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      Avances en el estudio de la neurobiología de la depresión: rol de la hormona concentradora de melanina

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          Abstract

          Introducción: la depresión mayor (DM) es una enfermedad psiquiátrica frecuente, con importante morbilidad y una relación estrecha con el suicidio. Objetivo: hacer una puesta a punto de los avances en el estudio de la neurobiología de la DM, enfocándonos en el posible rol de la hormona concentradora de melanina (MCH) en esta patología. Metodología: revisión de la bibliografía con énfasis en nuestros propios trabajos originales. Resultados: la MCH es un neuromodulador peptídico sintetizado por neuronas del hipotálamo. Las neuronas MCHérgicas envían proyecciones hacia diversas regiones del sistema nervioso central, incluyendo las áreas vinculadas con la regulación de la vigilia y del sueño, así como a diversas estructuras del sistema límbico que participan en la regulación del humor. Aunque numerosos estudios han relacionado el sistema MCHérgico con el control de la homeostasis energética, hallazgos recientes han permitido señalar un rol de este sistema en los mecanismos de generación del sueño. A su vez, una convergencia de datos provenientes de diversos estudios sugiere que la MCH estaría involucrada en la fisiopatología de la DM. Nuestros propios estudios preclínicos tienden a indicar que la MCH promueve la generación del sueño REM y un estado tipo depresivo. Ambos efectos estarían siendo mediados a través de la modulación de la actividad de las neuronas serotoninérgicas del núcleo dorsal del rafe. Conclusiones: estudios preclínicos sugieren un rol protagónico del sistema MCHérgico en la fisiopatología de la depresión. Resta confirmar si esta afirmación es cierta en pacientes con DM.

          Translated abstract

          Abstract Introduction: major depression disorder (MDD) is a common psychiatric condition, it has high morbility rates and is closely related to suicide. Objective: to provide an update in the study of the neurobiology of depression, focusing on the potential role of the melanin-concentrating hormone (MCH) in this condition. Method: a bibliographical review with an emphasis on our own original studies. Results: the melanin-concentrating hormone is a peptide neuromodulator syhthetized by neurones in the hypothalamus. MCHergic neurons send projection towards different areas in the central nervous system, including areas associated to the regulation of the sleep-wake cycle, as well as different structures in the limbic system that take part in the regulation of mood. In spite of several studies having proved the MCHergic system with the control of energetic homeostasis, recent findings have enabled to identify a role for this system in the sleep generator mechanisms. Similarly, data arising from several studies suggests that MCH would be involved in the major depression disorder. Our own preclinical studies tend to pint out the MCH promotes the generation of REM sleep and a type of depression. Apparently both effects would be mediated through the modulation of the activity on the serotoninergic neurons in the dorsal raphe nucleus. Conclusions: paraclinical studies suggest the leading role of the MCHergic system in the pathophysiology of depression. It is to be proved still, whether this affirmation is true for patients with major depression disorder.

          Translated abstract

          Resumo Introdução: a depressão maior (DM) é uma enfermidade psiquiátrica frequente, com morbidade considerável e estreitamente relacionada com o suicídio. Objetivo: fazer uma atualização dos avanços no estudo da neurobiologia da DM, focando no possível papel do hormônio concentrador melanina (MCH) nesta patologia. Metodologia: revisão da bibliografia com ênfase em nossos trabalhos originais. Resultados: o MCH é um neuromodulador peptídico sintetizado pelos neurônios do hipotálamo. Os neurônios MCHérgicos enviam projeções a diversas regiões del sistema nervoso central, incluindo as áreas vinculadas com a regulação da vigília e do sono, bem como a diversas estruturas do sistema límbico que participam na regulação do humor. Embora numerosos estudos hajam relacionado o sistema MCHérgico com o controle da homeostase energética, descobrimentos recentes permitiram identificar um papel deste sistema nos mecanismos de geração do sono. Por outro lado, uma convergência de dados provenientes de diversos estudos sugere que o MCH estaria relacionado com a fisiopatologia da DM. Nossos estudos preclínicos tendem a indicar que o MCH promove a geração do sono REM e um estado tipo depressivo. Ambos efeitos estariam sendo mediados pela modulação da atividade dos neurônios serotoninérgicos do núcleo dorsal do rafe. Conclusões: estudos preclínicos sugerem um protagonismo do sistema MCHérgico na fisiopatologia da depressão. É necessário confirmar se esta afirmação é correta em pacientes com DM.

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          The neurobiology of depression and antidepressant action.

