多发性硬化症中的抑郁和焦虑. 对致命组合的审查
1Institute of Clinical Neurobiology, Alberichgasse 5/13, Vienna, A-1150, Austria. kurt.jellinger@univie.ac.at.
Journal of neural transmission (Vienna, Austria : 1996)
|June 13, 2024
概括
抑郁和焦虑在多发性硬化症 (MS) 中很常见,影响生活质量. 了解其复杂的大脑机制,改善评估和治疗对于患者的福祉至关重要.
科学领域:
- 神经免疫学 神经免疫学
- 神经精神病学是一种神经精神病学.
- 神经退行性疾病 神经退行性疾病
背景情况:
- 抑郁和焦虑是多发性硬化症 (MS) 中普遍存在的神经精神症状,分别影响了25-65%和20-54%的患者.
- 这些症状往往先于MS诊断,与疲劳和认知问题相关,并对生活质量和残疾进展产生负面影响.
- 风险因素包括年龄较小,遗传倾向和家族史,与神经炎症,氧化应激和神经内分泌功能障碍有潜在联系.
研究的目的:
- 审查目前对MS抑郁和焦虑的理解,重点关注患病率,临床特征,神经成像发现,免疫机制和治疗策略.
- 突出MS患者对这些疾病的低估和治疗.
- 强调需要个性化的管理方法.
主要方法:
- 对PubMed,谷歌学者和科克兰图书馆数据库的系统文献综述.
- 分析重点关注到2024年5月之前发表的研究.
- 纳入标准包括患病率,临床表现,神经成像,免疫机制以及MS中抑郁和焦虑的治疗.
主要成果:
- 神经成像揭示了双边前额,下皮层和边缘缩,白质病变以及患有抑郁症和焦虑症的多发性硬化症患者中受损的大脑网络.
- 病变发生包括共享的机制,如氧化应激,线粒体功能障碍,神经炎症和神经内分泌因素,以及社会影响.
- 目前的治疗方法包括抗抑郁药,跨磁刺激,认知和放松疗法以及饮食调整,需要个性化.
结论:
- 在MS中,抑郁和焦虑与广泛的脑乱和复杂的致病机制有关.
- 需要进一步的研究来阐明这些机制,以改善早期诊断和管理.
- 优化治疗策略对于改善MS和相关神经精神疾病患者的生活质量至关重要.
相关概念视频
Depression: Overview
Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
Antidepressant Drugs: MAOIs and Other Agents
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
Anxiolytic Drugs: Benzodiazepines and Buspirone
Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
Stress and Mental Health
Chronic stress profoundly affects mental health, significantly influencing mood, behavior, and overall quality of life. Research closely links chronic stress with mental health conditions such as depression, anxiety, and substance use disorders. Ongoing exposure to stress can lead to physiological and psychological changes, initiating a cycle of emotional distress and maladaptive coping mechanisms.
Individuals with depression often experience challenges in both their personal and professional...
Individuals with depression often experience challenges in both their personal and professional...
Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
Multiple Sclerosis l: Introduction
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...


