Neurobiology of depression: an integrated view of key findings.
OBJECTIVE
The objectives of the present review were to summarise the key findings from the clinical literature regarding the neurobiology of major depressive disorder (MDD) and their implications for maximising treatment outcomes. Several neuroanatomical structures in the prefrontal and limbic areas of the brain are involved in affective regulation. In patients with MDD, alterations in the dynamic patterns of activity among these structures have profound implications for the pathogenesis of this illness.


CONCLUSIONS
The present work reviews the evidence for the progressive nature of MDD along with associated changes in neuroanatomical structure and function, especially for the hippocampus. The role of glucocorticoids, inflammatory cytokines and brain-derived growth factors are discussed as mediators of these pathological alterations. From this integrated model, the role of antidepressant therapy in restoring normative processes is examined along with additional treatment guidelines.


CONCLUSIONS
Major depressive disorder is an illness with significant neurobiological consequences involving structural, functional and molecular alterations in several areas of the brain. Antidepressant pharmacotherapy is associated with restoration of the underlying physiology. Clinicians are advised to intervene with MDD using an early, comprehensive treatment approach that has remission as the goal.
Maletic
V
V
School of Medicine, University of South Carolina, Greer, SC 29650, USA. vmaletic@bellsouth.net
Robinson
M
M
Oakes
T
T
Iyengar
S
S
Ball
S G
SG
Russell
J
J
D002540:Cerebral Cortex / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003866:Depressive Disorder / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D004644:Emotions / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000502:physiology; D009422:Nervous System Diseases / Q000150:complications* / Q000473:pathology / Q000628:therapy; D009446:Neurobiology; D018377:Neurotransmitter Agents / Q000502:physiology
D018377:Neurotransmitter Agents