White Matter Damage in Major Depressive Disorder and TCM Treatment： A Review

LIU Li; LIU Qingwu; FENG Xue; LI Tao; LIU Bin; LIU Yaqing; DU Xinke; LI Qi; YANG Weipeng

doi:10.13422/j.cnki.syfjx.20221901

您当前的位置：

首页 >

文章列表页 >

White Matter Damage in Major Depressive Disorder and TCM Treatment： A Review

更新时间：2023-02-15

- White Matter Damage in Major Depressive Disorder and TCM Treatment： A Review
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 29, Issue 6, Pages: 237-245(2023)
- 作者机构：
  
  1.中国中医科学院中药研究所，北京 100700
  2.中日友好医院，北京 100029
  3.中国中医科学院医学实验中心，北京 100700
  4.黑龙江中医药大学基础医学院，哈尔滨 150040
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20221901
  CLC： R2-0;R22;R285.5;R284;R33
- Published：20 March 2023，
  
  Published Online：20 September 2022，
  
  Received：13 July 2022，
- 稿件说明：
扫描看全文
刘丽,刘青武,冯雪等.重度抑郁症中的白质损伤及中医药治疗现状[J].中国实验方剂学杂志,2023,29(06):237-245.

LIU Li,LIU Qingwu,FENG Xue,et al.White Matter Damage in Major Depressive Disorder and TCM Treatment： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(06):237-245.
刘丽,刘青武,冯雪等.重度抑郁症中的白质损伤及中医药治疗现状[J].中国实验方剂学杂志,2023,29(06):237-245. DOI： 10.13422/j.cnki.syfjx.20221901.

LIU Li,LIU Qingwu,FENG Xue,et al.White Matter Damage in Major Depressive Disorder and TCM Treatment： A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(06):237-245. DOI： 10.13422/j.cnki.syfjx.20221901.

摘要

重度抑郁症（MDD）目前高度流行，以高级神经障碍为主要病理表现。大脑灰质作为高级神经活动的生理功能承载者，成为MDD治疗的重点。但近年来文献表明，中枢神经系统（CNS）中白质与灰质彼此相对独立，功能整合联动。MDD除灰质损伤外，白质损伤同样是疾病进展的核心驱动事件，决定了疾病转归。治疗层面，目前MDD的药物治疗主要以灰质修复为主要焦点之一，而忽略了白质完整性对于疾病治疗的重要性，成为目前MDD治疗的短板。中医药在白质修复中具有良好的应用潜能。该文从以下3点展开论述：①总结梳理白质损伤在MDD发生发展中的作用；②以小胶质细胞的微环境调节为切入点，阐述MDD中白质修复的关键环节；③分析中医药在MDD中白质修复的应用价值。该综述旨在凸显白质完整性在MDD治疗中的重要性，有望从白质修复的角度拓展相关中药在MDD中的活性认识维度，解析其潜在应用价值。

Abstract

At present， major depressive disorder （MDD） is highly prevalent with advanced neurological disorders as the main pathological manifestations. As the physiological function bearer of higher neural activity， gray matter has become the focus of MDD treatment. However， recent research has shown that white matter and gray matter are independent of each other in the central nervous system （CNS）， and their functions are integrated and linked. In addition to gray matter damage， white matter damage is also the core driving event of disease progression and determines the outcome of MDD. At the treatment level， the current drug treatment of MDD mainly focuses on gray matter repair， while ignoring the importance of white matter integrity for the treatment of the disease， which has become the weakness of the current treatment of MDD. Traditional Chinese medicine （TCM） has good application potential in white matter repair. This paper elaborated on the following three aspects. ① The roles of white matter damage in the occurrence and development of MDD were summarized. ② The key link of white matter repair in MDD was elaborated with microglia microenvironment regulation as the entry point. ③ The application value of TCM in white matter repair in MDD was analyzed. This review aims to highlight the importance of white matter integrity in the treatment of MDD and is expected to expand the understanding dimension of the activity of related Chinese medicines in MDD from the perspective of white matter repair and analyze its potential application value.

关键词

重度抑郁症白质损伤白质修复小胶质细胞

Keywords

major depressive disorderwhite matter damagewhite matter repairmicroglia

references

MALHI G S，MANN J J.Depression［J］.Lancet，2018，392（10161）：2299-2312.

