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The Impact of Stress and Major Depressive Disorder on Hippocampal and Medial Prefrontal Cortex Morphology. Biol Psychiatry 2019; 85:443-453. [PMID: 30470559 PMCID: PMC6380948 DOI: 10.1016/j.biopsych.2018.09.031] [Citation(s) in RCA: 273] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/25/2018] [Accepted: 09/10/2018] [Indexed: 02/07/2023]
Abstract
Volumetric reductions in the hippocampus and medial prefrontal cortex (mPFC) are among the most well-documented neural abnormalities in major depressive disorder (MDD). Hippocampal and mPFC structural reductions have been specifically tied to MDD illness progression markers, including greater number of major depressive episodes (MDEs), longer illness duration, and nonremission/treatment resistance. Chronic stress plays a critical role in the development of hippocampal and mPFC deficits, with some studies suggesting that these deficits occur irrespective of MDE occurrence. However, preclinical and human research also points to other stress-mediated neurotoxic processes, including enhanced inflammation and neurotransmitter disturbances, which may require the presence of an MDE and contribute to further brain structural decline as the illness advances. Specifically, hypothalamic-pituitary-adrenal axis dysfunction, enhanced inflammation and oxidative stress, and neurotransmitter abnormalities (e.g., serotonin, glutamate, gamma-aminobutyric acid) likely interact to facilitate illness progression in MDD. Congruent with stress sensitization models of MDD, with each consecutive MDE it may take lower levels of stress to trigger these neurotoxic pathways, leading to more pronounced brain volumetric reductions. Given that stress and MDD have overlapping and distinct influences on neurobiological pathways implicated in hippocampal and mPFC structural decline, further work is needed to clarify which precise mechanisms ultimately contribute to MDD development and maintenance.
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Ott CV, Johnson CB, Macoveanu J, Miskowiak K. Structural changes in the hippocampus as a biomarker for cognitive improvements in neuropsychiatric disorders: A systematic review. Eur Neuropsychopharmacol 2019; 29:319-329. [PMID: 30654916 DOI: 10.1016/j.euroneuro.2019.01.105] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/19/2018] [Accepted: 01/06/2019] [Indexed: 02/07/2023]
Abstract
Cognitive impairments are a core feature of several neuropsychiatric disorders. A common biomarker for pro-cognitive effects may provide a much-needed tool to select amongst candidate treatments targeting cognition. The hippocampus is a promising biomarker for target-engagement due to the illness-associated morphological hippocampal changes across unipolar disorder (UD), bipolar disorder (BD) and schizophrenia (SCZ). Following the PRISMA guidelines, we searched PubMed and Embase, for clinical trials targeting cognition across neuropsychiatric disorders, with longitudinal structural magnetic resonance imaging (MRI) measures of the hippocampus. Five randomized and three open-label trials were included. Hippocampal volume increases were associated with treatment-related cognitive improvement following treatment with erythropoietin across UD, BD and SCZ, lithium treatment in BD and aerobic exercise in SCZ. Conversely, an exercise intervention in UD showed no effect on hippocampal volume or cognition. Together, these observations point to hippocampal volume change as a putative biomarker-model for cognitive improvement. Future cognition trials are encouraged to include MRI assessments pre- and post-treatment to assess the validity of hippocampal changes as a biomarker for pro-cognitive effects.
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Affiliation(s)
- Caroline Vintergaard Ott
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, 2100 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark
| | - Claire Bergstrom Johnson
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, 2100 Copenhagen, Denmark
| | - Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, 2100 Copenhagen, Denmark
| | - Kamilla Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Edel Sauntes Allé 10, 2100 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark.
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Zhou C, Chao F, Zhang Y, Jiang L, Zhang L, Fan J, Wu Y, Dou X, Tang Y. Fluoxetine delays the cognitive function decline and synaptic changes in a transgenic mouse model of early Alzheimer's disease. J Comp Neurol 2019; 527:1378-1387. [DOI: 10.1002/cne.24616] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Chun‐ni Zhou
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of EducationChongqing Medical University Chongqing China
| | - Feng‐lei Chao
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
| | - Yi Zhang
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of EducationChongqing Medical University Chongqing China
| | - Lin Jiang
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of EducationChongqing Medical University Chongqing China
| | - Lei Zhang
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
| | - Jin‐hua Fan
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of EducationChongqing Medical University Chongqing China
| | - Yong‐xin Wu
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
- Department of Laboratory Medicine, Key Laboratory of Diagnostic Medicine, Ministry of EducationChongqing Medical University Chongqing China
| | - Xiao‐yun Dou
- Institute of Life SciencesChongqing Medical University Chongqing China
| | - Yong Tang
- Department of Histology and EmbryologyChongqing Medical University Chongqing China
- Laboratory of Stem Cell and Tissue EngineeringChongqing Medical University Chongqing China
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Nandam LS, Brazel M, Zhou M, Jhaveri DJ. Cortisol and Major Depressive Disorder-Translating Findings From Humans to Animal Models and Back. Front Psychiatry 2019; 10:974. [PMID: 32038323 PMCID: PMC6987444 DOI: 10.3389/fpsyt.2019.00974] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/09/2019] [Indexed: 12/15/2022] Open
Abstract
Major depressive disorder (MDD) is a global problem for which current pharmacotherapies are not completely effective. Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has long been associated with MDD; however, the value of assessing cortisol as a biological benchmark of the pathophysiology or treatment of MDD is still debated. In this review, we critically evaluate the relationship between HPA axis dysfunction and cortisol level in relation to MDD subtype, stress, gender and treatment regime, as well as in rodent models. We find that an elevated cortisol response to stress is associated with acute and severe, but not mild or atypical, forms of MDD. Furthermore, the increased incidence of MDD in females is associated with greater cortisol response variability rather than higher baseline levels of cortisol. Despite almost all current MDD treatments influencing cortisol levels, we could find no convincing relationship between cortisol level and therapeutic response in either a clinical or preclinical setting. Thus, we argue that the absolute level of cortisol is unreliable for predicting the efficacy of antidepressant treatment. We propose that future preclinical models should reliably produce exaggerated HPA axis responses to acute or chronic stress a priori, which may, or may not, alter baseline cortisol levels, while also modelling the core symptoms of MDD that can be targeted for reversal. Combining genetic and environmental risk factors in such a model, together with the interrogation of the resultant molecular, cellular, and behavioral changes, promises a new mechanistic understanding of MDD and focused therapeutic strategies.
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Affiliation(s)
- L. Sanjay Nandam
- Mental Health Unit, Prince Charles Hospital, Brisbane, QLD, Australia
- *Correspondence: L. Sanjay Nandam, ; Dhanisha J. Jhaveri,
| | - Matthew Brazel
- Mental Health Unit, Prince Charles Hospital, Brisbane, QLD, Australia
- Department of Psychiatry, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Mei Zhou
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Dhanisha J. Jhaveri
- Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: L. Sanjay Nandam, ; Dhanisha J. Jhaveri,
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Chakrabarty B, Sud K, Goyal S. Hippocampal volume alteration in medication-naive depression patients in comparison to healthy individuals: An Indian perspective. JOURNAL OF MARINE MEDICAL SOCIETY 2019. [DOI: 10.4103/jmms.jmms_19_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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56
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Høifødt RS, Waterloo K, Wang CEA, Eisemann M, Figenschau Y, Halvorsen M. Cortisol levels and cognitive profile in major depression: A comparison of currently and previously depressed patients. Psychoneuroendocrinology 2019; 99:57-65. [PMID: 30176378 DOI: 10.1016/j.psyneuen.2018.08.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
The association between depressive symptoms and elevated cortisol levels, and depression and cognitive functioning, has been less robust in outpatients with symptoms in the mild to moderate range. Furthermore, the association between elevated cortisol levels and cognitive functioning is unclear. In the present study, currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50) were assessed on a range of neuropsychological measures. Salivary cortisol was measured in the morning and evening. Participants with current depression were non-hospitalized and had symptoms predominately in the mild to moderate range. Elevated salivary evening cortisol, but not morning cortisol, was significantly related to depressive symptoms. The difference in cortisol levels between the previously depressed group and the never depressed controls was not significant. The groups had significantly different cognitive profiles, with the currently depressed performing poorer on tasks related to working memory compared to the never depressed controls. Both the currently and previously depressed performed worse on attentional tasks. The findings indicate that outpatients with mild to moderate depression have elevated cortisol levels and limited mild cognitive impairments. Furthermore, mild impairments in attention may persist after remission, indicating that this could be a trait-marker in depression. The present study did not find support for a significant relationship between cortisol and cognitive functioning.
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Affiliation(s)
- Ragnhild Sørensen Høifødt
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Division of Mental Health and Addiction, University Hospital of North Norway, Tromsø, Norway.
| | - Knut Waterloo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Catharina E A Wang
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Martin Eisemann
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yngve Figenschau
- Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Laboratory Medicine, Diagnostic Clinic, University Hospital of North Norway, Tromsø, Norway
| | - Marianne Halvorsen
- Department of Pediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
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Echouffo-Tcheugui JB, Conner SC, Himali JJ, Maillard P, DeCarli CS, Beiser AS, Vasan RS, Seshadri S. Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study. Neurology 2018; 91:e1961-e1970. [PMID: 30355700 DOI: 10.1212/wnl.0000000000006549] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/10/2018] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To assess the association of early morning serum cortisol with cognitive performance and brain structural integrity in community-dwelling young and middle-aged adults without dementia. METHODS We evaluated dementia-free Framingham Heart Study (generation 3) participants (mean age 48.5 years, 46.8% men) who underwent cognitive testing for memory, abstract reasoning, visual perception, attention, and executive function (n = 2,231) and brain MRI (n = 2018) to assess total white matter, lobar gray matter, and white matter hyperintensity volumes and fractional anisotropy (FA) measures. We used linear and logistic regression to assess the relations of cortisol (categorized in tertiles, with the middle tertile as referent) to measures of cognition, MRI volumes, presence of covert brain infarcts and cerebral microbleeds, and voxel-based microstructural white matter integrity and gray matter density, adjusting for age, sex, APOE, and vascular risk factors. RESULTS Higher cortisol (highest tertile vs middle tertile) was associated with worse memory and visual perception, as well as lower total cerebral brain and occipital and frontal lobar gray matter volumes. Higher cortisol was associated with multiple areas of microstructural changes (decreased regional FA), especially in the splenium of corpus callosum and the posterior corona radiata. The association of cortisol with total cerebral brain volume varied by sex (p for interaction = 0.048); higher cortisol was inversely associated with cerebral brain volume in women (p = 0.001) but not in men (p = 0.717). There was no effect modification by the APOE4 genotype of the relations of cortisol and cognition or imaging traits. CONCLUSION Higher serum cortisol was associated with lower brain volumes and impaired memory in asymptomatic younger to middle-aged adults, with the association being evident particularly in women.
