Störungen der Vigilanzregulation bei depressiven Erkrankungen

Zusammenfassung

Auffälligkeiten der Vigilanzregulation in Form einer gestörten Schlafregulation sind ein Kernsymptom affektiver Erkrankungen. Weniger bekannt sind Störungen der Wachheitsregulation, die ebenfalls eine kausale Rolle in der Pathogenese affektiver Störungen spielen können. Der vorliegende Artikel soll einen Überblick über beide Gebiete der Vigilanzforschung geben und ausgewählte neurobiologische Grundlagen vorstellen. Dabei wird besonders auf die Rolle von Kernsystemen in Hirnstamm und Hypothalamus sowie zirkadianen und neuroendokrinen Systemen eingegangen. Veränderungen in diesen Systemen können zu Störungen der Vigilanzregulation führen. Diese können sowohl Prodrom als auch Symptom affektiver Erkrankungen sein, wiederum zirkadiane und neuroendokrine Prozesse beeinflussen und somit zur Aufrechterhaltung oder Verschlechterung der depressiven Symptomatik beitragen.

Summary

A dysfunctional regulation of vigilance in the sense of sleep problems is considered a core symptom of affective disorders. Less prominently discussed are disorders of wakefulness regulation which might also play a role in the pathogenesis of affective disorders. This article will provide an overview on both aspects of vigilance disorders as well as discussing some neurobiological basics of vigilance regulation. The focus will be on structures in the brain stem and the hypothalamus regulating sleep and wakefulness and their interaction with circadian and neuroendocrine systems. Disturbances in those systems can lead to disorders in vigilance regulation which can either precede affective disorders or be a symptom thereof. In turn, an impaired regulation of vigilance can affect circadian and neuroendocrine processes, thus maintaining or aggravating the depressive symptomatology.