抑郁障碍中西医整合诊治专家共识组，中国民族医药学会神志病分会.抑郁障碍中西医整合专家共识［J］.中国医药导报，2021，18（6）：4-12.

VAN VELZEN L S，KELLY S，ISAEV D，et al.White matter disturbances in major depressive disorder： A coordinated analysis across 20 international cohorts in the ENIGMA MDD working group［J］.Mol Psychiatry，2020，25（7）：1511-1525.

ZHAO W，ZHU D，ZHANG Y，et al.Relationship between illness duration，corpus callosum changes，and sustained attention dysfunction in major depressive disorder［J］.Quant Imaging Med Surg，2021，11（7）：2980-2993.

ZHANG Y，TAYLOR B V，SIMPSON S，et al.Feelings of depression，pain and walking difficulties have the largest impact on the quality of life of people with multiple sclerosis，irrespective of clinical phenotype［J］.Mult Scler，2021，27（8）：1262-1275.

ZHANG Y，BI X，ADEBIYI O，et al.Venlafaxine improves the cognitive impairment and depression-like behaviors in a cuprizone mouse model by alleviating demyelination and neuroinflammation in the brain［J］.Front Pharmacol，2019，10：332.

陈颖，袁勇贵.中药单体、药对、复方、中成药治疗抑郁症研究进展［J］.中国临床药理学与治疗学，2021，26（5）：586-593.

李龙龙，刘立，高丽娟，等.经方抗抑郁研究进展探讨［J］.中医研究，2018，31（9）：71-74.

单楠，谭子虎，杨冰，等.逍遥散通过PI3K/AKT/mTOR通路调节mPFC-BLA髓鞘功能改善VaD小鼠焦虑抑郁行为［J］.南京中医药大学学报，2022，38（3）：212-219.

BIREY F，KLOC M，CHAVALI M，et al.Genetic and stress-induced loss of NG2 glia triggers emergence of depressive-like behaviors through reduced secretion of FGF2［J］.Neuron，2015，88（5）：941-956.

LIANG S，WANG Q，KONG X，et al.White matter abnormalities in major depression biotypes identified by diffusion tensor imaging［J］.Neurosci Bull，2019，35（5）：867-876.

HE E，LIU M，GONG S，et al.White matter alterations in depressive disorder［J］.Front Immunol，2022，13：826812.

POGGI G，ALBIEZ J，PRYCE C R.Effects of chronic social stress on oligodendrocyte proliferation-maturation and myelin status in prefrontal cortex and amygdala in adult mice［J］.Neurobiol Stress，2022，18：100451.

BONNEFIL V，DIETZ K，AMATRUDA M，et al.Region-specific myelin differences define behavioral consequences of chronic social defeat stress in mice［J］.Elife，2019，doi：10.7554/eLife.40855http://dx.doi.org/10.7554/eLife.40855.

LEHMANN M L，WEIGEL T K，ELKAHLOUN A G，et al.Chronic social defeat reduces myelination in the mouse medial prefrontal cortex［J］.Sci Rep，2017，7：46548.

ASTON C，JIANG L，SOKOLOV B P.Transcriptional profiling reveals evidence for signaling and oligodendroglial abnormalities in the temporal cortex from patients with major depressive disorder［J］.Mol Psychiatry，2005，10（3）：309-322.

SILVER M，MOORE C M，VILLAMARIN V，et al.White matter integrity in medication-free women with peripartum depression： A tract-based spatial statistics study［J］.Neuropsychopharmacology，2018，43（7）：1573-1580.

YANG C，LI L，HU X，et al.Psychoradiologic abnormalities of white matter in patients with bipolar disorder： Diffusion tensor imaging studies using tract-based spatial statistics［J］.J Psychiatry Neurosci，2019，44（1）：32-44.

MA T，LI B，LE Y，et al.Demyelination contributes to depression comorbidity in a rat model of chronic epilepsy via dysregulation of Olig2/LINGO-1 and disturbance of calcium homeostasis［J］.Exp Neurol，2019，321：113034.

BRASANAC J，RAMIEN C，GAMRADT S，et al.Immune signature of multiple sclerosis-associated depression［J］.Brain Behav Immun，2022，100：174-182.

