Neuronal Network Plasticity and Recovery From Depression

Summary & key facts

Researchers describe evidence that some antidepressant drugs can reopen a juvenile-like window of brain changeability — called plasticity, meaning the brain can rewire itself. In studies, this drug-created plasticity let therapy or other guided rehabilitation reshape badly wired brain networks and improve their function. The authors say this helps explain why combining medicine with psychotherapy often works better than either one alone, and they suggest recovery from depression is a slow process that is helped by structured guidance while the brain is in that more changeable state.

Key facts:

• The brain’s networks that process sights, sounds and feelings are shaped by experience, especially in early life.
• Some antidepressant drugs can reactivate a juvenile-like state of brain plasticity in the adult cortex, meaning the adult brain becomes more able to change its wiring.
• When this drug-induced plasticity was combined with appropriate rehabilitation, such as psychotherapy, researchers observed a functional recovery of abnormally wired brain networks.
• The findings suggest antidepressants act permissively: they make the brain more open to change, and the environment or therapy then guides how the brain rewires.
• The authors propose recovery from depression is gradual and works best when drugs and structured psychological treatments are combined; this approach might reduce the number of people who do not 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 Sadness or low mood