The neurobiology of depression
Abstract
INTRODUCTION OR BACKGROUND: Depressive disorder is a long term, relapsing condition associated with high levels of disability and mortality. It has a neurobiological basis and is associated with functional and structural brain abnormalities. SOURCES OF DATA: The data discussed have been obtained mainly from meta-analyses, randomized controlled clinical trials and key review papers as well as animal studies. AREAS OF AGREEMENT: Genetic vulnerability and stress are key factors in its aetiopathogenesis. Dysregulation of the hypothalamo-pituitary-adrenal (HPA) axis reduces hippocampal volumes and prefrontal cortex (PFC) activity in depressed patients and disrupts homeostasis within the neurocircuit of depression. Antidepressant drugs increase brain-derived neurotrophin, restoring neuronal growth and activity and modulate interactions between the neurocircuit anatomical structures. AREAS OF CONTROVERSY: It remains to be confirmed whether structural changes in the brain are purely abnormalities in neuroplasticity and are fully reversible, whether they predate depression and whether they increase in the long term. GROWING POINTS: Investigation of the molecular mechanisms mediating gene and environment interaction is a growing and potentially fruitful area of research in the neurobiology of depression. Further elucidation of the neuroanatomical and physiological connections between the limbic structures and PFC may help identify key areas to target in treatment. The role of the dysregulation of the HPA axis and identifiable stressors in the recent or remote past which are not always present in depression need further study. AREAS TIMELY FOR DEVELOPING RESEARCH: Prospective studies examining the interaction between changes in brain function and structure in relation to stress and identified relevant genes and how these may be influenced by antidepressant drug treatment and the long-term course of depression would help clarify their role in the pathophysiology of this disorder.
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Dysfunctional response inhibition is a core symptom observed in various mental disorders, including attention deficit hyperactivity disorder, schizophrenia, and depression, as well as learning difficulties and behavioral problems.
“Dysfunctional response inhibition is a core symptom observed in various mental disorders, including attention deficit hyperactivity disorder (Schachar et al. 2007), schizophrenia (Vercammen et al. 2012), and depression (Palazidou 2012), as well as learning difficulties (Eickhoff et al. 2009) and behavioral problems (Liu et al. 2012).”
From Large-scale functional neural network correlates of response inhibition: an fMRI meta-analysis (2017) · cites this paper as Palazidou 2012
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- Authors
- Palazidou, E.
- Affiliations
- East London NHS Foundation Trust (GB)
- Corresponding author
- Palazidou, E.
- Venue
- British Medical Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-02-14
- Volume
- 101
- Issue
- 1
- Pages
- 127-145
- ISSN
- 0007-1420 (ISSN-L)
- 1471-8391
- OpenAlex
- W2118710970
- Semantic Scholar
- 44d4d7687cf9ee974468541fb0bff422cfbf4b6c
- Cited by
- 288
- References
- 61
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 23 · 2023: 15 · 2022: 22 · 2021: 15 · 2020: 24 · 2019: 28 · 2018: 19 · 2017: 18 · 2016: 23 · 2015: 14 · 2014: 24 · 2013: 31 · 2012: 8
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Medical Bulletin (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- depression, neurobiology of depression, HPA axis dysregulation, hippocampal volume, prefrontal cortex, brain-derived neurotrophic factor, antidepressants, neuroplasticity, genetic susceptibility, stress, gene-environment interaction, limbic system, depression pathophysiology
- MeSH terms
- Brain, Depressive Disorder, Humans, Stress, Psychological, Disease Progression, Genetic Predisposition to Disease
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