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Affiliation(s)
- Justin B Echouffo-Tcheugui
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio.
| | - Sarah C Conner
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Jayandra J Himali
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Pauline Maillard
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Charles S DeCarli
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Alexa S Beiser
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Ramachandran S Vasan
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
| | - Sudha Seshadri
- From the Division of Endocrinology, Diabetes and Hypertension (J.B.E.-T.), Brigham and Women's Hospital/Harvard Medical School, Boston; National Heart, Lung, and Blood Institute (J.B.E.-T., S.C.C., J.J.H., A.S.B., R.S.V., S.S.), Framingham Heart Study, MA; Department of Neurology (S.C.C., J.J.H., A.S.B., S.S.) and Sections of Preventive Medicine and Epidemiology (R.S.V.) and Cardiology (R.S.V.), Department of Medicine, Boston University School of Medicine; Departments of Biostatistics (J.J.H., A.S.B.) and Epidemiology (R.S.V.), Boston University School of Public Health, MA; Department of Neurology (P.M., C.S.D.), University of California, Davis, Sacramento; and Glenn Biggs Institute of Alzheimer's and Neurodegenerative Diseases (S.S.), University of Texas Health Sciences Center, San Antonio
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Lu XW, Guo H, Sun JR, Dong QL, Zhao FT, Liao XH, Zhang L, Zhang Y, Li WH, Li ZX, Liu TB, He Y, Xia MR, Li LJ. A shared effect of paroxetine treatment on gray matter volume in depressive patients with and without childhood maltreatment: A voxel-based morphometry study. CNS Neurosci Ther 2018; 24:1073-1083. [PMID: 30277663 DOI: 10.1111/cns.13055] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 12/28/2022] Open
Abstract
AIMS This study assessed whether antidepressant drug treatment has a common effect on gray matter (GM) volume in MDD patients with and without childhood maltreatment (CM). METHODS T1-weighted structural magnetic resonance imaging data were collected from 168 participants, including 51 MDD patients with CM, 31 MDD patients without CM, 48 normal controls with CM, and 38 normal controls without CM. MDD patients received 6 months of treatment with paroxetine, and 24 patients with CM, and 16 patients without CM received a second MRI scan. A whole-brain voxel-based morphometry approach was used to estimate GM volume in each participant at two time points. Two-way analysis of variance (ANOVA) was used to determine the effects of MDD and CM on GM volume at baseline. Repeated measures two-way ANOVA was used to determine the treatment-by-CM interactive effect and main effect of treatment during paroxetine treatment. We further investigated the relationship between GM volume and clinical variables. RESULTS At baseline, significant MDD-by-CM interactive effects on GM volume were mainly observed in the left parahippocampal gyrus, left entorhinal cortex, and left cuneus. GM volume was significantly lower mainly in the right middle temporal gyrus in patients with MDD than in normal controls. We did not find any significant treatment-by-CM interactive effects. However, a treatment-related increase in GM was found in the right middle temporal gyrus in both MDD groups. CONCLUSIONS These results suggest that paroxetine treatment operates via a shared neurobiological mechanism in MDD patients with and without CM.
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Affiliation(s)
- Xiao-Wen Lu
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Hua Guo
- Zhumadian Psychiatry Hospital, Zhumadian, China
| | - Jing-Rong Sun
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Qiang-Li Dong
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Fu-Tao Zhao
- Zhumadian Psychiatry Hospital, Zhumadian, China
| | - Xu-Hong Liao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Li Zhang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yan Zhang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Wei-Hui Li
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Ze-Xuan Li
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | | | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Ming-Rui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Ling-Jiang Li
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China.,Shenzhen Mental Health Center, Shenzhen, China
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59
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Moore A, Beidler J, Hong MY. Resveratrol and Depression in Animal Models: A Systematic Review of the Biological Mechanisms. Molecules 2018; 23:E2197. [PMID: 30200269 PMCID: PMC6225181 DOI: 10.3390/molecules23092197] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/25/2018] [Accepted: 08/28/2018] [Indexed: 12/20/2022] Open
Abstract
Depression is currently treated by pharmacotherapies that can elicit debilitating side effects for patients. Novel treatment options with limited side effects are currently being researched. Resveratrol is a polyphenol and phytoalexin found in the skins of grapes, red wine, Japanese knotweed, and peanuts. It has been studied extensively for its antioxidant and anti-inflammatory properties. Resveratrol has also gained attention for its neuroprotective properties. The aim of the review was to examine the mechanisms by which resveratrol reduces depressive behaviors in animal models. In total, 22 studies met the established criteria for final review. Behavioral aspects of depression were investigated using validated measures such as the forced swimming test, tail suspension test, sucrose preference test, and open field test. While many physical measures were taken, three main biological mechanisms were explored: Regulation of the hypothalamic⁻pituitary⁻adrenal axis; decreased inflammation; and increased Brain-Derived Neurotrophic Factor and neurogenesis. Based on these findings, resveratrol may be deemed an effective treatment for depression in animal models at doses between 10⁻80 mg/kg/day, although higher doses had the most significant effects. Future studies should examine the effects of resveratrol on depression in humans to determine the eligibility of resveratrol as a natural antidepressant with less severe side effects.
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Affiliation(s)
- Alyssa Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA.
| | - Joshua Beidler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA.
| | - Mee Young Hong
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA.
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Lax NC, Parker SAJ, Hilton EJ, Seliman Y, Tidgewell KJ, Kolber BJ. Cyanobacterial extract with serotonin receptor subtype 7 (5-HT 7 R) affinity modulates depression and anxiety-like behavior in mice. Synapse 2018; 72:e22059. [PMID: 29992647 DOI: 10.1002/syn.22059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/15/2018] [Accepted: 07/06/2018] [Indexed: 12/20/2022]
Abstract
Marine cyanobacteria represent a unique source in the field of drug discovery due to the secondary metabolites they produce and the structural similarity these compounds have to endogenous mammalian receptor ligands. A series of cyanobacteria were subjected to extraction, fractionation by column chromatography and screened for affinity against CNS targets with a focus on serotonin receptors (5-HTRs). Out of 276 fractions screened, 21% had activity at 5-HTRs and/or the 5-HT transporter (SERT). One sample, a cyanobacterium identified by 16S rRNA sequencing as Leptolyngbya from Las Perlas archipelago in Panama, contained a fraction with noted affinity for the 5-HT7 receptor (5-HT7 R). This fraction (DUQ0002I) was screened via intracerebroventricular (ICV) injections in mice using depression and anxiety assays including the forced swim, tail suspension, elevated zero maze, and light-dark preference tests. DUQ0002I decreased depression and anxiety-like behaviors in males and did not have effects in 5-HT7 R knockout or female mice. Administration of DUQ0002I to the CA1 of the hippocampus induced antidepression-like, but not anxiolytic-like behaviors. Testing of further purified materials showed no behavioral effects, leading us to hypothesize that the behavioral effects are likely caused by a synergistic effect between multiple compounds in the fraction. Finally, DUQ0002I was used in a model of neuropathic pain with comorbid depression (spared nerve injury-SNI). DUQ0002I had a similar antidepressant effect in animals with SNI, suggesting a role for the 5-HT7 R in the development of comorbid pain and depression. These results demonstrate the potential that cyanobacterial metabolites have in the field of neuropharmacognosy.
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Affiliation(s)
- Neil C Lax
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
| | - Stacy-Ann J Parker
- Mylan School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
| | - Edward J Hilton
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
| | - Youstina Seliman
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
| | - Kevin J Tidgewell
- Mylan School of Pharmacy, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
| | - Benedict J Kolber
- Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania.,Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania
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61
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Ouellette SJ, Hampson E. Memory and affective changes during the antepartum: A narrative review and integrative hypothesis. J Clin Exp Neuropsychol 2018; 41:87-107. [DOI: 10.1080/13803395.2018.1485881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Sarah J. Ouellette
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Elizabeth Hampson
- Department of Psychology, University of Western Ontario, London, ON, Canada
- Graduate Program in Neuroscience, University of Western Ontario, London, ON, Canada
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Sanacora G, Katz R. Ketamine: A Review for Clinicians. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2018; 16:243-250. [PMID: 31975918 DOI: 10.1176/appi.focus.20180012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A growing series of clinical trials and case series now suggest that ketamine-originally used as an anesthetic agent-potentially offers an exciting new treatment option for severe depression. Increasing numbers of studies show that ketamine can provide prompt relief for many depressed patients, including those with severe treatment-refractory depression. Although the effects of a single treatment are commonly short-lived, multiple infusion protocols may offer sustained relief. The uniquely rapid onset of antidepressant action raises the potential for ketamine use in a variety of clinical situations, including the prevention or shortening of hospital stays, the treatment of acute suicidal ideation, and the facilitation of medication crossovers. Ketamine, in combination with other multimodal treatment approaches, including psychotherapy, may further augment response effect and duration. Promises of efficacy have led to increasingly unbridled use to treat a variety of psychiatric disorders, with diverse approaches and treatment environments, despite inadequate data demonstrating the true clinical efficacy and safety of the various protocols or a thorough understanding of mechanisms of action. This article briefly reviews the history of ketamine's development as a potential antidepressant, current hypotheses related to its mechanisms of action, and existing evidence for its safety and efficacy with a focus on clinicians' interests.
