Depresion refractaria y alteracion vias fronto-limbicas
Autor: Daniel Serrani | Publicado:  27/04/2010 | Neurologia | |
Depresion refractaria y alteracion vias fronto-limbicas .3

El origen de las alteraciones micro-anatómicas en no remitentes no está claro del todo, pudiendo deberse a cambios vasculares subcorticales ya que hipocampo es particularmente sensible a los efectos del envejecimiento. La reducción del volumen de hipocampo correlaciona con duración de depresión (28). Como factor común de todas estas alteraciones esta el cambio en conexiones fronto-límbico-estriatales a nivel de fibras de sustancia blanca dando una vulnerabilidad para la depresión tarida y menor respuesta o remisión.

TABLA 3. Diferencias de anisotropía fraccional entre remitentes y no remitentes 



1. Judd LL, Akiskal HS, Maser JD, Zeller PJ, Endicott J, Coryell W, Paulus MP, Kunovac JL, Leon AC, Mueller TI, Rice JA, Keller MB: Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse. J Affect Disord 1998; 50:97–108
2. Lecrubier Y: How do you define remission? Acta Psychiatr Scand 2002; 415(suppl):7–11
3. Drevets WC: Neuroimaging studies of mood disorders. Biol Psychiatry 2000; 48:813–829
4. Mayberg H: Depression and frontal-subcortical circuits: focus on prefrontal-limbic interactions, in Frontal-Subcortical Circuits in Psychiatric and Neurological Disorders. Edited by Lichter D, Cummings J. New York, Guilford Press, 2001, pp 177–206
5. de Asis JM, Stern E, Alexopoulos GS, Pan H, Van Gorp W, Blumberg H, Kalayam B, Eidelberg D, Kiosses D, Silbersweig DA: Hippocampal and anterior cingulate activation deficits in patients with geriatric depression. Am J Psychiatry 2001; 158:1321–1323
6. Rolls E: A theory of emotion, and its application to understanding the neural basis of emotion. Cogn Emot 1990; 4:161–190
7. Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive Therapy of Depression. New York, Guilford Press, 1979
8. Hyman SE, Nestler EJ: Initiation and adaptation: a paradigm for understanding psychotropic drug action. Am J Psychiatry 1996; 153:151–162
9. Hoptman MJ, Gunning-Dixon FM, Murphy CF, Lim KO, Alexopoulos GS: Structural neuroimaging research methods in geriatric depression. Am J Geriatr Psychiatry 2006; 14:812–822
10. Alexopoulos GS: Depression in the elderly. Lancet 2005; 365: 1961–1970
11. Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
12. Kongs, S.K.; Thompson, L.L, PhD, Iverson, G.L, PhD and Heaton, R.K, PhD. (2000). Wisconsin Card Sorting Test - 64 Card Version Professional Manual. USA: Psychological Assesment Resources, Inc
13. Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K: The UKU Side Effect Rating Scale: a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl 1987; 334:1–100
14. Taylor WD, MacFall JR, Payne ME, McQuoid DR, Steffens DC, Provenzale JM, Krishnan RR: Greater MRI lesion volumes in elderly depressed subjects than in control subjects. Psychiatry Res 2005; 139:1–7
15. Nobuhara K, Okugawa G, Sugimoto T, Minami T, Tamagaki C, Takase K, Saito Y, Sawada S, Kinoshita T: Frontal white matter anisotropy and symptom severity of late-life depression: a magnetic resonance diffusion tensor imaging study. J Neurol Neurosurg Psychiatry 2006; 77:120–122
16. Taylor WD, MacFall JR, Payne ME, McQuoid DR, Provenzale JM, Steffens DC, Krishnan KR: Late-life depression and microstructural abnormalities in dorsolateral prefrontal cortex white matter. Am J Psychiatry 2004; 161:1293–126
17. Kumar A, Gupta RC, Albert Thomas M, Alger J, Wyckoff N, Hwang S: Biophysical changes in normal-appearing white matter and subcortical nuclei in late-life major depression detected using magnetization transfer. Psychiatry Res 2004; 130: 131–140
18. Hickie I, Scott E, Mitchell P, Wilhelm K, Austin M, Bennett B: Subcortical hyperintensities on magnetic resonance imaging: clinical correlates and prognostic significance in patients with severe depression. Biol Psychiatry 1995; 37:151–160
19. Patankar TF, Baldwin R, Mitra D, Jeffries S, Sutcliffe C, Burns A, Jackson A: Virchow-robin space dilatation may predict resistance to antidepressant monotherapy in elderly patients with depression. J Affect Disord 2007; 97:265–270
20. Steffens DC, Pieper CF, Bosworth HB, MacFall JR, Provenzale JM, Payne ME, Carroll BJ, George LK, Krishnan KR: Biological and social predictors of long-term geriatric depression outcome. Int Psychogeriatr 2005; 17:41–56
21. Bench CJ, Frackowiak RS, Dolan RJ: Changes in regional cerebral blood flow on recovery from depression. Psychol Med 1995; 25:247–261
22. Mayberg HS, Liotti M, Brannan SK, McGinnis S, Mahurin RK, Jerabek PA, Silva JA, Tekell JL, Martin CC, Lancaster JL, Fox PT: Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999; 156:675–682
23. Mayberg H, Brannan S, Mahurin R, Jerabek P, Brickman J, Tekell J, Silva J, McGinnis S, Glass T, Martin C, Fox P: Cingulate function in depression: a potential predictor of treatment response. Neuroreport 1997; 8:1057–1061
24. Nobler MS, Oquendo MA, Kegeles LS, Malone KM, Campbell CC, Sackeim HA, Mann JJ: Decreased regional brain metabolism after ECT. Am J Psychiatry 2001; 158:305–308
25. Smith GS, Reynolds CF 3rd, Pollock B, Derbyshire S, Nofzinger E, Dew MA, Houck PR, Milko D, Meltzer CC, Kupfer DJ: Cerebral glucose metabolic response to combined total sleep deprivation and antidepressant treatment in geriatric depression. Am J Psychiatry 1999; 156:683–689
26. Goldapple K, Segal Z, Garson C, Lau M, Bieling P, Kennedy S, Mayberg H: Modulation of cortical-limbic pathways in major depression: treatment-specific effects of cognitive behavior therapy. Arch Gen Psychiatry 2004; 61:34–41
27. Schneider F, Grodd W, Weiss U, Klose U, Mayer K, Nagele T, Gur R: Functional MRI reveals left amygdala activation during emotion. Psychiatry Res 1997; 76:75–82 28. Sheline Y: 3D MRI studies of neuroanatomic changes in unipolar major depression: the role of stress and medical comorbidity. Biol Psychiatry 2000; 48:791–800

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Revista de Medicina y Ciencias de la Salud, de periodicidad quincenal, dirigida a los profesionales de la Salud de habla hispana. ISSN 1886-8924