Schlüsselwörter

Depression - Vigilanz - Schlafstörungen - Elektroenzephalografie/EEG

Keywords

Major depression - vigilance - sleep disorders - electroencephalography/EEG

• Literatur

• 1 Anisman H, Merali Z. Cytokines, stress, and depressive illness. Brain, Behavior, and Immunity 2002; 16 (05) 513-524.
• 2 Antonijevic I. HPA axis and sleep: Identifying subtypes of major depression. Stress 2008; 11 (01) 15-27.
• 3 Balbo M, Leproult R, Van Cauter E. Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity. International Journal of Endocrinology. 2010 Epub doi: 10.1155/2010/759234.
• 4 Bao AM, Meynen G, Swaab DF. The stress system in depression and neurodegeneration: Focus on the human hypothalamus. Brain Research Reviews 2008; 57 (02) 531-553.
• 5 Barden N. Implication of the hypothalamic-pituitary-adrenal axis in the physiopathology of depression. Journal of Psychiatry & Neuroscience 2004; 29 (03) 185-193.
• 6 Benca RM, Obermeyer WH, Thisted RA, Gillin JC. Sleep and psychiatric-disorders – a meta-analysis. Archives of General Psychiatry 1992; 49 (08) 651-668.
• 7 Benca RM, Peterson MJ. Insomnia and depression. Sleep Medicine 2008; 09: S3-S9.
• 8 Bente D. Die Insuffizienz des Vigilitätstonus. Habilitationsschrift; Universität Erlangen: 1964
• 9 Bonnavion P, de Lecea L. Hypocretins in the control of sleep and wakefulness. Current Neurology and Neuroscience Reports 2010; 10 (03) 174-179.
• 10 Bonnet MH, Arand DL. Hyperarousal and insomnia: State of the science. Sleep Medicine Reviews 2010; 14 (01) 9-15.
• 11 Borbely AA. A two-process model of sleep regulation. Human Neurobiology 1982; 01 (03) 195-204.
• 12 Borbely AA. The S-deficiency hypothesis of depression and the 2-process model of sleep regulation. Pharmacopsychiatry 1987; 20 (01) 23-29.
• 13 Bunney JN, Potkin SG. Circadian abnormalities, molecular clock genes and chronobiological treatments in depression. British Medical Bulletin 2008; 86 (01) 23-32.
• 14 Cano G, Mochizuki T, Saper CB. Neural circuitry of stress-induced insomnia in rats. Journal of Neuroscience 2008; 28 (40) 10167-10184.
• 15 Carter ME, Borg JS, de Lecea L. The brain hypocretins and their receptors: mediators of allostatic arousal. Current Opinion in Pharmacology 2009; 09 (01) 39-45.
• 16 Dement W, Kleitman N. Cyclic variations in EEG during sleep and their relation to eye movements, body motility, and dreaming. Electroencephalography and Clinical Neurophysiology 1957; 09 (04) 673-690.
• 17 Dibner C, Schibler U, Albrecht U. The mammalian circadian timing system: Organization and coordination of central and peripheral clocks. Annual Review of Physiology 2010; 72: 517-549.
• 18 Emens J, Lewy A, Kinzie JM, Arntz D, Rough J. Circadian misalignment in major depressive disorder. Psychiatry Research 2009; 168 (03) 259-261.
• 19 Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues in Clinical Neuroscience 2008; 10 (04) 473-481.
• 20 Fuller PM, Gooley JJ, Saper CB. Neurobiology of the sleep-wake cycle: Sleep architecture, circadian regulation, and regulatory feedback. Journal of Biological Rhythms 2006; 21 (06) 482-493.
• 21 Germain A, Kupfer DJ. Circadian rhythm disturbances in depression. Human Psychopharmacology: Clinical & Experimental 2008; 23 (07) 571-585.
• 22 Golden RN, Gaynes BN, Ekstrom RD, Hamer RM, Jacobsen FM, Suppes T. et al. The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry 2005; 162 (04) 656-662.
• 23 Head H. The conception of nervous and mental energy – vigilance: a physiological state of the nervous system. British Journal of Psychology 1923; 14: 126-147.
• 24 Hegerl U, Olbrich S, Schonknecht P, Sander C. Manic behavior as an autoregulatory attempt to stabilize vigilance. Nervenarzt 2008; 79 (11) 1283-1290.
