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脑源性神经营养因子与中风后抑郁症

Brain-derived neurotrophic factor and post-stroke depression.

作者信息

Zhang Eric, Liao Ping

机构信息

Western University of Health Sciences, Pomona, CA.

Calcium Signalling Laboratory, National Neuroscience Institute, Singapore.

出版信息

J Neurosci Res. 2020 Mar;98(3):537-548. doi: 10.1002/jnr.24510. Epub 2019 Aug 5.

Abstract

Brain-derived neurotrophic factor (BDNF) is well known to play a critical role in cognition. Its role in mood disorders, including post stroke depression (PSD), is also recognized with more evidence surfacing. In patients with PSD, their serum BNDF level is lower than in those without depression. Furthermore, antidepressants could enhance BDNF expression in the brain, resulting in an alleviation of depression symptoms. Such therapeutic effect can be abolished in animals with the BDNF gene deleted. In PSD patients, the presence of stroke may contribute to the development of depression, including affecting the expression of BDNF. However, the mechanisms of BDNF in the development of PSD remain largely unknown. Lower BDNF levels may have existed in some patients before stroke onset, making them vulnerable to develop depressive symptoms. Meanwhile, the hypoxic environment induced by stroke could possibly downregulate BDNF expression in the brain. Current antidepressant treatments are not specific for PSD and there is a lack of treatments to address the linkage between stroke and PSD. This review summarizes the current knowledge of BDNF in PSD. By regulating BDNF expression, a synergistic effect may be achieved when such treatments are applied together with existing antidepressants.

摘要

脑源性神经营养因子(BDNF)在认知中发挥关键作用,这一点广为人知。随着越来越多的证据浮现,其在包括中风后抑郁(PSD)在内的情绪障碍中的作用也得到了认可。在PSD患者中,他们的血清BDNF水平低于无抑郁的患者。此外,抗抑郁药可增强大脑中BDNF的表达,从而减轻抑郁症状。在BDNF基因缺失的动物中,这种治疗效果会消失。在PSD患者中,中风的存在可能导致抑郁的发生,包括影响BDNF的表达。然而,BDNF在PSD发生发展中的机制仍 largely未知。在中风发作前,一些患者可能就存在较低的BDNF水平,这使他们易患抑郁症状。同时,中风诱导的缺氧环境可能会下调大脑中BDNF的表达。目前的抗抑郁治疗对PSD并不具有特异性,且缺乏针对中风与PSD之间联系的治疗方法。本综述总结了目前关于BDNF在PSD中的知识。通过调节BDNF的表达,当这种治疗方法与现有的抗抑郁药联合应用时,可能会产生协同效应。

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