          We present a comprehensive overview of the neurobiology of unipolar major depression and antidepressant drug action, integrating data from affective neuroscience, neuro- and psychopharmacology, neuroendocrinology, neuroanatomy, and molecular biology. We suggest that the problem of depression comprises three sub-problems: first episodes in people with low vulnerability ('simple' depressions), which are strongly stress-dependent; an increase in vulnerability and autonomy from stress that develops over episodes of depression (kindling); and factors that confer vulnerability to a first episode (a depressive diathesis). We describe key processes in the onset of a 'simple' depression and show that kindling and depressive diatheses reproduce many of the neurobiological features of depression. We also review the neurobiological mechanisms of antidepressant drug action, and show that resistance to antidepressant treatment is associated with genetic and other factors that are largely similar to those implicated in vulnerability to depression. We discuss the implications of these conclusions for the understanding and treatment of depression, and make some strategic recommendations for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            REM sleep dysregulation in depression: state of the art.

            Disturbances of sleep are typical for most depressed patients and belong to the core symptoms of the disorder. Since the 1960s polysomnographic sleep research has demonstrated that besides disturbances of sleep continuity, depression is associated with altered sleep architecture, i.e., a decrease in slow wave sleep (SWS) production and disturbed rapid eye movement (REM) sleep regulation. Shortened REM latency (i.e., the interval between sleep onset and the occurrence of the first REM period), increased REM sleep duration and increased REM density (i.e., the frequency of rapid eye movements per REM period) have been considered as biological markers of depression which might predict relapse and recurrence. High risk studies including healthy relatives of patients with depression demonstrate that REM sleep alterations may precede the clinical expression of depression and may thus be useful in identifying subjects at high risk for the illness. Several models have been developed to explain REM sleep abnormalities in depression, like the cholinergic-aminergic imbalance model or chronobiologically inspired theories, which are reviewed in this overview. Moreover, REM sleep alterations have been recently considered not only as biological "scars" but as true endophenotypes of depression. This review discusses the genetic, neurochemical and neurobiological factors that have been implicated to play a role in the complex relationships between REM sleep and depression. We hypothesize on the one hand that REM sleep dysregulation in depression may be linked to a genetic predisposition/vulnerability to develop the illness; on the other hand it is conceivable that REM sleep disinhibition in itself is a part of a maladaptive stress reaction with increased allostatic load. We also discuss whether the REM sleep changes in depression may contribute themselves to the development of central symptoms of depression such as cognitive distortions including negative self-esteem and the overnight consolidation of negatively toned emotional memories. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Melanin-concentrating hormone neurons discharge in a reciprocal manner to orexin neurons across the sleep-wake cycle.

              Neurons containing melanin-concentrating hormone (MCH) are codistributed with neurons containing orexin (Orx or hypocretin) in the lateral hypothalamus, a peptide and region known to be critical for maintaining wakefulness. Evidence from knockout and c-Fos studies suggests, however, that the MCH neurons might play a different role than Orx neurons in regulating activity and sleep-wake states. To examine this possibility, neurons were recorded across natural sleep-wake states in head-fixed rats and labeled by using the juxtacellular technique for subsequent immunohistochemical identification. Neurons identified as MCH+ did not fire during wake (W); they fired selectively during sleep, occasionally during slow wave sleep (SWS) and maximally during paradoxical sleep (PS). As W-Off/Sleep-On, the MCH neurons discharged in a reciprocal manner to the W-On/Sleep-Off Orx neurons and could accordingly play a complementary role to Orx neurons in sleep-wake state regulation and contribute to the pathophysiology of certain sleep disorders, such as narcolepsy with cataplexy.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rmu
                Revista Médica del Uruguay
                Rev. Méd. Urug.
                Sindicato Médico del Uruguay (Montevideo )
                1688-0390
                June 2014
                : 30
                : 2
                : 128-136
                Affiliations
                [1 ] Facultad de Medicina, Universidad de la República Uruguay
                [2 ] Instituto de Investigaciones Biológicas Clemente Estable
                [3 ] Instituto de Investigaciones Biológicas Clemente Estable Uruguay
                [4 ] Facultad de Medicina, Universidad de la República
                [5 ] Facultad de Medicina, Universidad de la República Uruguay
                [6 ] Facultad de Medicina, Universidad de la República Uruguay
                [7 ] Facultad de Medicina, Universidad de la República Uruguay
                [8 ] Facultad de Medicina, Universidad de la República Uruguay
                Article
                S1688-03902014000200008
                02ab4e35-5cfa-4733-b9eb-276cc024ef67

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Uruguay

                Self URI (journal page): http://www.scielo.edu.uy/scielo.php?script=sci_serial&pid=1688-0390&lng=en
                Categories
                MEDICAL LABORATORY TECHNOLOGY
                MEDICINE, GENERAL & INTERNAL
                MEDICINE, LEGAL
                MEDICINE, RESEARCH & EXPERIMENTAL
                ONCOLOGY
                SURGERY

                Oncology & Radiotherapy,Social law,Medicine,Surgery,Clinical chemistry,Internal medicine
                DEPRESSIVE DISORDER MAJOR,NEUROBIOLOGY,DEPRESSION,MELANIN CONCENTRATING HORMONE,NEUROBIOLOGÍA,DEPRESIÓN,TRASTORNO DEPRESIVO MAYOR,HORMONA CONCENTRADORA DE MELANINA

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