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首页> 外文期刊>The European Journal of Neuroscience >Perspectives in affective disorders: Clocks and sleep
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Perspectives in affective disorders: Clocks and sleep

机译：情感障碍的透视：时钟和睡眠

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Mood disorders are often characterised by alterations in circadian rhythms, sleep disturbances and seasonal exacerbation. Conversely, chronobiological treatments utilise zeitgebers for circadian rhythms such as light to improve mood and stabilise sleep, and manipulations of sleep timing and duration as rapid antidepressant modalities. Although sleep deprivation ("wake therapy") can act within hours, and its mood-elevating effects be maintained by regular morning light administration/medication/earlier sleep, it has not entered the regular guidelines for treating affective disorders as a first-line treatment. The hindrances to using chronotherapeutics may lie in their lack of patentability, few sponsors to carry out large multi-centre trials, non-reimbursement by medical insurance and their perceived difficulty or exotic "alternative" nature. Future use can be promoted by new technology (single-sample phase measurements, phone apps, movement and sleep trackers) that provides ambulatory documentation over long periods and feedback to therapist and patient. Light combinations with cognitive behavioural therapy and sleep hygiene practice may speed up and also maintain response. The urgent need for new antidepressants should hopefully lead to reconsideration and implementation of these non-pharmacological methods, as well as further clinical trials. We review the putative neurochemical mechanisms underlying the antidepressant effect of sleep deprivation and light therapy, and current knowledge linking clocks and sleep with affective disorders: neurotransmitter switching, stress and cortico-limbic reactivity, clock genes, cortical neuroplasticity, connectomics and neuroinflammation. Despite the complexity of multi-system mechanisms, more insight will lead to fine tuning and better application of circadian and sleep-related treatments of depression.
机译：情绪障碍通常是通过昼夜节律，睡眠障碍和季节性加剧的改变的特征。相反，时间计量治疗利用Zeitgebers进行昼夜节律，如光，以改善情绪和稳定睡眠，以及操纵睡眠时序和持续时间作为快速抗抑郁方式。虽然睡眠剥夺（“Wake Therapy”）可以在几小时内采取行动，但其情绪升高的效果通过常规早晨的晨光/药物/早期睡眠来维持，它还没有进入常规指导原则，将情感障碍视为一线治疗。使用计时器的障碍可能缺乏可专利性，很少有赞助商能够进行大量的多中心试验，由医疗保险和他们的感知困难或异国情调的“替代”性质。未来的使用可以通过新技术（单样式阶段测量，电话应用，移动和睡眠跟踪器）促进，这些技术提供长期长期的动态文件和对治疗师和患者的反馈。具有认知行为治疗和睡眠卫生实践的光组合可以加速并保持反应。新的抗抑郁药的迫切需要应该导致这些非药物方法的重新考虑和实施，以及进一步的临床试验。我们审查了睡眠剥夺和光疗的抗抑郁效果的推定神经化学机制，以及当前知识与情感疾病联系起钟和睡眠：神经递质切换，应力和皮质 - 肢体反应性，时钟基因，皮质神经塑性，Connectomics和神经源性。尽管多系统机制的复杂性，但更多的洞察力将导致微调和更好地应用昼夜睡眠和睡眠抑郁症的治疗。

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