Neuronal Network Plasticity and Recovery From Depression

Summary & key facts

The paper says that some antidepressant drugs can reopen a young brain’s ability to change. When that drug-caused openness to change is combined with guided rehabilitation, such as psychotherapy, badly wired brain networks can recover their normal function. The authors suggest this helps explain why medicines and therapy together often work better for depression, and that recovery is a slow process that needs structured support.

Key facts:

• The brain’s networks are shaped by experience, especially during early life, and they represent what we sense inside and outside our bodies.
• Researchers report that some antidepressant drugs can reopen a window of juvenile-like plasticity in the adult cortex. Plasticity means the brain can change and rewire itself.
• When drug-induced plasticity was combined with appropriate rehabilitation, researchers saw a functional recovery of abnormally wired neuronal networks. In other words, medicine plus guided practice helped miswired networks work better.
• The findings suggest antidepressants may act permissively. That means the drugs make the brain more able to be changed by the environment, for example by psychotherapy, rather than directly fixing the wiring on their own.
• The authors propose a network view of antidepressant action: recovery from depression is gradual and is helped when drug treatment is paired with structured guidance or rehabilitation. They say optimized combinations might reduce the number of patients who don’t respond to treatment.

Abstract

The brain processes sensory information in neuronal networks that are shaped by experience, particularly during early life, to optimally represent the internal and external milieu. Recent surprising findings have revealed that antidepressant drugs reactivate a window of juvenile-like plasticity in the adult cortex. When antidepressant-induced plasticity was combined with appropriate rehabilitation, it brought about a functional recovery of abnormally wired neuronal networks. These observations suggest that antidepressants act permissively to facilitate environmental influence on neuronal network reorganization and so provide a plausible neurobiological explanation for the enhanced effect of combining antidepressant treatment with psychotherapy. The results emphasize that pharmacological and psychological treatments of mood disorders are closely entwined: the effect of antidepressant-induced plasticity is facilitated by rehabilitation, such as psychotherapy, that guides the plastic networks, and psychotherapy benefits from the enhanced plasticity provided by the drug treatment. Optimized combinations of pharmacological and psychological treatments might help make best use of existing antidepressant drugs and reduce the number of treatment-resistant patients. The network hypothesis of antidepressant action presented here proposes that recovery from depression and related mood disorders is a gradual process that develops slowly and is facilitated by structured guidance and rehabilitation.

Topics

Functional Brain Connectivity Studies Neural dynamics and brain function Neuroscience and Neuropharmacology Research

Categories

Cognitive Neuroscience Life Sciences Neuroscience

Tags

Antidepressant Anxiety Depression (economics) Economics Hippocampus Macroeconomics Mood Mood disorders Neuroplasticity Neuroscience Psychiatry Psychology Rehabilitation

Conditions & symptoms

Anxiety Depression Sadness or low mood