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Synaptic plasticity model of therapeutic sleep deprivation in major depression
- Source :
- Sleep Medicine Reviews. 30:53-62
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Therapeutic sleep deprivation (SD) is a rapid acting treatment for major depressive disorder (MDD). Within hours, SD leads to a dramatic decrease in depressive symptoms in 50-60% of patients with MDD. Scientifically, therapeutic SD presents a unique paradigm to study the neurobiology of MDD. Yet, up to now, the neurobiological basis of the antidepressant effect, which is most likely different from today's first-line treatments, is not sufficiently understood. This article puts the idea forward that sleep/wake-dependent shifts in synaptic plasticity, i.e., the neural basis of adaptive network function and behavior, represent a critical mechanism of therapeutic SD in MDD. Particularly, this article centers on two major hypotheses of MDD and sleep, the synaptic plasticity hypothesis of MDD and the synaptic homeostasis hypothesis of sleep-wake regulation, and on how they can be integrated into a novel synaptic plasticity model of therapeutic SD in MDD. As a major component, the model proposes that therapeutic SD, by homeostatically enhancing cortical synaptic strength, shifts the initially deficient inducibility of associative synaptic long-term potentiation (LTP) in patients with MDD in a more favorable window of associative plasticity. Research on the molecular effects of SD in animals and humans, including observations in the neurotrophic, adenosinergic, monoaminergic, and glutamatergic system, provides some support for the hypothesis of associative synaptic plasticity facilitation after therapeutic SD in MDD. The model proposes a novel framework for a mechanism of action of therapeutic SD that can be further tested in humans based on non-invasive indices and in animals based on direct studies of synaptic plasticity. Further determining the mechanisms of action of SD might contribute to the development of novel fast acting treatments for MDD, one of the major health problems worldwide.
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
mental disorders
Neuroplasticity
Metaplasticity
medicine
Animals
Humans
Wakefulness
Depressive Disorder, Major
Neuronal Plasticity
Long-term potentiation
medicine.disease
Sleep deprivation
030104 developmental biology
Synaptic fatigue
Neurology
Synaptic plasticity
Sleep Deprivation
Major depressive disorder
Antidepressant
Neurology (clinical)
medicine.symptom
Sleep
Psychology
Neuroscience
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10870792
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Sleep Medicine Reviews
- Accession number :
- edsair.doi.dedup.....6b07caf62f5219837b53aaff5e13c381