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Affiliation(s)
- Gerard Sanacora
- Drs. Sanacora and Katz are both with the Yale Department of Psychiatry, Yale University, New Haven CT, and the Yale Interventional Psychiatry Service, Yale New Haven Psychiatric Hospital, New Haven, CT
| | - Rachel Katz
- Drs. Sanacora and Katz are both with the Yale Department of Psychiatry, Yale University, New Haven CT, and the Yale Interventional Psychiatry Service, Yale New Haven Psychiatric Hospital, New Haven, CT
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Tolahunase MR, Sagar R, Faiq M, Dada R. Yoga- and meditation-based lifestyle intervention increases neuroplasticity and reduces severity of major depressive disorder: A randomized controlled trial. Restor Neurol Neurosci 2018; 36:423-442. [DOI: 10.3233/rnn-170810] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Madhuri R. Tolahunase
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Muneeb Faiq
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rima Dada
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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The immunomodulatory tellurium compound ammonium trichloro (dioxoethylene-O,O') tellurate reduces anxiety-like behavior and corticosterone levels of submissive mice. Behav Pharmacol 2018; 28:458-465. [PMID: 28590303 DOI: 10.1097/fbp.0000000000000319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ammonium trichloro (dioxoethylene-O,O') tellurate (AS101) is a synthetic organotellurium compound with potent immunomodulatory and neuroprotective properties shown to inhibit the function of integrin αvβ3, a presynaptic cell-surface-adhesion receptor. As partial deletion of αvβ3 downregulated reuptake of serotonin by the serotonin transporter, we hypothesized that AS101 may influence pathways regulating anxiety. AS101 was tested in the modulation of anxiety-like behavior using the selectively bred Submissive (Sub) mouse strain that develop anxiety-like behavior in response to an i.p. injection. Mice were treated daily with AS101 (i.p., 125 or 200 μg/kg) or vehicle for 3 weeks, after which their anxiety-like behavior was measured in the elevated plus maze. Animals were then culled for the measurement of serum corticosterone levels by ELISA and hippocampal expression of brain-derived neurotrophic factor (BDNF) by RT-PCR. Chronic administration of AS101 significantly reduced anxiety-like behavior of Sub mice in the elevated plus maze, according to both time spent and entries to open arms, relative to vehicle-treated controls. AS101 also markedly reduced serum corticosterone levels of the treated mice and increased their hippocampal BDNF expression. Anxiolytic-like effects of AS101 may be attributed to the modulation of the regulatory influence integrin of αvβ3 upon the serotonin transporter, suggesting a multifaceted mechanism by which AS101 buffers the hypothalamic-pituitary-adrenal axis response to injection stress, enabling recovery of hippocampal BDNF expression and anxiety-like behavior in Sub mice. Further studies should advance the potential of AS101 in the context of anxiety-related disorders.
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Ortiz JB, Conrad CD. The impact from the aftermath of chronic stress on hippocampal structure and function: Is there a recovery? Front Neuroendocrinol 2018; 49:114-123. [PMID: 29428548 DOI: 10.1016/j.yfrne.2018.02.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 12/18/2022]
Abstract
Chronic stress results in functional and structural changes to the brain and especially the hippocampus. Decades of research have provided insights into the mechanisms by which chronic stress impairs hippocampal-mediated cognition and the corresponding reduction of hippocampal CA3 apical dendritic complexity. Yet, when chronic stress ends and time passes, which we refer to as a "post-stress rest period," hippocampal-mediated spatial memory deficits begin to improve and CA3 apical dendritic arbors increase in complexity. The processes by which the hippocampus improves from a chronically stressed state are not simply the reversal of the mechanisms that produced spatial memory deficits and CA3 apical dendritic retraction. This review will discuss our current understanding of how a chronically stressed hippocampus improves after a post-stress rest period. Untangling the mechanisms that allow for this post-stress plasticity is a critical next step in understanding how to promote resilience in the face of stressors.
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Affiliation(s)
- J Bryce Ortiz
- Department of Psychology, Arizona State University, Box 1104, Tempe, AZ 85287-1104, United States.
| | - Cheryl D Conrad
- Department of Psychology, Arizona State University, Box 1104, Tempe, AZ 85287-1104, United States
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66
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Dallé E, Mabandla MV. Early Life Stress, Depression And Parkinson's Disease: A New Approach. Mol Brain 2018; 11:18. [PMID: 29551090 PMCID: PMC5858138 DOI: 10.1186/s13041-018-0356-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 02/27/2018] [Indexed: 12/20/2022] Open
Abstract
This review aims to shed light on the relationship that involves exposure to early life stress, depression and Parkinson's disease (PD). A systematic literature search was conducted in Pubmed, MEDLINE, EBSCOHost and Google Scholar and relevant data were submitted to a meta-analysis . Early life stress may contribute to the development of depression and patients with depression are at risk of developing PD later in life. Depression is a common non-motor symptom preceding motor symptoms in PD. Stimulation of regions contiguous to the substantia nigra as well as dopamine (DA) agonists have been shown to be able to attenuate depression. Therefore, since PD causes depletion of dopaminergic neurons in the substantia nigra, depression, rather than being just a simple mood disorder, may be part of the pathophysiological process that leads to PD. It is plausible that the mesocortical and mesolimbic dopaminergic pathways that mediate mood, emotion, and/or cognitive function may also play a key role in depression associated with PD. Here, we propose that a medication designed to address a deficiency in serotonin is more likely to influence motor symptoms of PD associated with depression. This review highlights the effects of an antidepressant, Fluvoxamine maleate, in an animal model that combines depressive-like symptoms and Parkinsonism.
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Affiliation(s)
- Ernest Dallé
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
| | - Musa V. Mabandla
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
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67
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Prado CE, Watt S, Crowe SF. A meta-analysis of the effects of antidepressants on cognitive functioning in depressed and non-depressed samples. Neuropsychol Rev 2018; 28:32-72. [DOI: 10.1007/s11065-018-9369-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 02/01/2018] [Indexed: 12/11/2022]
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Apocynum venetum Leaf Extract Exerts Antidepressant-Like Effects and Inhibits Hippocampal and Cortical Apoptosis of Rats Exposed to Chronic Unpredictable Mild Stress. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:5916451. [PMID: 29576796 PMCID: PMC5822797 DOI: 10.1155/2018/5916451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/03/2017] [Indexed: 11/18/2022]
Abstract
We investigated the effects of Apocynum venetum leaf extract (AVLE) on depressive behaviors and neuronal apoptosis in a chronic unpredictable mild stress (CUMS) rat model of depression. Rats were randomly divided into six groups: control, chronic unpredictable mild stress, fluoxetine, AVLE30, AVLE60, and AVLE120. Except for the control group, all rats were submitted to chronic unpredictable mild stress paradigms for four weeks to induce depressive behavior. Neuronal apoptosis was assessed by the terminal deoxynucleotidyl transferase- (TDT-) mediated dUTP-biotin nick end-labeling (TUNEL) method. The expression levels of apoptosis-related proteins, such as B-cell lymphoma 2 (Bcl-2), Bcl-2 Associated X Protein (Bax), cysteine-aspartic acid protease-3 and protease-9 (caspase-3 and caspase-9), cytochrome c (cyt-C), brain-derived neurotrophic factor (BDNF), and cAMP-response element binding (CREB) protein, were evaluated by western blot. Treatment with AVLE (60 or 120 mg/kg/day) significantly improved depressive behavior. Increased apoptosis of hippocampus and cortical neurons were observed in CUMS rats, while 120 mg/kg/day of AVLE significantly reversed these changes and achieved the best antidepressant-like effects among the doses tested. Moreover, AVLE (120 mg/kg) significantly increased Bcl-2, BDNF, and CREB protein expression and decreased Bax, cyt-C, and caspase family protein expression. Our results indicate that AVLE has potent antidepressant activity, likely due to its ability to suppress neuronal apoptosis.
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69
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McFarland CP, Vasterling JJ. Prospective Memory in Depression: Review of an Emerging Field†. Arch Clin Neuropsychol 2017; 33:912-930. [DOI: 10.1093/arclin/acx118] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 11/07/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Jennifer J Vasterling
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
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70
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Hayasaka S, Nakamura M, Noda Y, Izuno T, Saeki T, Iwanari H, Hirayasu Y. Lateralized hippocampal volume increase following high-frequency left prefrontal repetitive transcranial magnetic stimulation in patients with major depression. Psychiatry Clin Neurosci 2017. [PMID: 28631869 DOI: 10.1111/pcn.12547] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM Repetitive transcranial magnetic stimulation (rTMS) has been applied as a treatment for patients with treatment-resistant depression in recent years, and a large body of evidence has demonstrated its therapeutic efficacy through stimulating neuronal plasticity. The aim of this study was to investigate structural alterations in the hippocampus (HIPP) and amygdala (AM) following conventional rTMS in patients with depression. METHODS Twenty-eight patients with depression underwent 10 daily 20-Hz left prefrontal rTMS over 2 weeks. The left dorsolateral prefrontal cortex (DLPFC) was identified using magnetic resonance imaging-guided neuronavigation prior to stimulation. Magnetic resonance imaging scans were obtained at baseline and after the completion of rTMS sessions. The therapeutic effects of rTMS were evaluated with the 17-item Hamilton Depression Rating Scale (HAM-D17 ), and the volumes of the HIPP and AM were measured by a manual tracing method. RESULTS Statistical analyses revealed a significant volume increase in the left HIPP (+3.4%) after rTMS but no significant volume change in the AM. No correlation was found between the left HIPP volume increase and clinical improvement, as measured by the HAM-D17 . CONCLUSION The present study demonstrated that conventional left prefrontal rTMS increases the HIPP volume in the stimulated side, indicating a remote neuroplastic effect through the cingulum bundle.
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Affiliation(s)
- Shunsuke Hayasaka
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.,ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Motoaki Nakamura
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.,ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Yoshihiro Noda
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Takuji Izuno
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan.,Department of Psychiatry, School of Medicine, Showa University, Tokyo, Japan
| | - Takashi Saeki
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan.,Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hideo Iwanari
- Laboratory of Neuromodulation, Kanagawa Psychiatric Center, Yokohama, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
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Peters AT, Jacobs RH, Crane NA, Ryan KA, Weisenbach SL, Ajilore O, Lamar M, Kassel MT, Gabriel LB, West AE, Zubieta JK, Langenecker SA. Domain-specific impairment in cognitive control among remitted youth with a history of major depression. Early Interv Psychiatry 2017; 11:383-392. [PMID: 26177674 PMCID: PMC4844809 DOI: 10.1111/eip.12253] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
AIM Impairment in neuropsychological functioning is common in major depressive disorder (MDD), but it is not clear to what degree these deficits are related to risk (e.g. trait), scar, burden or state effects of MDD. The objective of this study was to use neuropsychological measures, with factor scores in verbal fluency, processing speed, attention, set-shifting and cognitive control in a unique population of young, remitted, unmedicated, early course individuals with a history of MDD in hopes of identifying putative trait markers of MDD. METHODS Youth aged 18-23 in remission from MDD (rMDD; n = 62) and healthy controls (HC; n = 43) were assessed with neuropsychological tests at two time points. These were from four domains of executive functioning, consistent with previous literature as impaired in MDD: verbal fluency and processing speed, conceptual reasoning and set-shifting, processing speed with interference resolution, and cognitive control. RESULTS rMDD youth performed comparably to HCs on verbal fluency and processing speed, processing speed with interference resolution, and conceptual reasoning and set-shifting, reliably over time. Individuals with rMDD demonstrated relative decrements in cognitive control at Time 1, with greater stability than HC participants. CONCLUSION MDD may be characterized by regulatory difficulties that do not pertain specifically to active mood state or fluctuations in symptoms. Deficient cognitive control may represent a trait vulnerability or early course scar of MDD that may prove a viable target for secondary prevention or early remediation.