LI Y，SU P，CHEN Y，et al.The Eph receptor A4 plays a role in demyelination and depression-related behavior［J］.J Clin Invest，2022，132（8）：e152187.

LIU J，DUPREE J L，GACIAS M，et al.Clemastine enhances myelination in the prefrontal cortex and rescues behavioral changes in socially isolated mice［J］.J Neurosci，2016，36（3）：957-962.

COLE J，CHADDOCK C A，FARMER A E，et al.White matter abnormalities and illness severity in major depressive disorder［J］.Br J Psychiatry，2012，201（1）：33-39.

GHAZI SHERBAF F，SAME K，ASHRAF-GANJOUEI A，et al.Altered white matter microstructure associated with mild and moderate depressive symptoms in young adults，a diffusion tensor imaging study［J］.Neuroreport，2018，29（8）：685-689.

DE DIEGO-ADELIÑO J，PIRES P，GÓMEZ-ANSÓN B，et al.Microstructural white-matter abnormalities associated with treatment resistance，severity and duration of illness in major depression［J］.Psychol Med，2014，44（6）：1171-1182.

周晶晶，周佳，丰雷.北京市抑郁症患者首次就诊治疗情况及满意度调查分析［J］.精神医学杂志，2021，34（3）：208-211.

MYUNG W，HAN C E，FAVA M，et al.Reduced frontal-subcortical white matter connectivity in association with suicidal ideation in major depressive disorder［J］.Transl Psychiatry，2016，6（6）：e835.

RUSH A J，TRIVEDI M H，WISNIEWSKI S R，et al.Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps： A STAR*D report［J］.Am J Psychiatry，2006，163（11）：1905-1917.

VIEIRA R，COELHO A，REIS J，et al.White matter microstructure alterations associated with paroxetine treatment response in major depression［J］.Front Behav Neurosci，2021，15：693109.

KORGAONKAR M S，REKSHAN W，GORDON E，et al.Magnetic resonance imaging measures of brain structure to predict antidepressant treatment outcome in major depressive disorder［J］.EBioMedicine，2015，2（1）：37-45.

DAVIS A D，HASSEL S，ARNOTT S R，et al.White matter indices of medication response in major depression： A diffusion tensor imaging study［J］.Biol Psychiatry Cogn Neurosci Neuroimaging，2019，4（10）：913-924.

MAAS D A，VALLÈS A，MARTENS G.Oxidative stress，prefrontal cortex hypomyelination and cognitive symptoms in schizophrenia［J］.Transl Psychiatry，2017，7（7）：e1171.

ZHOU B，ZHU Z，RANSOM B R，et al.Oligodendrocyte lineage cells and depression［J］.Mol Psychiatry，2021，26（1）：103-117.

WINDREM M S，SCHANZ S J，ZOU L，et al.Human glial progenitor cells effectively remyelinate the demyelinated adult brain［J］.Cell Rep，2020，31（7）：107658.

MADEIRA C，VARGAS-LOPES C，BRANDÃO C O，et al.Elevated glutamate and glutamine levels in the cerebrospinal fluid of patients with probable Alzheimer's disease and depression［J］.Front Psychiatry，2018，9：561.

BEUREL E，TOUPS M，NEMEROFF C B.The bidirectional relationship of depression and inflammation： Double trouble［J］.Neuron，2020，107（2）：234-256.

LEVY M，BOULLE F，STEINBUSCH H W，et al.Neurotrophic factors and neuroplasticity pathways in the pathophysiology and treatment of depression［J］.Psychopharmacology （Berl），2018，235（8）：2195-2220.

KALAFATAKIS I，KARAGOGEOS D.Oligodendrocytes and microglia： Key players in myelin development，damage and repair［J］.Biomolecules，2021，11（7）：1058.

ZHANG L，ZHANG J，YOU Z.Switching of the microglial activation phenotype is a possible treatment for depression disorder［J］.Front Cell Neurosci，2018，12：306.

YIRMIYA R，RIMMERMAN N，RESHEF R.Depression as a microglial disease［J］.Trends Neurosci，2015，38（10）：637-658.

BÖTTCHER C，FERNÁNDEZ-ZAPATA C，SNIJDERS G，et al.Single-cell mass cytometry of microglia in major depressive disorder reveals a non-inflammatory phenotype with increased homeostatic marker expression［J］.Transl Psychiatry，2020，10（1）：310.

