Chronic Neuropathic Pain and Comorbid Depression Syndrome: From Neural Circuit Mechanisms to Treatment.

Chronic neuropathic pain and comorbid depression syndrome (CDS) is a major global health problem affecting quality of life and imposing a large socioeconomic burden. More than half of patients with chronic neuropathic pain also suffer from moderate or severe depression. The complex causes of CDS and limited research on its neural circuit mechanisms hinder effective treatments. Activating some neural circuits can alleviate pain or depression, while activating others worsens these conditions. Current and emerging pharmacotherapies, such as ketamine, are discussed. Understanding the circuit mechanisms may guide development of new drugs for better CDS management.

Study at a glance

Abstract

Chronic neuropathic pain and comorbid depression syndrome (CDS) is a major worldwide health problem that affects the quality of life of patients and imposes a tremendous socioeconomic burden. More than half of patients with chronic neuropathic pain also suffer from moderate or severe depression. Due to the complex pathogenesis of CDS, there are no effective therapeutic drugs available. The lack of research on the neural circuit mechanisms of CDS limits the development of treatments. The purpose of this article is to provide an overview of the various circuits involved in CDS. Notably, activating some neural circuits can alleviate pain and/or depression, while activating other circuits can exacerbate these conditions. Moreover, we discuss current and emerging pharmacotherapies for CDS, such as ketamine. Understanding the circuit mechanisms of CDS may provide clues for the development of novel drug treatments for improved CDS management.