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Entstehung von Depression

Die Rolle des „brain-derived neurotrophic factor“

The development of depression

The role of brain-derived neurotrophic factor

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Zusammenfassung

Ein Zusammenhang zwischen dem Auftreten und dysfunktionalem Verarbeiten von Stress und der Entstehung von Depression ist gut belegt. Die vorliegende Übersicht referiert und diskutiert Studien, die nahelegen, dass die stressbedingt reduzierte Ausschüttung des „brain-derived neurotrophic factor“ (BDNF) ein hierbei wirksamer Mechanismus sein könnte. Diese Studien zeigen, dass in Stresssituationen und bei Vorliegen einer Depression der BDNF-Spiegel im Blut erniedrigt ist und sich bei erfolgreicher antidepressiver Therapie normalisiert. Als möglicher Wirkmechanismus des BDNF wird eine Reaktivierung neuronaler Plastizität, speziell in hippokampalen und kortikalen Netzwerken, erwogen. Gegenstand andauernder wissenschaftlicher Diskussion ist die Aussagekraft dieser Studien in Anbetracht methodischer Limitationen, wie z. B. der Unmöglichkeit, die zerebrale BDNF-Konzentration in vivo zu bestimmen und Störfaktoren sicher auszuschließen. Eine weitere Frage ist, ob die festgestellten Veränderungen des BDNF-Spiegels im Zuge der Entstehung und Remission einer Depression tatsächlich als kausal pathogenetisch interpretiert werden können oder lediglich epiphänomenal ein Resultat depressionsinduzierten Stresses darstellen.

Summary

An association between the presence of psychosocial stress, its pathological processing and the development of depression is well documented. This review reports and discusses studies suggesting a reduced release of brain-derived neurotrophic factor (BDNF) under stress as a possible mechanism. The studies show a reduction of BDNF secretion in stressful situations, a decreased blood concentration in depression and a normalization of BDNF by successful antidepressant therapy. As a possible mechanism of BDNF action, a reactivation of neuroplasticity is being discussed, especially in hippocampal and cortical networks. On the other hand, methodological limitations, such as the impossibility of determining the cerebral BDNF concentration in vivo and ruling out a variety of possible confounders, may restrict the significance of the studies. The question of whether the ascertained changes of BDNF levels are causally involved in the pathophysiology of depression or whether they are just an epiphenomenal result of depression-induced stress is still under debate.

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  1. Klinik für Psychiatrie und Psychotherapie, Charité – Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    H. Stuke, R. Hellweg & F. Bermpohl

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Stuke, H., Hellweg, R. & Bermpohl, F. Entstehung von Depression. Nervenarzt 83, 869–877 (2012). https://doi.org/10.1007/s00115-011-3374-8

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