by positron emission tomography with [11C]WAY-100635. Mol Psychiatry. 2004; 9: 386-92.
    CrossrefSuche in Google Scholar
  • 9 Bowley MP. et al. Low glial numbers in the amygdala in major depressive disorder. Biol Psychiatry 2002; 52: 404-12.
    CrossrefSuche in Google Scholar
  • 10 Brannan SK, Mayberg HS. McGinnis. Cingulate metabolism predicts treatment response: a replication. Biol Psychiatry 2000; 47: 107S.
    Suche in Google Scholar
  • 11 Bremner JD. et al. Hippocampal volume reduction in major depression. Am J Psychiatry 2000; 157: 115-8.
    CrossrefSuche in Google Scholar
  • 12 Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 2000; 4: 215-22.
    CrossrefSuche in Google Scholar
  • 13 Carmichael ST, Price JL. Limbic connections of the orbital and medial prefrontal cortex in macaque monkeys. J Comp Neurol. 1995; 25: 615-41.
    Suche in Google Scholar
  • 14 Coffey CE. et al. Quantitative cerebral anatomy of the aging human brain: a cross-sectional study using magnetic resonance imaging. Neurology 1992; 42: 527-36.
    CrossrefSuche in Google Scholar
  • 15 Coffey CE. et al. Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. Arch Gen Psychiatry 1993a 50: 7-16.
  • 16 Coffey CE. et al. The dexamethasone suppression test and quantitative cerebral anatomy in depression. Biol Psychiatry 1993b 33: 442-9.
  • 17 Davidson RJ. et al. The neural substrates of affective processing in depressed patients treated with venlafaxine. Am J Psychiatry 2003; 160: 64-75.
    CrossrefSuche in Google Scholar
  • 18 Davidson RJ, Putnam KM, Larson CL. Dysfunction in the neural circuitry of emotion regulation- a possible prelude to violence. Science 2000; 28: 591-4.
    Suche in Google Scholar
  • 19 Dolan RJ. et al. Neuropsychological dysfunction in depression: the relationship to regional cerebral blood flow. Psychol Med. 1994; 24: 849-57.
    CrossrefSuche in Google Scholar
  • 20 Doherty J. et al. Abstract reward and punishment representations in the human orbitofrontal cortex. Nat Neurosci. 2001; 4: 95-102.
    CrossrefSuche in Google Scholar
  • 21 Dougherty DD. et al. Cerebral metabolic correlates as potential predictors of response to anterior cingulotomy for treatment of major depression. J Neurosurg. 2003; 99: 1010-7.
    CrossrefSuche in Google Scholar
  • 22 Drevets WC. Functional anatomical abnormalities in limbic and prefrontal cortical structures in major depression. Prog Brain Res. 2000; 126: 413-31.
    Suche in Google Scholar
  • 23 Drevets WC, Bogers W, Raichle ME. Functional anatomical correlates of antidepressant drug treatment assessed using PET measures of regional glucose metabolism. Eur Neuropsychopharmacol. 2002; 12: 527-44.
    CrossrefSuche in Google Scholar
  • 24 Drevets WC. et al. Subgenual prefrontal cortex abnormalities in mood disorders. Nature 1997; 24: 824-7.
    Suche in Google Scholar
  • 25 Drevets WC, Raichle ME. Neuroanatomical circuits in depression: implications for treatment mechanisms. Psychopharmac Bull 1992; 28: 261-74.
    Suche in Google Scholar
  • 26 Drevets WC. et al. A functional anatomical study of unipolar depression. J Neurosci. 1992; 12: 3628-41.
    CrossrefSuche in Google Scholar
  • 27 Ebert D, Ebmeier KP. The role of the cingulate gyrus in depression: from functional anatomy to neurochemistry. Biol Psychiatry 1996; 15: 1044-50.
    Suche in Google Scholar
  • 28 Elliott R. The neuropsychological profile in unipolar depression. Trends in Cognitive Sciences 1998; 2: 447-54.
    CrossrefSuche in Google Scholar
  • 29 Elliott R. et al. Prefrontal dysfunction in depressed patients performing a complex planning task: a study using positron emission tomography. Psychol Med. 1997; 27: 931-42.
    CrossrefSuche in Google Scholar
  • 30 Erk S, Walter H, Spitzer M. Functional Neuroimaging of Depression. Perspectives in Affective Disorders. Adv Biol Psychiatry 2000; 21: 63-69.
    Suche in Google Scholar
  • 31 Frodl T. et al. Enlargement of the amygdala in patients with a first episode of major depression. Biol Psychiatry 2002; 51: 708-14.
    CrossrefSuche in Google Scholar
  • 32 Fu CHY, Walsh ND, Drevets WC. Neuroimaging studies of mood disorders. In: Fu CHY, Senior C, Russell TA, Weinberger D, Murray R. (eds). Neuroimaging in psychiatry. Washington: MD, Taylor & Francis; 2003: 131-69.