• 25 Hegerl U, Sander C, Olbrich S, Schoenknecht P. Are psychostimulants a treatment option in mania?. Pharmacopsychiatry 2009; 42 (05) 169-174.
• 26 Hegerl U. et al. Hyperstable regulation of vigilance in patients with major depressive disorder. World J Biol Psychiatry. 2011 Epub ahead of print, doi: 10.3109/15622975.2011.579164.
• 27 Himmerich H, Berthold-Losleben M, Pollmacher T. The relevance of the TNF-alpha system in psychiatric disorders. Fortschritte der Neurologie Psychiatrie 2009; 77 (06) 334-345.
• 28 Holshoe JM. Antidepressants and sleep: A review. perspectives in psychiatric care 2009; 45 (03) 191-197.
• 29 Iber C, Ancoli-Israel S, Chesson A, Quan SF. for the American Adademy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications. 1st ed. Westchester, IL: American Academy of Sleep Medicine; 2007.;
• 30 Imeri L, Opp MR. How (and why) the immune system makes us sleep. Nature Reviews Neuroscience 2009; 10 (03) 199-210.
• 31 Irwin M. Effects of sleep and sleep loss on immunity and cytokines. Brain Behavior and Immunity 2002; 16 (05) 503-512.
• 32 Janssen DGA, Caniato RN, Verster JC, Baune BT. A psychoneuroimmunological review on cytokines involved in antidepressant treatment response. Human Psychopharmacology: Clinical & Experimental 2010; 25 (03) 201-215.
• 33 Kaplan KA, Harvey AG. Hypersomnia across mood disorders: A review and synthesis. Sleep Medicine Reviews 2009; 13 (04) 275-285.
• 34 Kennaway DJ. Clock genes at the heart of depression. Journal of Psychopharmacology 2010; 24: 5-14.
• 35 Kupfer DJ, Spiker DG, Coble PA, Neil JF, Ulrich R, Shaw DH. Sleep and treatment prediction in endogenous-depression. American Journal of Psychiatry 1981; 138 (04) 429-434.
• 36 Leonard BE, Myint A. The psychoneuroimmunology of depression. Human Psychopharmacology: Clinical and Experimental 2009; 24 (03) 165-175.
• 37 Lewy AJ, Nurnberger JI, Wehr TA, Pack D, Becker LE, Powell RL. et al. Supersensitivity to light – possible trait marker for manic-depressive illness. American Journal of Psychiatry 1985; 142 (06) 725-727.
• 38 Loftis JM, Huckans M, Morasco BJ. Neuroimmune mechanisms of cytokine-induced depression: Current theories and novel treatment strategies. Neurobiology of Disease 2010; 37 (03) 519-533.
• 39 Loomis AL, Harvey EN, Hobart GA. Cerebral states during sleep as studied by human brain potentials. Journal of Experimental Psychology 1937; 21: 127-144.
• 40 Lorton D, Lubahn CL, Estus C, Millar BA, Carter JL, Wood CA. et al. Bidirectional communication between the brain and the immune system: Implications for physiological sleep and disorders with disrupted sleep. Neuroimmunomodulation 2006; 13 (5–6): 357-374.
• 41 Magnusson A, Boivin D. Seasonal affective disorder: An overview. Chronobiology International 2003; 20 (02) 189-207.
• 42 Majde JA, Krueger JM. Links between the innate immune system and sleep. Journal of Allergy and Clinical Immunology 2005; 116 (06) 1188-1198.
• 43 Manber R, Chambers AS. Insomnia and depression: A multifaceted interplay. Current Psychiatry Reports 2009; 11 (06) 437-442.
• 44 McClung CA. Circadian genes, rhythms and the biology of mood disorders. Pharmacology & Therapeutics 2007; 114 (02) 222-232.
• 45 McEwen BS. Allostasis and allostatic load: implications for neuropsychopharmacology. Neuropsychopharmacology 2000; 22 (02) 108-124.
• 46 McIsaac SA, Young AH. The role of hypothalamic pituitary-adrenal axis dysfunction in the etiology of depressive disorders. Drugs of Today 2009; 45 (02) 127-133.
• 47 Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: Effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Medicine Reviews 2008; 12 (03) 197-210.
• 48 Meijer JH, Schwartz WJ. In search of the pathways for light-induced pacemaker resetting in the suprachiasmatic nucleus. Journal of Biological Rhythms 2003; 18 (03) 235-249.