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Affiliation(s)
- Amy T Peters
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Rachel H Jacobs
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Natania A Crane
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Kelly A Ryan
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Sara L Weisenbach
- Research & Development Program, The Jesse Brown VA Medical Center, Chicago, Illinois.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Olusola Ajilore
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Melissa Lamar
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Michelle T Kassel
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Laura B Gabriel
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Amy E West
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Jon-Kar Zubieta
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Scott A Langenecker
- Departments of Psychology and Psychiatry, University of Illinois at Chicago, Chicago, Illinois.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
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72
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McEwen BS. Epigenetic Interactions and the Brain-Body Communication. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 86:1-4. [PMID: 27884000 DOI: 10.1159/000449150] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/16/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, New York, N.Y., USA
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73
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Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression. J Affect Disord 2017; 219:58-63. [PMID: 28525821 DOI: 10.1016/j.jad.2017.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 03/29/2017] [Accepted: 05/06/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. METHODS In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. RESULTS Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. LIMITATIONS No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. CONCLUSIONS The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals.
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Yue JK, Burke JF, Upadhyayula PS, Winkler EA, Deng H, Robinson CK, Pirracchio R, Suen CG, Sharma S, Ferguson AR, Ngwenya LB, Stein MB, Manley GT, Tarapore PE. Selective Serotonin Reuptake Inhibitors for Treating Neurocognitive and Neuropsychiatric Disorders Following Traumatic Brain Injury: An Evaluation of Current Evidence. Brain Sci 2017; 7:E93. [PMID: 28757598 PMCID: PMC5575613 DOI: 10.3390/brainsci7080093] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/15/2017] [Accepted: 07/20/2017] [Indexed: 01/15/2023] Open
Abstract
The prevalence of neuropsychiatric disorders following traumatic brain injury (TBI) is 20%-50%, and disorders of mood and cognition may remain even after recovery of neurologic function is achieved. Selective serotonin reuptake inhibitors (SSRI) block the reuptake of serotonin in presynaptic cells to lead to increased serotonergic activity in the synaptic cleft, constituting first-line treatment for a variety of neurocognitive and neuropsychiatric disorders. This review investigates the utility of SSRIs in treating post-TBI disorders. In total, 37 unique reports were consolidated from the Cochrane Central Register and PubMed (eight randomized-controlled trials (RCTs), nine open-label studies, 11 case reports, nine review articles). SSRIs are associated with improvement of depressive but not cognitive symptoms. Pooled analysis using the Hamilton Depression Rating Scale demonstrate a significant mean decrease of depression severity following sertraline compared to placebo-a result supported by several other RCTs with similar endpoints. Evidence from smaller studies demonstrates mood improvement following SSRI administration with absent or negative effects on cognitive and functional recovery. Notably, studies on SSRI treatment effects for post-traumatic stress disorder after TBI remain absent, and this represents an important direction of future research. Furthermore, placebo-controlled studies with extended follow-up periods and concurrent biomarker, neuroimaging and behavioral data are necessary to delineate the attributable pharmacological effects of SSRIs in the TBI population.
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Affiliation(s)
- John K Yue
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - John F Burke
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - Pavan S Upadhyayula
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Department of Psychiatry, University of California, San Diego, CA 92093, USA.
| | - Ethan A Winkler
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - Hansen Deng
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - Caitlin K Robinson
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - Romain Pirracchio
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA 94143, USA.
| | - Catherine G Suen
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Department of Neurology, University of Utah School of Medicine, Salt Lake, UT 84112, USA.
| | - Sourabh Sharma
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60660, USA.
| | - Adam R Ferguson
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
- San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
| | - Laura B Ngwenya
- Department of Neurological Surgery, University of Cincinnati, Cincinnati, OH 45220, USA.
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, CA 92093, USA.
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, Building 1, Room 101, San Francisco, CA 94110, USA.
- Brain and Spinal Injury Center, Zuckerberg San Francisco General Hospital, San Francisco, CA 94110, USA.
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75
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Almeida RFD, Ganzella M, Machado DG, Loureiro SO, Leffa D, Quincozes-Santos A, Pettenuzzo LF, Duarte MMMF, Duarte T, Souza DO. Olfactory bulbectomy in mice triggers transient and long-lasting behavioral impairments and biochemical hippocampal disturbances. Prog Neuropsychopharmacol Biol Psychiatry 2017; 76:1-11. [PMID: 28223107 DOI: 10.1016/j.pnpbp.2017.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/17/2017] [Accepted: 02/16/2017] [Indexed: 12/31/2022]
Abstract
Major depressive disorder (MDD) is a neuropsychiatric disease that is associated with profound disturbances in affected individuals. Elucidating the pathophysiology of MDD has been frustratingly slow, especially concerning the neurochemical events and brain regions associated with disease progression. Thus, we evaluated the time-course (up to 8weeks) behavioral and biochemical effects in mice that underwent to a bilateral olfactory bulbectomy (OBX), which is used to modeling depressive-like behavior in rodents. Similar to the symptoms in patients with MDD, OBX induced long-lasting (e.g., impairment of habituation to novelty, hyperactivity and an anxiety-like phenotype) and transient (e.g., loss of self-care and motivational behavior) behavioral effects. Moreover, OBX temporarily impaired hippocampal synaptosomal mitochondria, in a manner that would be associated with hippocampal-related synaptotoxicity. Finally, long-lasting pro-oxidative (i.e., increased levels of reactive oxygen species and nitric oxide and decreased glutathione levels) and pro-inflammatory (i.e., increased levels of pro-inflammatory cytokines IL-1, IL-6, TNF-α and decreased anti-inflammatory cytokine IL-10 levels) effects were induced in the hippocampus by OBX. Additionally, these parameters were transiently affected in the posterior and frontal cortices. This study is the first to suggest that the transient and long-lasting behavioral effects from OBX strongly correlate with mitochondrial, oxidative and inflammatory parameters in the hippocampus; furthermore, these effects show a weak correlation with these parameters in the cortex. Our findings highlight the underlying mechanisms involved in the biochemical time course of events related to depressive behavior.
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Affiliation(s)
- Roberto Farina de Almeida
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Marcelo Ganzella
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Max Planck Institute for Biophysical Chemistry, Neurobiology Department, Göttingen, Germany.
| | - Daniele Guilhermano Machado
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Samanta Oliveira Loureiro
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Douglas Leffa
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - André Quincozes-Santos
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Letícia Ferreira Pettenuzzo
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Thiago Duarte
- Departamento de Ciências da Saúde, Universidade Luterana do Brasil - Campus Santa Maria, RS, Brazil.
| | - Diogo Onofre Souza
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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76
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Yang X, Peng Z, Ma X, Meng Y, Li M, Zhang J, Song X, Liu Y, Fan H, Zhao L, Deng W, Li T, Ma X. Sex differences in the clinical characteristics and brain gray matter volume alterations in unmedicated patients with major depressive disorder. Sci Rep 2017; 7:2515. [PMID: 28559571 PMCID: PMC5449404 DOI: 10.1038/s41598-017-02828-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/19/2017] [Indexed: 02/05/2023] Open
Abstract
This study was to explore the sex differences in clinical characteristics and brain gray matter volume (GMV) alterations in 29 male patients with major depressive disorder (MDDm), 53 female patients with MDD (MDDf), and in 29 male and 53 female matched healthy controls. Maps of GMV were constructed using magnetic resonance imaging data and compared between groups. We evaluated clinical symptoms using the Hamilton Rating Scale for Depression and obtained a total score and five syndrome scores. A two-factor ANCOVA model was specified using SPM8, with sex and diagnosis as the between-subject factors. We found that: (1) significant GMV increase in the left cerebellum and GMV reduction in the bilateral middle temporal gyrus and left ventral medial prefrontal gyrus occurred selectively in male patients, while the GMV reduction in the left lingual gyrus and dorsal medial prefrontal gyrus occurred selectively in female patients; (2) MDDf may have experienced more severe sleep disturbance than MDDm; and (3) the severity of sleep symptom could be predicted by the sex specific brain structural alterations in depressions. These findings suggest that sex specific anatomical alterations existed in MDD, and these alterations were associated with the clinical symptoms.
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Affiliation(s)
- Xiao Yang
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zugui Peng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaojuan Ma
- Chengdu First People's Hospital, Chengdu, China
| | - Yajing Meng
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Mingli Li
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jian Zhang
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiuliu Song
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ye Liu
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huanhuan Fan
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Liansheng Zhao
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Deng
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China. .,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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77
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Watanabe R, Kakeda S, Watanabe K, Liu X, Katsuki A, Umeno-Nakano W, Hori H, Abe O, Yoshimura R, Korogi Y. Relationship between the hippocampal shape abnormality and serum cortisol levels in first-episode and drug-naïve major depressive disorder patients. Depress Anxiety 2017; 34:401-409. [PMID: 28129464 DOI: 10.1002/da.22604] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/29/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to investigate the relationship between the hippocampal shape deformations and the serum cortisol levels in first-episode and drug-naïve major depression disorder (MDD) patients. METHODS Thirty first-episode and drug-naïve MDD patients and 40 healthy subjects were recruited. High-resolution T1-weighted imaging and morning blood samples for cortisol measurement were obtained from all MDD patients and healthy subjects. In the hippocampal shape analysis, we compared the hippocampal shape between MDD patients and healthy subjects and evaluated the linear correlation between hippocampal shape deformations and the serum cortisol levels in MDD patients and healthy subjects. RESULTS MDD patients showed significant inward deformations predominantly in the cornu ammonis (CA) 1 and subiculum in bilateral hippocampi compared to healthy subjects (false discovery rate (FDR) corrected, P < .05). Furthermore, in MDD patients, a significant linear correlation between inward deformations and high cortisol levels were found predominantly in the CA1 and subiculum, extending into the CA2-3 (FDR-corrected, P < .05), whereas no significant linear correlation was observed in healthy subjects. CONCLUSIONS The serum cortisol levels are therefore considered to be associated with hippocampal shape abnormalities in MDD.
