Stereotaxy and MR-based OR-techniques/Department of Neurosurgery, University Hospital Bonn, Germany.
Neurosci Biobehav Rev. 2011 Oct;35(9):1971-81. doi: 10.1016/j.neubiorev.2010.12.009. Epub 2010 Dec 22.
Major depression (MD) might be conceptualized as pathological under-arousal of positive affective systems as parts of a network of brain regions assessing, reconciling and storing emotional stimuli versus an over-arousal of parts of the same network promoting separation-distress/GRIEF. In this context depression can be explained as an emotional pain state that is the result of a disregulation of several sub-systems that under physiological conditions are concerned with bodily or emotional homeostasis of the human organism in a social context. Physiologically, homeostasis is maintained by influences of the SEEKING system represented - amongst others - by the medial forebrain bundle (MFB). Neuroimaging studies show that the MFB has a proven access to the GRIEF/Sadness system. A functional decoupling of these systems with a dysfunctional GRIEF pathway might result in MD. Therewith GRIEF and SEEKING/PLEASURE systems play important roles as opponents in maintenance of emotional homeostasis. Chronic electrical modulation of the reward SEEKING pathways with deep brain stimulation might show anti-depressive effects in humans suffering from MD by re-initiating an emotional equilibrium (of higher or lower activity) between these opposing systems.
重度抑郁症(MD)可能被概念化为积极情感系统的病理性唤醒不足,这些系统是评估、调和和储存情绪刺激的大脑区域网络的一部分,而同一网络的某些部分过度唤醒则会导致分离痛苦/悲伤。在这种情况下,抑郁症可以被解释为一种情绪痛苦状态,是几个子系统失调的结果,这些子系统在生理条件下与人类机体在社会环境中的身体或情绪稳态有关。从生理上讲,稳态是通过寻求系统的影响来维持的,其中包括内侧前脑束(MFB)。神经影像学研究表明,MFB 可以进入悲伤/悲伤系统。这些系统之间的功能解耦以及功能失调的悲伤途径可能导致 MD。因此,悲伤和寻求/愉悦系统作为情绪稳态维持的对立面起着重要作用。通过深部脑刺激对奖励寻求途径进行慢性电调节可能会通过在这些对立系统之间重新建立情绪平衡(更高或更低的活动)来显示出对 MD 患者的抗抑郁作用。