• 49 Mendoza J, Challet E. Brain clocks: From the suprachiasmatic nuclei to a cerebral network. Neuroscientist 2009; 15 (05) 477-488.
• 50 Miller AH, Maletic V, Raison CL. Inflammation and its discontents: The role of cytokines in the pathophysiology of major depression. Biological Psychiatry 2009; 65 (09) 732-741.
• 51 Monteleone P, Maj M. The circadian basis of mood disorders: Recent developments and treatment implications. European Neuropsychopharmacology 2008; 18 (10) 701-711.
• 52 Montgomery SA. Why do we need new and better antidepressants?. International Clinical Psychopharmacology 2006; 21: S1-S10.
• 53 Nishino S, Ripley B, Overeem S, Lammers GJ, Mignot E. Hypocretin (orexin) deficiency in human narcolepsy. Lancet 2000; 355 (9197): 39-40.
• 54 Nishino S. The hypothalamic peptidergic system, hypocretin/orexin and vigilance control. Neuropeptides 2007; 41 (03) 117-133.
• 55 Nutt D, Wilson S, Paterson L. Sleep disorders as core symtom of depression. Dialogues in Clinical Neuroscience 2008; 10 (04) 329-336.
• 56 Ohayon MM, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders. Journal of Psychiatric Research 2003; 37 (01) 9-15.
• 57 Oken BS, Salinsky MC, Elsas SM. Vigilance, alertness, or sustained attention: physiological basis and measurement. Clinical Neurophysiology 2006; 117 (09) 1885-1901.
• 58 Olbrich S. et al. Unstable EEG-vigilance in patients with cancer-related fatigue (CRF) in comparison to healthy controls. World J Biol Psychiatry. 2011 Epub ahead of print, doi: 10.3109/15622975.2010.545434.
• 59 Pandi-Perumal SR, Moscovitch A, Srinivasan V, Spence DW, Cardinali DP, Brown GM. Bidirectional communication between sleep and circadian rhythms and its implications for depression: Lessons from agomelatine. Progress in Neurobiology 2009; 88 (04) 264-271.
• 60 Pariante CM, Lightman SL. The HPA axis in major depression: classical theories and new developments. Trends in Neurosciences 2008; 31 (09) 464-468.
• 61 Perlis ML, Giles DE, Buysse DJ, Tu X, Kupfer DJ. Self-reported sleep disturbance as a prodromal symptom in recurrent depression. Journal of Affective Disorders 1997; 42 (2–3): 209-212.
• 62 Peyron C, Tighe DK, Van den Pol AN, de Lecea L, Heller HC, Sutcliffe JG. et al. Neurons containing hypocretin (orexin) project to multiple neuronal systems. Journal of Neuroscience 1998; 18 (23) 9996-10015.
• 63 Plante DT, Winkelman JW. Sleep disturbance in bipolar disorder: therapeutic implications. American Journal of Psychiatry 2008; 165 (07) 830-843.
• 64 Pollock VE, Schneider LS. Quantitative, waking EEG research on depression. Biological Psychiatry 1990; 27 (07) 757-780.
• 65 Porkka-Heiskanen T, Alanko L, Kalinchuk A, Stenberg D. Adenosine and sleep. Sleep Medicine Reviews 2002; 06 (04) 321-332.
• 66 Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages in human subjects. Washington, DC: National Institute of Health Publications 204, US Government Printing Office; 1968
• 67 Riedel M. et al. Häufigkeit und klinische Charakteristika von atypisch depressiven Symptomen. Nervenheilkunde 2009; 28 (04) 193-199.
• 68 Riemann D, Wiegand M, Berger M. Are there predictors for sleep-deprivation response in depressed-patients. Biological Psychiatry 1991; 29 (07) 707-710.
• 69 Riemann D, Berger M, Voderholzer U. Sleep and depression – results from psychobiological studies: an overview. Biological Psychology 2001; 57 (1–3): 67-103.
• 70 Riemann D, Voderholzer U. Primary insomnia: a risk factor to develop depression?. Journal of Affective Disorders 2003; 76 (1–3): 255-259.
• 71 Rosenwasser AM. Functional neuroanatomy of sleep and circadian rhythms. Brain Research Reviews 2009; 61 (02) 281-306.