KREISEL T，FRANK M G，LICHT T，et al.Dynamic microglial alterations underlie stress-induced depressive-like behavior and suppressed neurogenesis［J］.Mol Psychiatry，2014，19（6）：699-709.

MCKIM D B，WEBER M D，NIRAULA A，et al.Microglial recruitment of IL-1β-producing monocytes to brain endothelium causes stress-induced anxiety［J］.Mol Psychiatry，2018，23（6）：1421-1431.

ENACHE D，PARIANTE C M，MONDELLI V.Markers of central inflammation in major depressive disorder： A systematic review and Meta-analysis of studies examining cerebrospinal fluid，positron emission tomography and post-mortem brain tissue［J］.Brain Behav Immun，2019，81：24-40.

WANG H，HE Y，SUN Z，et al.Microglia in depression： An overview of microglia in the pathogenesis and treatment of depression［J］.J Neuroinflammation，2022，19（1）：132.

TONG L，GONG Y，WANG P，et al.Microglia loss contributes to the development of major depression induced by different types of chronic stresses［J］.Neurochem Res，2017，42（10）：2698-2711.

ZHANG L，TANG M，XIE X，et al.Ginsenoside Rb1 induces a pro-neurogenic microglial phenotype via PPARγ activation in male mice exposed to chronic mild stress［J］.J Neuroinflammation，2021，18（1）：171.

MIRON V E，BOYD A，ZHAO J W，et al.M2 microglia and macrophages drive oligodendrocyte differentiation during CNS remyelination［J］.Nat Neurosci，2013，16（9）：1211-1218.

KALAFATAKIS I，KARAGOGEOS D.Oligodendrocytes and microglia： Key players in myelin development，damage and repair［J］.Biomolecules，2021，11（7）：1058.

ZHAO Q，WU X，YAN S，et al.The antidepressant-like effects of pioglitazone in a chronic mild stress mouse model are associated with PPARγ-mediated alteration of microglial activation phenotypes［J］.J Neuroinflammation，2016，13（1）：259.

WAN TENG G X L S.Research progress on the relationship between microglia polarization and depression［J］.Prog Biochem Biophys，2021，12（48）：1404-1413.

ZHANG J，XIE X，TANG M，et al.Salvianolic acid B promotes microglial M2-polarization and rescues neurogenesis in stress-exposed mice［J］.Brain Behav Immun，2017，66：111-124.

WORTHEN R J，GARZON ZIGHELBOIM S S，TORRES JARAMILLO C S，et al.Anti-inflammatory IL-10 administration rescues depression-associated learning and memory deficits in mice［J］.J Neuroinflammation，2020，17（1）：246.

PORRO C，CIANCIULLI A，PANARO M A.The regulatory role of IL-10 in neurodegenerative diseases［J］.Biomolecules，2020，10（7）：1017.

AROSIO B，GUERINI F R，VOSHAAR R，et al.Blood brain-derived neurotrophic factor （BDNF） and major depression： Do we have a translational perspective？［J］.Front Behav Neurosci，2021，15：626906.

YAO W，CAO Q，LUO S，et al.Microglial ERK-NRBP1-CREB-BDNF signaling in sustained antidepressant actions of （R）-ketamine［J］.Mol Psychiatry，2022，27（3）：1618-1629.

蔺晓源，孟盼，龙红萍，等.抑郁症“脑郁”病机探讨及应用［J］.中国中医药信息杂志，2020，27（3）：10-13.

YAN Z Y，JIAO H Y，CHEN J B，et al.Antidepressant mechanism of traditional chinese medicine formula Xiaoyaosan in cums-induced depressed mouse model via RIPK1-RIPK3-MLKL mediated necroptosis based on network pharmacology analysis［J］.Front Pharmacol，2021，12：773562.

杨靖.逍遥散及其功能药队抗抑郁效应和分子机制研究［D］.成都：成都中医药大学，2014.

李晓娟，陈家旭，周雪明，等.逍遥散抗抑郁和抗焦虑研究进展［J］.世界科学技术—中医药现代化，2017，19（8）：1300-1306.

单楠，谭子虎，杨冰，等.逍遥散促进小胶质细胞极化改善血管性痴呆伴抑郁小鼠髓鞘再生及抑郁表型［J］.中国实验方剂学杂志，2021，27（19）：19-27.

