Zusammenfassung
Im Gegensatz zur vorherrschenden Lehrmeinung der 80er-Jahre zeichnet sich heute ab, dass die grundsätzliche Formbarkeit (so genannte Neuroplastizität) des menschlichen Gehirns im Normalfall ein lebenslanges Phänomen darstellt. Repräsentationen der Umgebung bilden sich im Gehirn auf neuronaler Ebene ab, werden stabilisiert, verschwinden wieder oder ändern sich. Diese Neuroplastizität geht mit Veränderungen der Biochemie der Synapsen und konsekutiv mit Veränderungen der Mikrostruktur des Gehirns einher. Neben Glutamat und Gamma-Amino-Buttersäure (GABA) nehmen Dopamin und Serotonin, aber auch Endorphine und Enkephaline und die dazugehörigen Nervenzellsysteme dabei eine Schlüsselstellung ein. Sie beeinflussen auf der Mikroebene neuronale Plastizität und modulieren auf der Systemebene beispielsweise Stimmung, wirken auf Emotionen, positive Motivation oder auf die Bewertung von Umweltreizen. Erleben, Handeln und Gestalten sowie Veränderungsprozesse im Rahmen des Lernens werden dadurch beeinflusst. Neuroplastizität verändert über diese Mechanismen kortikale und subkortikale Repräsentationen („Funktionslandkarten”). Jeder epileptische Anfall erhöht aber auch die Wahrscheinlichkeit eines weiteren epileptischen Anfalls und jede depressive Episode die Wahrscheinlichkeit einer nächsten. Vergleichbare neuronale Mechanismen finden auch statt, wenn jemand sich einer Psychotherapie oder Rehabilitation unterzieht. Im Rahmen des Beitrags werden grundlegende Mechanismen der neuronalen Plastizität im Rahmen von Lernen und Gedächtnisbildung dargestellt, und es wird versucht, diese in den Kontext sozialpsychiatrischer Interventionen zu setzen.
Abstract
In contrast to the opinion that prevailed in the 1980es, there is now increasing evidence that the plasticity of the human brain, i. e. its remarkable ability to adapt to and change with experience, is, under normal conditions, a lifelong phenomenon. Representations of the environment are associated with activations and biochemical modifications in neuronal networks, which will be stabilized, modified or will wither in the course of cumulated experience. The capability to modify the biochemistry of synapses as well as the growth and change in terms of rewiring of synapses, dendritic branching and glial cell proliferation via the dialogue of synapses and genes, results in specific changes in neuronal connectivity and function. On the neurotransmitter level, glutamate and gamma-amino-butyric acid (GABA) as well as dopamine and serotonin, but also endorphin and encephalin, have a key position in this context. These neurotransmitter systems modulate neuronal plasticity on the neuronal level; on the behavioural level they influence affect, emotion, positive motivation and the correct evaluation of environmental stimuli. Experience, action as well as learning and memory are influenced by these systems. A basic thesis of this paper is that these mechanisms are involved in neuronal plasticity and that learning and memory are thus not only used and reused in structuring the CNS during the initial establishment of connections in the immature brain, in lifelong memory consolidation or the rewiring after brain damage, but can also be used to mould experience, learning und behaviour during psychotherapy and rehabilitation in adults.
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Univ.-Prof. Dr. Dieter F. Braus
NeuroImage Nord und Klinik und Poliklinik für Psychiatrie und Psychotherapie · Universitätsklinikum Hamburg-Eppendorf (UKE)
Martinistraße 52
20246 Hamburg
eMail: dbraus@uke.uni-hamburg.de
