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Roy JC, Hédouin R, Desmidt T, Dam S, Mirea-Grivel I, Weyl L, Bannier E, Barantin L, Drapier D, Batail JM, David R, Coloigner J, Robert GH. Quantifying Apathy in Late-Life Depression: Unraveling Neurobehavioral Links Through Daily Activity Patterns and Brain Connectivity Analysis. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:639-649. [PMID: 38615911 DOI: 10.1016/j.bpsc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/04/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Better understanding apathy in late-life depression would help improve prediction of poor prognosis of diseases such as dementia. Actimetry provides an objective and ecological measure of apathy from patients' daily motor activity. We aimed to determine whether patterns of motor activity were associated with apathy and brain connectivity in networks that underlie goal-directed behaviors. METHODS Resting-state functional magnetic resonance imaging and diffusion magnetic resonance imaging were collected from 38 nondemented participants with late-life depression. Apathy was evaluated using the diagnostic criteria for apathy, Apathy Evaluation Scale, and Apathy Motivation Index. Functional principal components (fPCs) of motor activity were derived from actimetry recordings taken for 72 hours. Associations between fPCs and apathy were estimated by linear regression. Subnetworks whose connectivity was significantly associated with fPCs were identified via threshold-free network-based statistics. The relationship between apathy and microstructure metrics was estimated along fibers by diffusion tensor imaging and a multicompartment model called neurite orientation dispersion and density imaging via tractometry. RESULTS We found 2 fPCs associated with apathy: mean diurnal activity, negatively associated with Apathy Evaluation Scale scores, and an early chronotype, negatively associated with Apathy Motivation Index scores. Mean diurnal activity was associated with increased connectivity in the default mode, cingulo-opercular, and frontoparietal networks, while chronotype was associated with a more heterogeneous connectivity pattern in the same networks. We did not find significant associations between microstructural metrics and fPCs. CONCLUSIONS Our findings suggest that mean diurnal activity and chronotype could provide indirect ambulatory measures of apathy in late-life depression, associated with modified functional connectivity of brain networks that underlie goal-directed behaviors.
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Affiliation(s)
- Jean-Charles Roy
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France.
| | - Renaud Hédouin
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; Centre d'Investigation Clinique 1415, CHU de Tours, INSERM, Tours, France
| | - Sébastien Dam
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Iris Mirea-Grivel
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Louise Weyl
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Elise Bannier
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; CHU de Rennes, Service de Radiologie, Rennes, France
| | - Laurent Barantin
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
| | - Dominique Drapier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Jean-Marie Batail
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Renaud David
- CHU de Nice, Université Côte d'Azur, Nice, France
| | - Julie Coloigner
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Gabriel H Robert
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
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Haniffa S, Narain P, Hughes MA, Petković A, Šušić M, Mlambo V, Chaudhury D. Chronic social stress blunts core body temperature and molecular rhythms of Rbm3 and Cirbp in mouse lateral habenula. Open Biol 2023; 13:220380. [PMID: 37463657 PMCID: PMC10353891 DOI: 10.1098/rsob.220380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/29/2023] [Indexed: 07/19/2023] Open
Abstract
Chronic social stress in mice causes behavioural and physiological changes that result in perturbed rhythms of body temperature, activity and sleep-wake cycle. To further understand the link between mood disorders and temperature rhythmicity in mice that are resilient or susceptible to stress, we measured core body temperature (Tcore) before and after exposure to chronic social defeat stress (CSDS). We found that Tcore amplitudes of stress-resilient and susceptible mice are dampened during exposure to CSDS. However, following CSDS, resilient mice recovered temperature amplitude faster than susceptible mice. Furthermore, the interdaily stability (IS) of temperature rhythms was fragmented in stress-exposed mice during CSDS, which recovered to control levels following stress. There were minimal changes in locomotor activity after stress exposure which correlates with regular rhythmic expression of Prok2 - an output signal of the suprachiasmatic nucleus. We also determined that expression of thermosensitive genes Rbm3 and Cirbp in the lateral habenula (LHb) were blunted 1 day after CSDS. Rhythmic expression of these genes recovered 10 days later. Overall, we show that CSDS blunts Tcore and thermosensitive gene rhythms. Tcore rhythm recovery is faster in stress-resilient mice, but Rbm3 and Cirbp recovery is uniform across the phenotypes.