    Suche in Google Scholar
  • 33 Galynker II. et al. Hypofrontality and negative symptoms in major depressive disorder. J Nucl Med. 1998; 39: 608-12.
    Suche in Google Scholar
  • 34 George MS. et al. Blunted left cingulate activation in mood disorder subjects during a response interference task (the Stroop). J Neuropsychiatry Clin Neurosci. 1997; 9: 55-63.
    CrossrefSuche in Google Scholar
  • 35 George MS, Ketter TA, Post RM. SPECT and PET imaging in mood disorders. J Clin Psychiatry 1993; 54 Suppl: 6-13.
    Suche in Google Scholar
  • 36 Goldapple K. et al. Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy. Arch Gen Psychiatry. 4 61: 34-41.
  • 37 Holthoff VA. et al. Changes in brain metabolism associated with remission in unipolar major depression. Acta Psychiatr Scand. 2004; 110: 184-94.
    CrossrefSuche in Google Scholar
  • 38 Husain MM. et al. A magnetic resonance imaging study of putamen nuclei in major depression. Psychiatry Res. 1991; 40: 95-9.
    CrossrefSuche in Google Scholar
  • 39 Kendler KS. et al. The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry. 1993; 150: 1139-48.
    CrossrefSuche in Google Scholar
  • 40 Kennedy SH. et al. Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. Am J Psychiatry 2001; 158: 899-905.
    CrossrefSuche in Google Scholar
  • 41 Krishnan KR. et al. Magnetic resonance imaging of the caudate nuclei in depression. Preliminary observations. Arch Gen Psychiatry 1992; 49: 553-7.
    Suche in Google Scholar
  • 42 Kumar A. et al. Quantitative anatomic measures and comorbid medical illness in late-life major depression. Am J Geriatr Psychiatry. 1997; 5: 15-25.
    CrossrefSuche in Google Scholar
  • 43 Liotti M, Mayberg HS. The role of functional neuroimaging in the neuropsychology of depression. J Clin Exp Neuropsychol. 2001; 23: 121-36.
    CrossrefSuche in Google Scholar
  • 44 Liotti M. et al. An ERP study of mood provocation in remitted depression. Abstracts of the Society for Neuroscience 1996; 23: 1657.
    Suche in Google Scholar
  • 45 Lu L. et al. Modification of hippocampal neurogenesis and neuroplasticity by social environments. Exp Neurol. 2003; 183: 600-9.
    CrossrefSuche in Google Scholar
  • 46 MacQueen GM. et al. Course of illness, hippocampal function, and hippocampal volume in major depression. Proc Natl Acad Sci USA 2003; 4: 1387-92.
    Suche in Google Scholar
  • 47 Malberg JE, Duman RS. Cell proliferation in adult hippocampus is decreased by inescapable stress: reversal by fluoxetine treatment. Neuropsychopharmacology 2003; 28: 1562-71.
    CrossrefSuche in Google Scholar
  • 48 Mayberg HS. Modulating limbic-cortical circuits in depression: targets of antidepressant treatments. Semin Clin Neuropsychiatry. 2002; 7: 255-68.
    CrossrefSuche in Google Scholar
  • 49 Mayberg HS. Positron emission tomography imaging in depression: a neural systems perspective. Neuroimaging Clin N Am. 2003; 13: 805-15.
    CrossrefSuche in Google Scholar
  • 50 Mayberg HS. et al. Cingulate function in depression: a potential predictor of treatment response. Neuroreport 1997; 3: 1057-61.
    Suche in Google Scholar
  • 51 Mayberg HS. et al. Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999; 156: 675-82.
    PubMedSuche in Google Scholar
  • 52 Meaney MJ. et al. Molecular basis for the development of individual differences in the hypothalamicpituitary-adrenal stress response. Cell Mol Neurobiol. 1993; 13: 321-47.
    CrossrefSuche in Google Scholar
  • 53 Mega MS, Cummings JL. Frontal-subcortical circuits and neuropsychiatric disorders. J Neuropsychiatry Clin Neurosci. 1994; 6: 358-70.
    CrossrefSuche in Google Scholar
  • 54 Mega MS. et al. The limbic system: an anatomic, phylogenetic, and clinical perspective. J Neuropsychiatry Clin Neurosci. 1997; 9: 315-30.
    CrossrefSuche in Google Scholar
  • 55 Messa C. et al. 5-HT(2A) receptor binding is reduced in drug-naive and unchanged in SSRI-responder depressed patients compared to healthy controls: a PET study. Psychopharmacology (Berl). 2003; 167: 72-8.
    CrossrefSuche in Google Scholar
  • 56 Meyer JH. et al. Lower dopamine transporter binding potential in striatum during depression. Neuroreport. 2001; 12: 4121-5.
    CrossrefSuche in Google Scholar
  • 57 Michaud CM, Murray CJ, Bloom BR. Burden of disease – implications for future research. JAMA 2001; 285: 535-9.
    CrossrefSuche in Google Scholar
  • 58 Nauta WJ. Neural associations of the frontal cortex. Acta Neurobiol Exp 1972; 32: 125-40.