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Affiliation(s)
- Rieko Watanabe
- Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shingo Kakeda
- Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Keita Watanabe
- Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Xiaodan Liu
- Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan.,Medical imaging center, 1st Affiliated Hospital of Jinan University, Guangzhou, China
| | - Asuka Katsuki
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Wakako Umeno-Nakano
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hikaru Hori
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Yukunori Korogi
- Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan
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78
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Abdallah CG, Southwick SM, Krystal JH. Neurobiology of posttraumatic stress disorder (PTSD): A path from novel pathophysiology to innovative therapeutics. Neurosci Lett 2017; 649:130-132. [DOI: 10.1016/j.neulet.2017.04.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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79
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Abstract
The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.
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Affiliation(s)
- Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065.
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80
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Bedard-Gilligan M, Zoellner LA, Feeny NC. Is Trauma Memory Special? Trauma Narrative Fragmentation in PTSD: Effects of Treatment and Response. Clin Psychol Sci 2017; 5:212-225. [PMID: 28503366 DOI: 10.1177/2167702616676581] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Seminal theories posit that fragmented trauma memories are critical to posttraumatic stress disorder (PTSD; van der Kolk & Fisler, 1995; Brewin, 2014) and that elaboration of the trauma narrative is necessary for recovery (e.g., Foa, Huppert, & Cahill, 2006). According to fragmentation theories, trauma narrative changes, particularly for those receiving trauma-focused treatment, should accompany symptom reduction. Trauma and control narratives in 77 men and women with chronic PTSD were examined pre- and post-treatment, comparing prolonged exposure (PE) and sertraline. Utilizing self-report, rater coding, and objective coding of narrative content, fragmentation was compared across narrative types (trauma, negative, positive) by treatment modality and response, controlling for potential confounds. Although sensory components increased with PE (d = 0.23 - 0.44), there were no consistent differences in fragmentation from pre- to post-treatment between PE and sertraline or treatment responders and non-responders. Contrary to theories, changes in fragmentation may not be a crucial mechanism underlying PTSD therapeutic recovery.
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81
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Hilbert K, Lueken U, Muehlhan M, Beesdo-Baum K. Separating generalized anxiety disorder from major depression using clinical, hormonal, and structural MRI data: A multimodal machine learning study. Brain Behav 2017; 7:e00633. [PMID: 28293473 PMCID: PMC5346520 DOI: 10.1002/brb3.633] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/11/2016] [Accepted: 12/05/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is difficult to recognize and hard to separate from major depression (MD) in clinical settings. Biomarkers might support diagnostic decisions. This study used machine learning on multimodal biobehavioral data from a sample of GAD, MD and healthy subjects to differentiate subjects with a disorder from healthy subjects (case-classification) and to differentiate GAD from MD (disorder-classification). METHODS Subjects with GAD (n = 19), MD without GAD (n = 14), and healthy comparison subjects (n = 24) were included. The sample was matched regarding age, sex, handedness and education and free of psychopharmacological medication. Binary support vector machines were used within a nested leave-one-out cross-validation framework. Clinical questionnaires, cortisol release, gray matter (GM), and white matter (WM) volumes were used as input data separately and in combination. RESULTS Questionnaire data were well-suited for case-classification but not disorder-classification (accuracies: 96.40%, p < .001; 56.58%, p > .22). The opposite pattern was found for imaging data (case-classification GM/WM: 58.71%, p = .09/43.18%, p > .66; disorder-classification GM/WM: 68.05%, p = .034/58.27%, p > .15) and for cortisol data (38.02%, p = .84; 74.60%, p = .009). All data combined achieved 90.10% accuracy (p < .001) for case-classification and 67.46% accuracy (p = .0268) for disorder-classification. CONCLUSIONS In line with previous evidence, classification of GAD was difficult using clinical questionnaire data alone. Particularly cortisol and GM volume data were able to provide incremental value for the classification of GAD. Findings suggest that neurobiological biomarkers are a useful target for further research to delineate their potential contribution to diagnostic processes.
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Affiliation(s)
- Kevin Hilbert
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany; Behavioral Epidemiology Technische Universität Dresden Dresden Germany; Department of Psychology Neuroimaging CenterTechnische Universität Dresden Dresden Germany
| | - Ulrike Lueken
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany; Department of Psychology Neuroimaging Center Technische Universität Dresden Dresden Germany; Department of Psychiatry, Psychosomatics, and Psychotherapy University Hospital Wuerzburg Wuerzburg Germany
| | - Markus Muehlhan
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany; Department of Psychology Neuroimaging Center Technische Universität Dresden Dresden Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Dresden Germany; Behavioral Epidemiology Technische Universität Dresden Dresden Germany; Department of Psychology Neuroimaging CenterTechnische Universität Dresden Dresden Germany
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82
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Lupien SJ, Sasseville M, François N, Giguère CE, Boissonneault J, Plusquellec P, Godbout R, Xiong L, Potvin S, Kouassi E, Lesage A. The DSM5/RDoC debate on the future of mental health research: implication for studies on human stress and presentation of the signature bank. Stress 2017; 20:95-111. [PMID: 28124571 DOI: 10.1080/10253890.2017.1286324] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In 2008, the National Institute of Mental Health (NIMH) announced that in the next few decades, it will be essential to study the various biological, psychological and social "signatures" of mental disorders. Along with this new "signature" approach to mental health disorders, modifications of DSM were introduced. One major modification consisted of incorporating a dimensional approach to mental disorders, which involved analyzing, using a transnosological approach, various factors that are commonly observed across different types of mental disorders. Although this new methodology led to interesting discussions of the DSM5 working groups, it has not been incorporated in the last version of the DSM5. Consequently, the NIMH launched the "Research Domain Criteria" (RDoC) framework in order to provide new ways of classifying mental illnesses based on dimensions of observable behavioral and neurobiological measures. The NIMH emphasizes that it is important to consider the benefits of dimensional measures from the perspective of psychopathology and environmental influences, and it is also important to build these dimensions on neurobiological data. The goal of this paper is to present the perspectives of DSM5 and RDoC to the science of mental health disorders and the impact of this debate on the future of human stress research. The second goal is to present the "Signature Bank" developed by the Institut Universitaire en Santé Mentale de Montréal (IUSMM) that has been developed in line with a dimensional and transnosological approach to mental illness.
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Affiliation(s)
- S J Lupien
- a Centre for Studies on Human Stress , CIUSSS Est , Quebec , Canada
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - M Sasseville
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - N François
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
| | - C E Giguère
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
| | - J Boissonneault
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
| | - P Plusquellec
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- d Department of Psychoeducation, Faculty of Arts and Sciences , University of Montreal , Montreal , Canada
| | - R Godbout
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - L Xiong
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - S Potvin
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
| | - E Kouassi
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
| | - A Lesage
- b Research Centre , Montreal Mental Health University Institute, CIUSSS Est , Quebec , Canada
- c Department of Psychiatry, Faculty of Medicine , University of Montreal , Montreal , Canada
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83
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Qiu H, Li X, Zhao W, Du L, Huang P, Fu Y, Qiu T, Xie P, Meng H, Luo Q. Electroconvulsive Therapy-Induced Brain Structural and Functional Changes in Major Depressive Disorders: A Longitudinal Study. Med Sci Monit 2016; 22:4577-4586. [PMID: 27888657 PMCID: PMC5129700 DOI: 10.12659/msm.898081] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background This study aimed to study the brain structural and functional changes after 8 courses of electroconvulsive therapy (ECT) on patients with major depressive disorder (MDD). Material/Methods MRI scans were performed on 12 depressive patients before and after 8 courses of ECT and compared with those of 15 normal controls. Data were analyzed by voxel-based morphometry (VBM) using SPM8 software. Functional MRI (fMRI) and regional homogeneity (ReHo) analyses were used to assess the functional changes after ECT. Results Grey matter volumes were smaller in the right cingulate gyrus of depressive patients before ECT compared with normal controls. After false discovery rate (FDR) correction, post-ECT grey matter volumes were increased in bilateral amygdala and hippocampus compared with pre-ECT. Resting-state ReHo maps showed significant differences in brain activity pre- and post-ECT. Compared with healthy controls, MDD patients treated with 8 courses of ECT showed higher ReHo values in the bilateral frontal lobe, bilateral parietal lobe, and right caudate nucleus. Decreased ReHo values were observed in the right medial temporal gyrus, right superior temporal gyrus, right cingulate gyrus, and left anterior cerebellar lobe. Conclusions Results suggested that there were both structural and functional differences between the brains of MDD patients and healthy controls. After ECT, both structural and functional changes occurred, but without complete recovery to normal. ECT may display effects through regulating other brain regions to compensate for the original defects.
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Affiliation(s)
- Haitang Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Xirong Li
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Wenjing Zhao
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Lian Du
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Peiyu Huang
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Yixiao Fu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Tian Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Peng Xie
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Huaqing Meng
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Qinghua Luo
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
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84
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Azevedo JA, Carter BS, Meng F, Turner DL, Dai M, Schatzberg AF, Barchas JD, Jones EG, Bunney WE, Myers RM, Akil H, Watson SJ, Thompson RC. The microRNA network is altered in anterior cingulate cortex of patients with unipolar and bipolar depression. J Psychiatr Res 2016; 82:58-67. [PMID: 27468165 PMCID: PMC5026930 DOI: 10.1016/j.jpsychires.2016.07.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 07/08/2016] [Accepted: 07/12/2016] [Indexed: 11/26/2022]
Abstract
MicroRNAs (miRNAs) are small, non-coding RNAs acting as post-transcriptional regulators of gene expression. Though implicated in multiple CNS disorders, miRNAs have not been examined in any psychiatric disease state in anterior cingulate cortex (AnCg), a brain region centrally involved in regulating mood. We performed qPCR analyses of 29 miRNAs previously implicated in psychiatric illness (major depressive disorder (MDD), bipolar disorder (BP) and/or schizophrenia (SZ)) in AnCg of patients with MDD and BP versus controls. miR-132, miR-133a and miR-212 were initially identified as differentially expressed in BP, miR-184 in MDD and miR-34a in both MDD and BP (although none survived multiple correction testing and must be considered preliminary). In silico target prediction algorithms identified putative targets of differentially expressed miRNAs. Nuclear Co-Activator 1 (NCOA1), Nuclear Co-Repressor 2 (NCOR2) and Phosphodiesterase 4B (PDE4B) were selected based upon predicted targeting by miR-34a (with NCOR2 and PDE4B both targeted by miR-184) and published relevance to psychiatric illness. Luciferase assays identified PDE4B as a target of miR-34a and miR-184, while NCOA1 and NCOR2 were targeted by miR-34a and 184, respectively. qPCR analyses were performed to determine whether changes in miRNA levels correlated with mRNA levels of validated targets. NCOA1 showed an inverse correlation with miR-34a in BP, while NCOR2 demonstrated a positive correlation. In sum, this is the first study to demonstrate miRNA changes in AnCg in psychiatric illness and validate miR-34a as differentially expressed in CNS in MDD. These findings support a mechanistic role for miRNAs in the regulation of stress-responsive genes disrupted in psychiatric illness.