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Affiliation(s)
- Salma Haniffa
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Priyam Narain
- Centre for Genomics and Systems Biology (CGSB), New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Michelle Ann Hughes
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Aleksa Petković
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Marko Šušić
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Vongai Mlambo
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Dipesh Chaudhury
- Department of Biology, Science Division, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
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Amidfar M, Garcez ML, Kim YK. The shared molecular mechanisms underlying aging of the brain, major depressive disorder, and Alzheimer's disease: The role of circadian rhythm disturbances. Prog Neuropsychopharmacol Biol Psychiatry 2023; 123:110721. [PMID: 36702452 DOI: 10.1016/j.pnpbp.2023.110721] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/07/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023]
Abstract
An association with circadian clock function and pathophysiology of aging, major depressive disorder (MDD), and Alzheimer's disease (AD) is well established and has been proposed as a factor in the development of these diseases. Depression and changes in circadian rhythm have been increasingly suggested as the two primary overlapping and interpenetrating changes that occur with aging. The relationship between AD and depression in late life is not completely understood and probably is complex. Patients with major depression or AD suffer from disturbed sleep/wake cycles and altered rhythms in daily activities. Although classical monoaminergic hypotheses are traditionally proposed to explain the pathophysiology of MDD, several clinical and preclinical studies have reported a strong association between circadian rhythm and mood regulation. In addition, a large body of evidence supports an association between disruption of circadian rhythm and AD. Some clock genes are dysregulated in rodent models of depression. If aging, AD, and MDD share a common biological basis in pathophysiology, common therapeutic tools could be investigated for their prevention and treatment. Nitro-oxidative stress (NOS), for example, plays a fundamental role in aging, as well as in the pathogenesis of AD and MDD and is associated with circadian clock disturbances. Thus, development of therapeutic possibilities with these NOS-related conditions is advisable. This review describes recent findings that link disrupted circadian clocks to aging, MDD, and AD and summarizes the experimental evidence that supports connections between the circadian clock and molecular pathologic factors as shared common pathophysiological mechanisms underlying aging, AD, and MDD.
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Affiliation(s)
- Meysam Amidfar
- Department of Neuroscience, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Michelle Lima Garcez
- Laboratory of Translational Neuroscience, Department of Biochemistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea.
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Haniffa S, Narain P, Hughes MA, Petković A, Šušić M, Mlambo V, Chaudhury D. Chronic social stress blunts core body temperature and molecular rhythms of Rbm3and Cirbpin mouse lateral habenula.. [DOI: 10.1101/2023.01.02.522528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Abstract
AbstractChronic social stress in mice causes behavioral and physiological changes that result in perturbed rhythms of body temperature, activity and sleep-wake cycle. To further understand the link between mood disorders and temperature rhythmicity in mice that are resilient or susceptible to stress, we measured core body temperature (Tcore) before and after exposure to chronic social defeat stress (CSDS). We found that Tcore amplitudes of stress-resilient and susceptible mice are dampened during exposure to CSDS. However, following CSDS, resilient mice recovered temperature amplitude faster than susceptible mice. Furthermore, the interdaily stability (IS) of temperature rhythms was fragmented in stress-exposed mice during CSDS, which recovered to control levels following stress. There were minimal changes in locomotor activity after stress exposure which correlates with regular rhythmic expression ofProk2- an output signal of the suprachiasmatic nucleus. We also determined that expression of thermosensitive genesRbm3andCirbpin the lateral habenula (LHb) were blunted 1-day after CSDS. Rhythmic expression of these genes recovered 10 days later. Overall, we show that CSDS blunts Tcore and thermosensitive gene rhythms. Tcore rhythm recovery is faster in stress-resilient mice, butRbm3andCirbprecovery is uniform across the phenotypes.