    Suche in Google Scholar
  • 59 Navarro V. et al. Frontal cerebral perfusion after antidepressant drug treatment versus ECT in elderly patients with major depression: a 12-month follow-up control study. J Clin Psychiatry 1972; 65: 656-61.
    Suche in Google Scholar
  • 60 Navarro V. et al. Prognostic value of frontal functional neuroimaging in late-onset severe major depression. Br J Psychiatry 2004; 184: 306-11.
    CrossrefSuche in Google Scholar
  • 61 Neumeister A. et al. Reduced serotonin type 1A receptor binding in panic disorder. J Neurosci. 2004; 21: 589-91.
    Suche in Google Scholar
  • 62 Overstreet DH. The Flinders sensitive line rats: a genetic animal model of depression. Neurosci Biobehav Rev. 1993; 17: 51-68.
    CrossrefSuche in Google Scholar
  • 63 Paquette V. et al. „Change the mind and you change the brain“: effects of cognitive-behavioral therapy on the neural correlates of spider phobia. Neuroimage 2003; 18: 401-9.
    CrossrefSuche in Google Scholar
  • 64 Rajkowska G. Depression: what we can learn from postmortem studies. Neuroscientist 2003; 9: 273-84.
    CrossrefSuche in Google Scholar
  • 65 Rajkowska G. et al. Morphometric evidence for neuronal and glial prefrontal cell pathology in major depression. Biol Psychiatry 1999; 1: 1085-98.
    Suche in Google Scholar
  • 66 Santarelli L. et al. Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science 2003; 8: 805-9.
    Suche in Google Scholar
  • 67 Seminowicz DA. et al. Limbic-frontal circuitry in major depression: a path modeling metanalysis. Neuroimage 2004; 22: 409-18.
    CrossrefSuche in Google Scholar
  • 68 Shah PJ. et al. Cortical grey matter reductions associated with treatment-resistant chronic unipolar depression. Controlled magnetic resonance imaging study. Br J Psychiatry 1998; 172: 527-32.
    Suche in Google Scholar
  • 69 Sheline YI. Neuroimaging studies of mood disorder effects on the brain. Biol Psychiatry 2003; 54: 338-52.
    CrossrefSuche in Google Scholar
  • 70 Sheline YI, Gado MH, Price JL. Amygdala core nuclei volumes are decreased in recurrent major depression. Neuroreport 1998; 22: 2023-8.
    Suche in Google Scholar
  • 71 Simpson HB. et al. Serotonin transporters in obsessive-compulsive disorder: a positron emission tomography study with [(11)C]McN 5652. Biol Psychiatry. 2003; 15: 1414-21.
    Suche in Google Scholar
  • 72 Soares JC, Mann JJ. The functional neuroanatomy of mood disorders. J Psychiatr Res 1997; 31: 393-432.
    CrossrefSuche in Google Scholar
  • 73 Stefurak T, Mahurin R, Soloman D. Response specific regional metabolism changes with fluoxetine treatment in depressed Parkinson´s patients. Movement Disorders 2001; 16 (Suppl. 01) S39.
    Suche in Google Scholar
  • 74 Strakowski SM, Adler CM, DelBello MP. Volumetric MRI studies of mood disorders: do they distinguish unipolar and bipolar disorder?. Bipolar Disord 2002; 4: 80-8.
    CrossrefSuche in Google Scholar
  • 75 Strakowski SM. Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. Arch Gen Psychiatry 1999; 56 (03) 254-60.
    CrossrefSuche in Google Scholar
  • 76 Swerdlow NR, Koob GF. Dopamine, schizophrenia, mania and depression: toward a unified hypothesis of cortico-striato-pallido-thalamic function. Behav Brain Sci 1987; 10: 197-245.
    CrossrefSuche in Google Scholar
  • 77 Tebartz van Elst L. Bildgebende Befunde bei affektiven Störungen. In: Walter H. (Hrsg.). Funktionelle Bildgebung in Psychiatrie und Psychotherapie. Stuttgart, New York: Schattauer Verlag; 2004: 274-302.
    Suche in Google Scholar
  • 78 Vogel G. Neuroscience. Depression drugs' powers may rest on new neurons. Science 2003; 8: 757.
    Suche in Google Scholar
  • 79 Vogt BA, Pandya DN. Cingulate cortex of the rhesus monkey: II. Cortical afferents. J Comp Neurol. 1987; 8: 271-89.
    Suche in Google Scholar
  • 80 Walter H. Neurowissenschaft der Emotionen und Psychiatrie. Nervenheilkunde 1999; 18: 116-126.
    Suche in Google Scholar
  • 81 Walter H. (Hrsg.). Funktionelle Bildgebung in Psychiatrie und Psychotherapie. Stuttgart, New York: Schattauer Verlag; 2004
  • 82 Yatham LN. et al. Brain serotonin2 receptors in major depression: a positron emission tomography study. Arch Gen Psychiatry 2000; 57: 850-8.
    CrossrefSuche in Google Scholar