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Affiliation(s)
- Joshua A Azevedo
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA
| | - Bradley S Carter
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA; Neuroscience Program, Oberlin College, Science Center A261, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Fan Meng
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry, University of Michigan, 530 Church St, Ann Arbor, MI, 48109, USA
| | - David L Turner
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA; Department of Biological Chemistry, University of Michigan, 5301 MSRB III, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Manhong Dai
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA
| | - Alan F Schatzberg
- Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd, Stanford, CA, 94305, USA
| | - Jack D Barchas
- Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry, Weill Cornell Medical College, 525 East 68th Street, New York, NY, 10065, USA
| | - Edward G Jones
- Pritzker Neuropsychiatric Disorders Research Consortium, USA; Center for Neuroscience, University of California - Davis, 1544 Newton Court, Davis, CA, 95618, USA
| | - William E Bunney
- Pritzker Neuropsychiatric Disorders Research Consortium, USA; Psychiatry and Human Behavior, University of California - Irvine, 101 The City Dr S, Orange, CA, 92868, USA
| | - Richard M Myers
- Pritzker Neuropsychiatric Disorders Research Consortium, USA; Hudson Alpha Institute for Biotechnology, 601 Genome Way Northwest, Huntsville, AL, 35806, USA
| | - Huda Akil
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA; Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry, University of Michigan, 530 Church St, Ann Arbor, MI, 48109, USA
| | - Stanley J Watson
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA; Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry, University of Michigan, 530 Church St, Ann Arbor, MI, 48109, USA
| | - Robert C Thompson
- Molecular and Behavioral Neuroscience Institute, University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, 48109, USA; Neuroscience Graduate Program, University of Michigan, 4137 Undergraduate Science Building (USB), 204 Washtenaw Avenue, Ann Arbor, MI, 48109, USA; Pritzker Neuropsychiatric Disorders Research Consortium, USA; Department of Psychiatry, University of Michigan, 530 Church St, Ann Arbor, MI, 48109, USA.
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Yang Y, Ang W, Long H, Chang Y, Li Z, Zhou L, Yang T, Deng Y, Luo Y. Scaffold Hopping Toward Agomelatine: Novel 3, 4-Dihydroisoquinoline Compounds as Potential Antidepressant Agents. Sci Rep 2016; 6:34711. [PMID: 27698414 PMCID: PMC5048153 DOI: 10.1038/srep34711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/19/2016] [Indexed: 02/05/2023] Open
Abstract
A scaffold-hopping strategy toward Agomelatine based on in silico screening and knowledge analysis was employed to design novel antidepressant agents. A series of 3, 4-dihydroisoquinoline compounds were selected for chemical synthesis and biological assessment. Three compounds (6a-1, 6a-2, 6a-9) demonstrated protective effects on corticosterone-induced lesion of PC12 cells. Compound 6a-1 also displayed low inhibitory effects on the growth of HEK293 and L02 normal cells and it was further evaluated for its potential antidepressant effects in vivo. The forced swim test (FST) results revealed that compound 6a-1 remarkably reduced the immobility time of rats and the open field test (OFT) results indicated a better general locomotor activity of the rats treated with compound 6a-1 than those with Agomelatine or Fluoxetine. Mechanism studies implied that compound 6a-1 can significantly reduce PC12 cell apoptosis by up-regulation of GSH and down-regulation of ROS in corticosterone-induced lesion of PC12 cells. Meanwhile, the down-regulation of calcium ion concentration and up-regulation of BDNF level in PC12 cells may account for the neuroprotective effects. Furthermore, compound 6a-1 can increase cell survival and cell proliferation, promote cell maturation in the rat hippocampus after chronic treatment. The acute toxicity data in vivo indicated compound 6a-1 exhibited less hepatotoxicity than Agomelatine.
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Affiliation(s)
- Yang Yang
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Wei Ang
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Key Laboratory of Drug Targeting and Drug Delivery System, Ministry of Education, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, P. R. China
| | - Haiyue Long
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ying Chang
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Zicheng Li
- Department of Pharmaceutical and Bioengineering, School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P. R. China
| | - Liangxue Zhou
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Tao Yang
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yong Deng
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China.,Key Laboratory of Drug Targeting and Drug Delivery System, Ministry of Education, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, P. R. China
| | - Youfu Luo
- State Key Laboratory of Biotherapy and Department of Neurosurgery/Collaborative Innovation Center for Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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86
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Jin RO, Mason S, Mellon SH, Epel ES, Reus VI, Mahan L, Rosser RL, Hough CM, Burke HM, Mueller SG, Wolkowitz OM. Cortisol/DHEA ratio and hippocampal volume: A pilot study in major depression and healthy controls. Psychoneuroendocrinology 2016; 72:139-46. [PMID: 27428086 PMCID: PMC5203799 DOI: 10.1016/j.psyneuen.2016.06.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/28/2016] [Accepted: 06/28/2016] [Indexed: 11/19/2022]
Abstract
Structural imaging studies investigating the relationship between hippocampal volume (HCV) and peripheral measures of glucocorticoids (GCs) have produced conflicting results in both normal populations and in individuals with MDD, raising the possibility of other modulating factors. In preclinical studies, dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS; together abbreviated, DHEA(S)) have been shown to antagonize the actions of GCs on the central nervous system. Therefore, considering the relationship of HCV to both of these hormones simultaneously may be important, although it has rarely been done in human populations. Using high-resolution magnetic resonance imaging (MRI), the present pilot study examined the relationship between morning serum cortisol, DHEA(S), and HCV in nineteen normal controls and eighteen unmedicated subjects with Major Depressive Disorder (MDD). Serum cortisol and DHEA(S) were not significantly correlated with HCV across all subjects (cortisol: r=-0.165, p=0.33; DHEA: r=0.164, p=0.35; DHEAS: r=0.211, p=0.22, respectively). However, the ratios of cortisol/DHEA(S) were significantly negatively correlated with HCV in combined group (Cortisol/DHEA: r=-0.461, p=0.005; Cortisol/DHEAS: r=-0.363, p=0.03). Significant or near-significant correlations were found between some hormonal measurements and HCV in the MDDs alone (DHEA: r=0.482, p=0.059; DHEAS: r=0.507, p=0.045; cort/DHEA: r=-0.589, p=0.02; cort/DHEAS: r=-0.424p=0.10), but not in the controls alone (DHEA: r=0.070, p=0.79; DHEAS: r=0.077, p=0.77; cort/DHEA: r=-0.427, p=0.09; cort/DHEAS: r=-0.331, p=0.19). However, Group (MDDs vs controls) did not have a significant effect on the relationship between cortisol, DHEA(S), and their ratios with HCV (p>0.475 in all analyses). Although the exact relationship between serum and central steroid concentrations as well as their effects on the human hippocampus remains not known, these preliminary results suggest that the ratio of cortisol to DHEA(S), compared to serum cortisol alone, may convey additional information about "net steroid activity" with relation to HCV.
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Affiliation(s)
- Rowen O Jin
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Sara Mason
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Synthia H Mellon
- Department of Obstetrics-Gynecology and Reproductive Sciences, University of California, San Francisco, School of Medicine California, 94143, United States
| | - Elissa S Epel
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Victor I Reus
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Laura Mahan
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Rebecca L Rosser
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Christina M Hough
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Heather M Burke
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States
| | - Susanne G Mueller
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, School of Medicine California, 94143, United States
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California, San Francisco, School of Medicine, CA, 94143, United States.
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87
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Travis SG, Coupland NJ, Hegadoren K, Silverstone PH, Huang Y, Carter R, Fujiwara E, Seres P, Malykhin NV. Effects of cortisol on hippocampal subfields volumes and memory performance in healthy control subjects and patients with major depressive disorder. J Affect Disord 2016; 201:34-41. [PMID: 27162154 DOI: 10.1016/j.jad.2016.04.049] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/24/2016] [Indexed: 01/01/2023]
Abstract
Overactivity of the hypothalamic-pituitary-adrenal (HPA) axis in major depressive disorder (MDD) is among the most consistently replicated biological findings in psychiatry. Magnetic resonance imaging (MRI) studies have consistently demonstrated that hippocampal (HC) volume is decreased in patients with MDD. The improved spatial resolution of high field strength MRI has recently enabled measurements of HC subfield volumes in vivo. The main goal of the present study was to examine the relationship between cortisol concentrations over a day and HC subfield volumes in patients with MDD compared to healthy controls and to investigate whether diurnal cortisol measures are related to memory performance. Fourteen MDD patients with moderate or severe episodes were recruited, together with 14 healthy controls. Imaging was performed using a 4.7T whole-body imaging system. HC subfields and subregions were segmented manually using previously defined protocol. Memory performance was assessed using the Wechsler Memory Scale IV. The salivary cortisol levels were measured over the course of one day. We found that cortisol awakening response to 8h (CAR-8h) was higher in MDD patients compared to controls and that this increase in CAR-8h in MDD patients correlated negatively with left total Cornu Ammonis (CA)1-3 and left HC head volume. In healthy controls mean cortisol levels were negatively associated with right total CA1-3, right HC head, and right total HC volume. In addition, in healthy controls higher CAR-8h was related to worse performance on the immediate content memory. These results provide the first in vivo evidence of the negative associations between cortisol level, CA1-3 HC subfield volume and memory performance in patients with MDD and healthy controls.