JIN Y，CUI R，ZHAO L，et al.Mechanisms of Panax ginseng action as an antidepressant［J］.Cell Prolif，2019，52（6）：e12696.

MURATA K，FUJITA N，TAKAHASHI R，et al.Ninjinyoeito improves behavioral abnormalities and hippocampal neurogenesis in the corticosterone model of depression［J］.Front Pharmacol，2018，9：1216.

GAO J，WAN F，TIAN M，et al.Effects of ginsenoside‑Rg1 on the proliferation and glial‑like directed differentiation of embryonic rat cortical neural stem cells in vitro［J］.Mol Med Rep，2017，16（6）：8875-8881.

李欣娱，楚世峰，李晚晚，等.人参皂苷Rg1对慢性脑缺血导致白质损伤的影响［J］.中国药理学通报，2022，38（4）：576-582.

DONG Y X，CHU S F，WANG S S，et al.Rg1 exerts protective effect in CPZ-induced demyelination mouse model via inhibiting CXCL10-mediated glial response［J］.Acta Pharmacol Sin，2022，43（3）：563-576.

张颖，王联生，陈宇霞，等.基于神经血管单元稳态探索开心解郁方抗抑郁作用机制［J］.世界科学技术—中医药现代化，2017，19（8）：1355-1359.

黄芳，谭子虎，陈奕妙，等.六味地黄汤促进自噬调控小胶质细胞表型减轻糖尿病抑郁大鼠ACC髓鞘损伤及抑郁行为［J］.中国实验方剂学杂志，2022，28（6）：7-16.

张淑波，张玲，祝亮，等.养血清脑颗粒治疗卒中后抑郁的疗效及对脑白质结构改变的影响［J］.中华中医药学刊，2017，35（12）：3172-3175.

GRYGLEWSKI G，SEIGER R，BALDINGER-MELICH P，et al.Changes in white matter microstructure after electroconvulsive therapy for treatment-resistant depression［J］.Int J Neuropsychopharmacol，2020，23（1）：20-25.

LUO Y，XIAO Q，WANG J，et al.Running exercise protects oligodendrocytes in the medial prefrontal cortex in chronic unpredictable stress rat model［J］.Transl Psychiatry，2019，9（1）：322.

ABDEL-HAQ R，SCHLACHETZKI J，GLASS C K，et al.Microbiome-microglia connections via the gut-brain axis［J］.J Exp Med，2019，216（1）：41-59.

YAMAWAKI Y，YOSHIOKA N，NOZAKI K，et al.Sodium butyrate abolishes lipopolysaccharide-induced depression-like behaviors and hippocampal microglial activation in mice［J］.Brain Res，2018，1680：13-38.

ZHOU F，WANG X，HAN B，et al.Short-chain fatty acids contribute to neuropathic pain via regulating microglia activation and polarization［J］.Mol Pain，2021，17：1744806921996520.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Improvement of Depression-like Behavior of Depression Model Mice by Sinisan via Regulating GSK-3β/A20/C/EBPβ to Inhibit Activation of Microglia

Effect of Early Intervention of Yishen Huazhuo Prescription on Learning and Memory of Accelerated Aging SAMP8 Mice and Its Mechanism

Wenyang Jieyu Prescription Regulates Hippocampal Neural Plasticity in Depressed Mice via NLRP3/Caspase-1/IL-1β Pathway

Chaihu Longgu Mulitang Relieves Generalized Anxiety Disorder in Rats via p38 MAPK/NF-κB Signaling Pathway

Dihydroartemisinin Regulates Neuro-microglia to Relieve Neuropathic Pain

Related Author

CHEN Hongyun

YANG Dongying

LIAO Huiqing

ZENG Yanyan

PAN Linke

BAI Shasha

DENG Di

SHI Yafei

Related Institution

Chinese Materia Medica，Guangzhou University of Chinese Medicine

Tianjin University of Traditional Chinese Medicine（TCM）

The Second Affiliated Hospital of Tianjin University of TCM

Institute of Basic Theory for Chinese Medicine，China Academy of Chinese Medical Sciences

School of Basic Medicine，Henan University of Chinese Medicine

Postal code：100700
Tel：010-84076882 Email：syfjx_2010@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备11006657号-10 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