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Erschienen in:

2022 | OriginalPaper | Buchkapitel

2. Neurobiologie der therapieresistenten Depression (TRD)

verfasst von : Andreas Reif

Erschienen in: Therapieresistenz bei Depressionen und bipolaren Störungen

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Zur Neurobiologie der therapieresistenten Depression (TRD) gibt es erstaunlich wenig robuste Befunde, was methodische Gründe hat, aber auch an der Heterogenität des Begriffs liegt. Auf genetischer Ebene gibt es nur wenige Befunde, die zeigen, dass die polygenen Risikoscores für ADHS, Schizophrenie, aber auch für Depression selbst bei der TRD erhöht sind. Überwiegend aus Serummessungen ergeben sich Hinweise dafür, dass neuroinflammatorische Mechanismen bei der TRD beteiligt sind. Diese tragen auch zu einer Aktivierung des Kynurenin-Pathways bei, in dem die Metabolisierung zu Quiloninsäure zu einer glutamatergen Neurotoxizität beiträgt. Diese führt zu reduzierter synaptischer Plastizität und Pathologien der Markscheiden; beide Phänomene tragen wahrscheinlich zu einer gestörten präfrontal-limbischen Konnektivität bei, was der Störung des Emotionsregulation bei TRD zugrundliegt.

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Titel: Neurobiologie der therapieresistenten Depression (TRD)
verfasst von: Andreas Reif
Verlag: Springer Berlin Heidelberg
Buch: Therapieresistenz bei Depressionen und bipolaren Störungen
Print ISBN: 978-3-662-65733-1

Electronic ISBN: 978-3-662-65734-8

Copyright-Jahr: 2022
DOI: https://doi.org/10.1007/978-3-662-65734-8_2

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