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Affiliation(s)
- Scott G Travis
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | | | - K Hegadoren
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Yushan Huang
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Rawle Carter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Esther Fujiwara
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Peter Seres
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nikolai V Malykhin
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
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88
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Corwin EJ, Ferranti EP. Integration of biomarkers to advance precision nursing interventions for family research across the life span. Nurs Outlook 2016; 64:292-298. [DOI: 10.1016/j.outlook.2016.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/25/2016] [Accepted: 04/30/2016] [Indexed: 12/11/2022]
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Jacobson D, Bursch M, Lajiness-O'Neill R. Potential Role of Cortisol in Social and Memory Impairments in Individuals with 22q11.2 Deletion Syndrome. J Pediatr Genet 2016; 5:150-7. [PMID: 27617156 DOI: 10.1055/s-0036-1584549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 05/07/2016] [Indexed: 10/21/2022]
Abstract
22q11.2 Deletion syndrome is a genetic disorder characterized by physiological and psychological symptoms. This study investigated the role of cortisol on the social and cognitive impairments in children with 22q11.2. A total of 11 children with 22q11.2 were assessed for baseline cortisol levels and received broad neuropsychological testing. Results were compared with 11 controls. Children with 22q11.2 had significantly higher cortisol levels. A significant negative correlation was observed between the general memory and attention/concentration indices of the Wide Range Assessment of Memory and Learning, 2nd edition and cortisol concentrations in the control population. These data provide evidence of a possible causal mechanism that underlies social impairments in stress disorders.
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Affiliation(s)
- Daniel Jacobson
- Department of Psychology, Eastern Michigan University, Gulfport, Mississippi, United States
| | - Megan Bursch
- Department of Social Work, University of Michigan, Ann Arbor, Michigan, United States
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90
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Harvey AG, Lee J, Smith RL, Gumport NB, Hollon SD, Rabe-Hesketh S, Hein K, Dolsen EA, Haman KL, Kanady JC, Thompson MA, Abrons D. Improving outcome for mental disorders by enhancing memory for treatment. Behav Res Ther 2016; 81:35-46. [PMID: 27089159 PMCID: PMC5559714 DOI: 10.1016/j.brat.2016.03.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/11/2016] [Accepted: 03/28/2016] [Indexed: 11/21/2022]
Abstract
Patients exhibit poor memory for treatment. A novel Memory Support Intervention, derived from basic science in cognitive psychology and education, is tested with the goal of improving patient memory for treatment and treatment outcome. Adults with major depressive disorder (MDD) were randomized to 14 sessions of cognitive therapy (CT)+Memory Support (n = 25) or CT-as-usual (n = 23). Outcomes were assessed at baseline, post-treatment and 6 months later. Memory support was greater in CT+Memory Support compared to the CT-as-usual. Compared to CT-as-usual, small to medium effect sizes were observed for recall of treatment points at post-treatment. There was no difference between the treatment arms on depression severity (primary outcome). However, the odds of meeting criteria for 'response' and 'remission' were higher in CT+Memory Support compared with CT-as-usual. CT+Memory Support also showed an advantage on functional impairment. While some decline was observed, the advantage of CT+Memory Support was evident through 6-month follow-up. Patients with less than 16 years of education experience greater benefits from memory support than those with 16 or more years of education. Memory support can be manipulated, may improve patient memory for treatment and may be associated with an improved outcome.
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Affiliation(s)
| | - Jason Lee
- University of California, Berkeley, CA, USA
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91
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Mu Z, Chang Y, Xu J, Pang X, Zhang H, Liu X, Zheng Y, Liu X, Liu X, Wan Y. Pre-attentive dysfunction of musical processing in major depressive disorder: A mismatch negativity study. J Affect Disord 2016; 194:50-6. [PMID: 26802507 DOI: 10.1016/j.jad.2016.01.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/06/2016] [Accepted: 01/12/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Deficits of pre-attentive information processing have been frequently found in patients with major depressive disorder, nevertheless the results are quite inconsistent due to clinical heterogeneity and methodological difference. Cognitive processing of music is a useful tool for investigating human cognition and its underlying brain mechanisms. Although general auditory processing and perception of musical sound are hampered in patients with MDD, whether the deficits in musical processing begin from pre-attentive stage is not well investigated yet. The present study aimed to investigate the MMN of musical sound in patients with MDD. METHOD MMN responses to different musical features were compared in 20 patients with MDD and 20 age-matched healthy controls. The multi-feature paradigm was used to examine automatic change detection of six different musical sound features (pitch, timbre, location, intensity, slide, rhythm) in a complex musical context. Severity of depression and co-morbid anxiety were evaluated using the Hamilton Rating Scale of Depression (HRSD-17) and the Hamilton Anxiety Rating Scale (HAMA). RESULTS MMNs were obtained with all deviants. The timbre-MMN was significantly larger in MDD patients than in healthy controls, while the other deviants (pitch, location, intensity, slide and rhythm) elicited similar MMN across groups. For MDD patients, the amplitudes and latencies of MMNs did not correlate with severity of depression or co-morbid anxiety. LIMITATIONS The sample size in this study is relatively small. CONCLUSION Patients with MDD do not perform at the same level as controls in automatic change detection of timbre. This dysfunction is considered to be a trait-dependent feature of MDD.
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Affiliation(s)
- Zhen Mu
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China; Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, China
| | - Yi Chang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China.
| | - Jing Xu
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China.
| | - Xiaomei Pang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China
| | - Huimin Zhang
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China
| | - Xiaowei Liu
- Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, China
| | - Ya Zheng
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, China
| | - Xuemei Liu
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, China
| | - Xiaojing Liu
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, China
| | - Yuan Wan
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, China
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92
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Han KM, Won E, Sim Y, Tae WS. Hippocampal subfield analysis in medication-naïve female patients with major depressive disorder. J Affect Disord 2016; 194:21-9. [PMID: 26802503 DOI: 10.1016/j.jad.2016.01.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/10/2015] [Accepted: 01/10/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hippocampal volume loss is known as the best-replicated finding of structural brain imaging studies on major depressive disorder (MDD). Several evidences suggest localized mechanisms of hippocampal neuroplasticity lead the brain imaging studies on the hippocampus and MDD to perform analyses in the subfield level. The aim of this study was to investigate the differences in total and subfield hippocampal volumes, between medication-naïve female MDD patients and healthy controls, through automated segmentation and volumetric methods. METHODS Twenty medication-naïve female patients diagnosed with MDD and 21 age-matched healthy controls, underwent T1-weighted structural magnetic resonance scanning. Total volumes of both hippocampi and subfield regions were calculated by the automated procedure for volumetric measures implemented in FreeSurfer and automated segmentation method by Van Leemput et al. RESULTS We observed patients to have significantly smaller volumes of the left hippocampus, subiculum, cornu ammonis 2-3, cornu ammonis 4-dentate gyrus, and right subiculum compared to healthy controls. There were no significant predictors for these subfield region volumes among the illness burden-related parameters including duration of illness, number of depressive episodes, severity of depressive symptoms and memory performances. LIMITATIONS Our findings relied on the data of only female participants. CONCLUSIONS We found significant volume reductions in several hippocampal subfield regions in medication-naïve female MDD patients. Our results are consistent with neurobiological evidences on hippocampal neuroplasticity in MDD, and replicate previous findings that suggest morphologic changes of hippocampal subfields in MDD patients.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youngbo Sim
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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93
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Abstract
The hippocampus plays an important role in emotional and cognitive processing, and both of these domains are affected in patients with major depressive disorder (MDD). Extensive preclinical research and the notion that modulation of serotonin (5-HT) neurotransmission plays a key role in the therapeutic efficacy of selective serotonin reuptake inhibitors (SSRIs) support the view that 5-HT is important for hippocampal function in normal and disease-like conditions. The hippocampus is densely innervated by serotonergic fibers, and the majority of 5-HT receptor subtypes are expressed there. Furthermore, hippocampal cells often co-express multiple 5-HT receptor subtypes that can have either complementary or opposing effects on cell function, adding to the complexity of 5-HT neurotransmission. Here we review the current knowledge of how 5-HT, through its various receptor subtypes, modulates hippocampal output and the activity of hippocampal pyramidal cells in rodents. In addition, we discuss the relevance of 5-HT modulation for cognitive processing in rodents and possible clinical implications of these results in patients with MDD. Finally, we review the data on how SSRIs and vortioxetine, an antidepressant with multimodal activity, affect hippocampal function, including cognitive processing, from both a preclinical and clinical perspective.
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Abstract
The brain is the central organ for adaptation to experiences, including stressors, which are capable of changing brain architecture as well as altering systemic function through neuroendocrine, autonomic, immune, and metabolic systems. Because the brain is the master regulator of these systems, as well as of behavior, alterations in brain function by chronic stress can have direct and indirect effects on cumulative allostatic overload, which refers to the cost of adaptation. There is much new knowledge on the neural control of systemic physiology and the feedback actions of physiologic mediators on brain regions regulating higher cognitive function, emotional regulation, and self-regulation. The healthy brain has a considerable capacity for resilience, based upon its ability to respond to interventions designed to open "windows of plasticity" and redirect its function toward better health. As a result, plasticity-facilitating treatments should be given within the framework of a positive behavioral intervention; negative experiences during this window may even make matters worse. Indeed, there are no magic bullets and drugs cannot substitute for targeted interventions that help an individual become resilient, of which mindfulness-based stress reduction and meditation are emerging as useful tools.
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Affiliation(s)
- Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York
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95
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Abstract
BACKGROUND Cognitive dysfunction in major depressive disorder (MDD) encompasses several domains, including but not limited to executive function, verbal memory, and attention. Furthermore, cognitive dysfunction is a frequent residual manifestation in depression and may persist during the remitted phase. Cognitive deficits may also impede functional recovery, including workforce performance, in patients with MDD. The overarching aims of this opinion article are to critically evaluate the effects of available antidepressants as well as novel therapeutic targets on neurocognitive dysfunction in MDD. DISCUSSION Conventional antidepressant drugs mitigate cognitive dysfunction in some people with MDD. However, a significant proportion of MDD patients continue to experience significant cognitive impairment. Two multicenter randomized controlled trials (RCTs) reported that vortioxetine, a multimodal antidepressant, has significant precognitive effects in MDD unrelated to mood improvement. Lisdexamfetamine dimesylate was shown to alleviate executive dysfunction in an RCT of adults after full or partial remission of MDD. Preliminary evidence also indicates that erythropoietin may alleviate cognitive dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil, galantamine, scopolamine, N-acetylcysteine, curcumin, statins, and coenzyme Q10. The management of cognitive dysfunction remains an unmet need in the treatment of MDD. However, it is hoped that the development of novel therapeutic targets will contribute to 'cognitive remission', which may aid functional recovery in MDD.