• 72 Roth B. The clinical and theoretical importance of EEG rhythms corresponding to states of lowered vigilance. Electroencephalography & Clinical Neurophysiology 1961; 13: 395-399.
• 73 Sakurai T, Amemiya A, Ishii M, Matsuzaki I, Chemelli RM, Tanaka H. et al. Orexins and orexin receptors: A family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior. Cell 1998; 92 (04) 573-585.
• 74 Sakurai T. The neural circuit of orexin (hypocretin): maintaining sleep and wakefulness. Nature Reviews Neuroscience 2007; 08 (03) 171-181.
• 75 Santamaria J, Chiappa KH. The EEG of drowsiness in normal adults. Journal of Clinical Neurophysiology 1987; 04 (04) 327-382.
• 76 Saper CB, Fuller PM, Pedersen NP, Lu J, Scammell TE. Sleep state switching. Neuron 2010; 68 (06) 1023-1042.
• 77 Scammell TE, Gerashchenko DY, Mochizuki T, McCarthy MT, Estabrooke IV, Sears CA. et al. An adenosine A2a agonist increases sleep and induces Fos in ventrolateral preoptic neurons. Neuroscience 2001; 107 (04) 653-663.
• 78 Siegel JM. The Neurobiology of Sleep. Seminars in Neurology 2009; 29 (04) 277-296.
• 79 Simpson N, Dinges DF. Sleep and inflammation. Nutrition Reviews 2007; 65 (12) S244-S252.
• 80 Smith SM, Vale WW. The role of the hypothalamicpituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience 2008; 08 (04) 383-395.
• 81 Steiger A. Sleep and the hypothalamo-pituitary-adrenocortical system. Sleep Medicine Reviews 2002; 06 (02) 125-138.
• 82 Steiger A. Neurochemical regulation of sleep. Journal of Psychiatric Research 2007; 41 (07) 537-552.
• 83 Steiger A, Kimura M. Wake and sleep EEG provide biomarkers in depression. Journal of Psychiatric Research 2010; 44 (04) 242-252.
• 84 Stenberg D. Neuroanatomy and neurochemistry of sleep. Cellular and Molecular Life Sciences 2007; 64 (10) 1187-1204.
• 85 Sutcliffe JG, de Lecea L. The hypocretins: Excitatory neuromodulatory peptides for multiple homeostatic systems including sleep and feeding: A review. Journal of Neurochemistry 2000; 74: S24.
• 86 Thomson F, Craighead M. Innovative approaches for the treatment of depression: Targeting the HPA axis. Neurochemical Research 2008; 33 (04) 691-707.
• 87 Ulrich G, Brand C. Dynamically rigid EEG and subtyping of depressive syndromes. European Psychiatry 1993; 08: 25-34.
• 88 Ulrich G. Psychiatrische Elektroenzephalographie. Jena: Gustav Fischer; 1994
• 89 Ulrich G, Fuerstenberg U. Quantitative assessment of dynamic electroencephalogram (EEG) organization as a tool for subtyping depressive syndromes. European Psychiatry 1999; 14: 217-229.
• 90 von Känel R. Normaler und gestörter Schlaf. In: Ehlert U, von Känel R. Psychoendokrinologie und Psychoimmunologie. Berlin: Springer; 2011: 247-266.
• 91 Weinberg WA, Harper CR. Vigilance and its disorders. Neurologic Clinics 1993; 11 (01) 59-78.
• 92 Westrin A, Lam RW. Seasonal affective disorder: a clinical update. Annals of Clinical Psychiatry 2007; 19 (04) 239-246.
• 93 Winkler D, Pjrek E, Iwaki R, Kasper S. Treatment of seasonal affective disorder. Expert Reviews of Neurotherapeutics 2006; 06 (07) 1039-1048.
• 94 Winsky-Sommerer R, Boutrel B, de Lecea L. Stress and arousal – the corticotrophin-releasing factor/ hypocretin circuitry. Molecular Neurobiology 2005; 32 (03) 285-294.
• 95 Wirz-Justice A, Van den Hoofdakker RH. Sleep deprivation in Depression: What do we know, where do we go?. Biological Psychiatry 1999; 46 (04) 445-453.
• 96 Wirz-Justice A. Diurnal variation of depressive symptoms. Dialogues in Clinical Neuroscience 2008; 10 (03) 337-343.
• 97 Schmidt FM. et al. Die Rolle der Hypocretine bei affektiven Störungen. Nervenheilkunde 2011; 30: 893-898.
• 98 Schönherr J. et al. Zytokinproduktion in vitro unter Einfluss von Antidepressiva. Nervenheilkunde 2011; 30: 884-892.