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Nervenheilkunde 2011; 30(11): 870-877
DOI: 10.1055/s-0038-1628439
DOI: 10.1055/s-0038-1628439
Depression
Störungen der Vigilanzregulation bei depressiven Erkrankungen
Disturbed regulation of vigilance in depressionFurther Information
Publication History
Eingegangen am:
01 July 2011
angenommen am:
21 July 2011
Publication Date:
22 January 2018 (online)
Zusammenfassung
Auffälligkeiten der Vigilanzregulation in Form einer gestörten Schlafregulation sind ein Kernsymptom affektiver Erkrankungen. Weniger bekannt sind Störungen der Wachheitsregulation, die ebenfalls eine kausale Rolle in der Pathogenese affektiver Störungen spielen können. Der vorliegende Artikel soll einen Überblick über beide Gebiete der Vigilanzforschung geben und ausgewählte neurobiologische Grundlagen vorstellen. Dabei wird besonders auf die Rolle von Kernsystemen in Hirnstamm und Hypothalamus sowie zirkadianen und neuroendokrinen Systemen eingegangen. Veränderungen in diesen Systemen können zu Störungen der Vigilanzregulation führen. Diese können sowohl Prodrom als auch Symptom affektiver Erkrankungen sein, wiederum zirkadiane und neuroendokrine Prozesse beeinflussen und somit zur Aufrechterhaltung oder Verschlechterung der depressiven Symptomatik beitragen.
Summary
A dysfunctional regulation of vigilance in the sense of sleep problems is considered a core symptom of affective disorders. Less prominently discussed are disorders of wakefulness regulation which might also play a role in the pathogenesis of affective disorders. This article will provide an overview on both aspects of vigilance disorders as well as discussing some neurobiological basics of vigilance regulation. The focus will be on structures in the brain stem and the hypothalamus regulating sleep and wakefulness and their interaction with circadian and neuroendocrine systems. Disturbances in those systems can lead to disorders in vigilance regulation which can either precede affective disorders or be a symptom thereof. In turn, an impaired regulation of vigilance can affect circadian and neuroendocrine processes, thus maintaining or aggravating the depressive symptomatology.
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