Basis Neurobiologi Depresi

8/20/2019 Basis Neurobiologi Depresi

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Basis NeurobiologiGangguan Mood

Oleh:

Dr. H. Jaya Mualimin,

SpKJ,Mkes.


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WHAT CAUSE GANGGUAN MOOD?

• he !ause o" bipolar disorder is no# en#irely kno$n

• Gene#i!, neuro%!hemi!al and en&ironmen#al"a!#ors probably in#era!# a# many le&els #o play arole in #he onse# and progression o" bipolardisorder

• he !urren# #hinking is #ha# #his is a predominan#lybiologi!al disorder #ha# o!!urs in a spe!i'! par# o"#he brain and is due #o a mal"un!#ion o" #heneuro#ransmi##ers (!hemi!al messengers in #hebrain)

• *s a biologi!al disorder, i# may lie dorman# and bea!#i&a#ed spon#aneously or i# may be #riggered bys#ressors in li"e


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umbuh%Kembang O#ak

• Gopni!k et. al. (+)→hipo#esis -aringankabel #elepon

/0 gr

1/00sinap2neur

on

+000 gr

+/000sinap2neur

on

+100%+300 gr

+00 Milyarneuron

Sinap 444


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Neuron dan koneksi sinap#ik

Impuls dari

neuron lain

Transmisi

Impuls

saraf

Pembebasan

zat hantar saraf

Hebb Rule’s

The New Born Brain 2002, p 208


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Mekanisme%mekanisme neuroplas#isi#as

• Prunning

• Apoptosis

• Sprouting – Collateral sprouting

• Heterotypic• Homotypic

Seeman P. Brain development. Am J Psych

1!1"#$2%&1#8


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5a#hopsikologis Neuron

GenesMul#iple

sus!ep#ibili#yalleles ea!h o"small e6e!#7BDN8, B!l%1,dia!ylgly!erolkinasee#a

EpigeneticsGene and 5ro#ein

9pression,e.g., BDN8 le&elsredu!ed duringdepression,mania,Oida#i&e s#ress

Cells:Mul#iple

glialandneuronalabnormali#ies7mi#o!hondrialdys"un!#ion

Systems:*bnormal "un!#ion andin"orma#ion pro!essing

;n mul#iple, in#era!#ing!ir!ui#sBipolarDisorders

Behavi!:


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Ne"!t!pi# Se$agai %at&silgi De&sit 'gniti( pa)a GB


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Hipo#esis• *i!st messenge!:

– De'!ien!y monoamin neuro#ransmi##er

– Se!tnine +,-HT.-N!epineph!ine +NE.-Dpamine +DA. – Glu#ama#e%G*B*

– ;on !hannel: Na?7


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B i A th t 3 l t M )


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B!ain A!eas that 3eg"late M)• *C: *!ntal c!te4 +esp5

p!e(!ntal an) cing"late.-cgnitive ("nctin2 attentin

• H%: 6ent!al Hippcamp"s-cgnitive ("nctin2 mem!y

• NAc: N"cle"sAcc"m$ens+vent!al st!iat"m.-!e7a!) an) ave!sin

• Amy: Amyg)ala-me)iates!espnses t emtinalstim"li

• H8%: Hypthalam"s !eg"latessleep2 appetite2 ene!gy2 se4

• 6TA: 6ent!al TegmentalA!ea-Sen)s)pamine!gicp!9ectins t

the! a!eas

• D3: D!sal 3aphen"clei -sen)se!tne!gicinp"t t the!a!eas

• C: c"s Ce!"le"s-sen)sn!a)!ene!gic inp"t t the!a!eas5


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% $ h St #t Ot #


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%e!"$ahan St!"#t"! Ota#pa)a GB

%ele$a!an vent!i#el late!al ata"ventricular/brain ratios (VBRs) ↑↑(1)

Ventrikel lateral pada Lk >> Wt

Volume lobus temporal medial↓↓pada GB vs kontrol ditemukan pula pada keadaan eutim (!)

Rata"rata VBRmenin#katsecarabermaknasetela$%ta$un (%)+.*ndreasenN


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%at&silgi De&sit 'gniti( pa)a GB


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5eranan BDN8 pada 5erubahan Neuron


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De&sit 'gniti( %enan)a Si(at GB

De&sit #gniti( te!lihat pa)a sta)i"m

a7al penya#it +;.

Te!)apat pa)a #el"a!ga #an)"ng yangti)a# GB tetapi memp"nyai pe!samaan#e!entanan geneti# +


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De&sit'gniti(pa)aDep!esiBipla! 6S Unipla!

8ungsi

ekseku#i"Memori

* # N i# ) GB


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*a#t! Ne"!t!pi# pa)a GB

BDN*2 NG*2 )an *N*

Di hip#amp"s )an #!te#s se!e$!iHip#amp"s $e!pe!anan penting

)alam mood dan memori

Volume berkuran# pada depresi &entin# dalam kelan#sun#an $idup

G'B' ' * dan +erotonin

B,-men#aturmooddanko#niti.-padaGB-↓↓


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#erimakasih

Basis Neurobiologi Depresi

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