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Liu Y, Yang X, Zhao L, Zhang J, Li T, Ma X. Increased miR-132 level is associated with visual memory dysfunction in patients with depression. Neuropsychiatr Dis Treat 2016; 12:2905-2911. [PMID: 27877044 PMCID: PMC5108558 DOI: 10.2147/ndt.s116287] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Impaired visual memory seems to be a core feature of depression, while increased microRNA-132 (miR-132) levels have been widely reported in depression patients. The authors aimed to explore the relationship between miR-132 changes and visual memory deficits in unmedicated patients with major depressive disorder (MDD). PATIENTS AND METHODS A total of 62 medication-free MDD patients and 73 matched healthy controls (HCs) were tested for miR-132 expression level in peripheral blood using quantitative real-time polymerase chain reaction. We used a computerized neurocognitive task from the Cambridge Neuropsychological Test Automated Battery (CANTAB) - pattern recognition memory (PRM) task - as a measurement of visual memory. The relationship between visual memory, miR-132 expression level, and clinical symptoms was explored in patients with MDD. RESULTS Upregulated miR-132 expression levels were seen in MDD patients but not in HCs. Two-sample t-tests showed that MDD patients had decreased visual memory, mainly memory delayed compared to that of HCs. Correlation analyses revealed that in MDD patients, increased miR-132 expression levels were significantly correlated with visual memory as measured by the CANTABPRM. Hamilton Rating Scale for Anxiety scores were negatively correlated with PRM - number correct (immediate) and PRM - percent correct (immediate). LIMITATIONS The main limitations were missing data and lack of follow-up studies. CONCLUSION Our study suggests that increased miR-132 expression levels were associated with visual memory deficits, which may underlie the pathophysiology of MDD. In individuals with depression, immediate visual memory defects were positively correlated with anxiety symptoms.
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Affiliation(s)
- Ye Liu
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiao Yang
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Liansheng Zhao
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jian Zhang
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Tao Li
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaohong Ma
- Psychiatric Laboratory, Department of Psychiatry; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Suh S, Kim H, Dang-Vu TT, Joo E, Shin C. Cortical Thinning and Altered Cortico-Cortical Structural Covariance of the Default Mode Network in Patients with Persistent Insomnia Symptoms. Sleep 2016; 39:161-71. [PMID: 26414892 DOI: 10.5665/sleep.5340] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 07/18/2015] [Indexed: 01/11/2023] Open
Abstract
STUDY OBJECTIVES Recent studies have suggested that structural abnormalities in insomnia may be linked with alterations in the default-mode network (DMN). This study compared cortical thickness and structural connectivity linked to the DMN in patients with persistent insomnia (PI) and good sleepers (GS). METHODS The current study used a clinical subsample from the longitudinal community-based Korean Genome and Epidemiology Study (KoGES). Cortical thickness and structural connectivity linked to the DMN in patients with persistent insomnia symptoms (PIS; n = 57) were compared to good sleepers (GS; n = 40). All participants underwent MRI acquisition. Based on literature review, we selected cortical regions corresponding to the DMN. A seed-based structural covariance analysis measured cortical thickness correlation between each seed region of the DMN and other cortical areas. Association of cortical thickness and covariance with sleep quality and neuropsychological assessments were further assessed. RESULTS Compared to GS, cortical thinning was found in PIS in the anterior cingulate cortex, precentral cortex, and lateral prefrontal cortex. Decreased structural connectivity between anterior and posterior regions of the DMN was observed in the PIS group. Decreased structural covariance within the DMN was associated with higher PSQI scores. Cortical thinning in the lateral frontal lobe was related to poor performance in executive function in PIS. CONCLUSION Disrupted structural covariance network in PIS might reflect malfunctioning of antero-posterior disconnection of the DMN during the wake to sleep transition that is commonly found during normal sleep. The observed structural network alteration may further implicate commonly observed sustained sleep difficulties and cognitive impairment in insomnia.
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Affiliation(s)
- Sooyeon Suh
- Sungshin Women's University, Department of Psychology, Seoul, Korea.,Stanford University, Department of Psychiatry, Palo Alto, CA
| | - Hosung Kim
- University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA
| | - Thien Thanh Dang-Vu
- Center for Studies in Behavioral Neurobiology, PERFORM Center & Department of Exercise Science, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal & Department of Neurosciences, University of Montreal, Montreal, Canada
| | - Eunyeon Joo
- Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chol Shin
- Korea University Ansan Hospital, Institute of Human Genomic Study, Seoul, Korea.,Korea University Ansan Hospital, Department of Internal Medicine, Seoul, Korea
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98
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Porter RJ, Bourke C, Carter JD, Douglas KM, McIntosh VVW, Jordan J, Joyce PR, Frampton CMA. No change in neuropsychological dysfunction or emotional processing during treatment of major depression with cognitive-behaviour therapy or schema therapy. Psychol Med 2016; 46:393-404. [PMID: 26446709 DOI: 10.1017/s0033291715001907] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Impaired neuropsychological functioning is a feature of major depression. Previous studies have suggested that at least some aspects of neuropsychological functioning improve with successful treatment of major depression. The extent to which medications may affect the degree of normalization of these functions is unclear. The aim of the current study was to examine the course of neuropsychological functioning during treatment of major depression with cognitive-behaviour therapy (CBT) or schema therapy (ST). METHOD A total of 69 out-patients with a primary diagnosis of major depression and 58 healthy controls completed mood ratings, neuropsychological measures, and measures of emotional processing at baseline and after 16 weeks. Participants were randomized after baseline assessment to a year-long course of CBT or ST. Patients reassessed at 16 weeks were medication-free throughout the study. RESULTS Significant neuropsychological impairment was evident at baseline in depressed participants compared with healthy controls. After 16 weeks of psychotherapy, mean depression rating scores fell more than 50%. However, no neuropsychological measures showed convincing evidence of significant improvement and emotional processing did not change. CONCLUSIONS Persisting impairment in neuropsychological functioning after the first 16 weeks of CBT or ST suggests a need to modify psychological treatments to include components targeting cognitive functioning.
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Affiliation(s)
- R J Porter
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - C Bourke
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - J D Carter
- Department of Psychology,University of Canterbury,Christchurch,New Zealand
| | - K M Douglas
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - V V W McIntosh
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - J Jordan
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - P R Joyce
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
| | - C M A Frampton
- Department of Psychological Medicine,University of Otago,Christchurch,New Zealand
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99
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Steen NE, Aas M, Simonsen C, Dieset I, Tesli M, Nerhus M, Gardsjord E, Mørch R, Agartz I, Melle I, Vaskinn A, Spigset O, Andreassen OA. Serum level of venlafaxine is associated with better memory in psychotic disorders. Schizophr Res 2015; 169:386-392. [PMID: 26516101 DOI: 10.1016/j.schres.2015.10.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/08/2015] [Accepted: 10/15/2015] [Indexed: 12/18/2022]
Abstract
Cognitive impairment is a core feature of psychosis spectrum disorders. Antipsychotics have at best small positive effects on cognitive performance. There is a lack of knowledge regarding the effects of antidepressants on cognitive functioning in these disorders. In the present study cognitive performance was investigated in relation to serum levels of antidepressants in persons with bipolar disorder and schizophrenia. Serum concentrations of escitalopram, citalopram and venlafaxine plus O-desmethylvenlafaxine were measured in a total of 187 participants with bipolar disorder (N=74) or schizophrenia spectrum disorders (N=113), and analyzed in relation to neuropsychological tests performance of verbal learning, verbal memory, attention, working memory, executive functioning and processing speed. Analyses were performed using linear regression adjusting for a range of confounders. There was a significant positive association between the serum level of venlafaxine plus O-desmethylvenlafaxine and verbal memory (immediate recall: Logical Memory Test immediate recall [p=0.015], and long term delayed recall: Logical Memory Test delayed recall [p=0.011]). No significant associations were seen between citalopram or escitalopram and verbal memory. There were no significant associations between the tested antidepressants and verbal learning, attention, working memory, executive functioning, or processing speed. Venlafaxine seem to be associated with better verbal memory in bipolar disorder and schizophrenia. This suggests a possible beneficial role of certain antidepressants on cognitive dysfunction, which may have clinical implications and provide insight into underlying pathophysiology. However, the current findings should be replicated in independent samples.
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Affiliation(s)
- Nils Eiel Steen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway; Drammen District Psychiatric Center, Clinic of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway.
| | - Monica Aas
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Ingrid Dieset
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Martin Tesli
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Mari Nerhus
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Erlend Gardsjord
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Ragni Mørch
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, PO Box 85, Vinderen, 0319 Oslo, Norway
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
| | - Anja Vaskinn
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway; Department of Psychology, University of Oslo, PO Box 1094, Blindern, 0317 Oslo, Norway
| | - Olav Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, PO Box 3250, Sluppen, 7006 Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, PO Box 4956, Nydalen, 0424, Oslo, Norway
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100
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Khalaf A, Edelman K, Tudorascu D, Andreescu C, Reynolds CF, Aizenstein H. White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression. Neuropsychopharmacology 2015; 40:3027-35. [PMID: 26058663 PMCID: PMC4864637 DOI: 10.1038/npp.2015.158] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 05/26/2015] [Accepted: 05/30/2015] [Indexed: 12/19/2022]
Abstract
White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis. All depressed subjects started pharmacological treatment for depression shortly after a baseline magnetic resonance imaging (MRI) scan. At 12 weeks, patients underwent a follow-up MRI scan, and were categorized as either treatment remitters (n=23) or non-remitters (n=24). Among all patients, there was as a significant increase in WMHs over 12 weeks (t(46)=2.36, P=0.02). When patients were stratified by remission status, non-remitters demonstrated a significant increase in WMHs (t(23)=2.17, P=0.04), but this was not observed in remitters (t(22)=1.09, P=0.29). Other markers of brain integrity were also investigated including whole brain gray matter volume, hippocampal volume, and fractional anisotropy. No significant differences were observed in any of these markers during treatment, including when patients were stratified based on remission status. These results add to existing literature showing the association between WMH accumulation and LLD treatment outcomes. Moreover, this is the first study to demonstrate similar findings over a short interval (ie 12 weeks), which corresponds to the typical length of an antidepressant trial. These findings serve to highlight the acute interplay of cerebrovascular ischemic disease and LLD.
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Affiliation(s)
- Alexander Khalaf
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn Edelman
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dana Tudorascu
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carmen Andreescu
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charles F Reynolds
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard Aizenstein
- Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA,Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Room 459, Pittsburgh, PA 15213, USA, Tel: +1 412 246 5464, Fax: + 1 412 586 9111, E-mail:
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