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5
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He S, Ding L, He K, Zheng B, Liu D, Zhang M, Yang Y, Mo Y, Li H, Cai Y, Peng D. Reliability and validity of the Chinese version of the biological rhythms interview of assessment in neuropsychiatry in patients with major depressive disorder. BMC Psychiatry 2022; 22:834. [PMID: 36581864 PMCID: PMC9798705 DOI: 10.1186/s12888-022-04487-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although disturbances in biological rhythms are closely related to the onset of major depressive disorder (MDD), they are not commonly assessed in Chinese clinical practice. The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) has been used to evaluate disturbances in biological rhythms in MDD. We aimed to assess and confirm the reliability and validity of the Chinese version of the BRIAN (C-BRIAN) in patients with MDD. METHODS A total of 120 patients with MDD and 40 age- and sex-matched controls were recruited consecutively. Reliability was estimated using Cronbach's alpha, the split-half coefficient, and the test-retest coefficient; test-retest reliability was assessed using Spearman's correlation coefficient. A confirmatory factor analysis was used to determine the construct validity of the scale. The Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ) were used to check concurrent validity by evaluating the correlation between the C-BRIAN, PSQI, and MEQ. RESULTS The overall Cronbach's α value was 0.898, indicating good internal consistency. The Guttman split-half coefficient was 0.792, indicating good split-half reliability. Moreover, the test-retest reliability for both the total and individual item score was excellent. Confirmatory factor analysis revealed that construct validity was acceptable (χ2/df = 2.117, GFI = 0.80, AGFI = 0.87, CFI = 0.848, and RMSEA = 0.097). Furthermore, total BRIAN scores were found to be negatively correlated with MEQ (r = - 0.517, P < 0.001) and positively correlated with PSQI (r = 0.586, P < 0.001). In addition, patients with MDD had higher BRIAN scores than those in controls. CONCLUSIONS This study revealed that the C-BRIAN scale has great validity and reliability in evaluating the disturbance of biological rhythms in patients with MDD.
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Affiliation(s)
- Shen He
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Lei Ding
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Kaibing He
- grid.11841.3d0000 0004 0619 8943Shanghai Medical College of Fudan University, Shanghai, China
| | - Baoying Zheng
- grid.500245.6Hospital Tuanku Jaafar, Seremban, Malaysia
| | - Dan Liu
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Min Zhang
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Yao Yang
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Yingqun Mo
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Hua Li
- grid.16821.3c0000 0004 0368 8293Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030 People’s Republic of China
| | - Yiyun Cai
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, People's Republic of China.
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai, 200030, People's Republic of China.
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Kahawage P, Bullock B, Meyer D, Gottlieb J, Crowe M, Swartz HA, Yatham LN, Inder M, Porter RJ, Nierenberg AA, Meesters Y, Gordijn M, Haarman BCM, Murray G. Social Rhythm Disruption is Associated with Greater Depressive Symptoms in People with Mood Disorders: Findings from a Multinational Online Survey During COVID-19. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:831-840. [PMID: 35535550 PMCID: PMC9096005 DOI: 10.1177/07067437221097905] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Societal restrictions imposed to prevent transmission of COVID-19 may challenge circadian-driven lifestyle behaviours, particularly amongst those vulnerable to mood disorders. The overarching aim of the present study was to investigate the hypothesis that, in the routine-disrupted environment of the COVID-19, amongst a sample of people living with mood disorders, greater social rhythm disruption would be associated with more severe mood symptoms. METHODS We conducted a two-wave, multinational survey of 997 participants (MAge=39.75±13.39,Female=81.6%) who self-reported a mood disorder diagnosis (i.e., major depressive disorder or bipolar disorder). Respondents completed questionnaires assessing demographics, social rhythmicity (The Brief Social Rhythm Scale), depression symptoms (Patient Health Questionnaire-9), sleep quality and diurnal preference (The Sleep, Circadian Rhythms and Mood questionnaire) and stressful life events during the COVID-19 pandemic (The Social Readjustment Rating Scale). RESULTS The majority of participants indicated COVID-19-related social disruption had affected the regularity of their daily routines to at least some extent (n = 788, 79.1%). As hypothesised, lower social rhythmicity was associated with greater depressive symptoms when tested cross-sectionally (standardised β = -.25, t = -7.94, P = 0.000) and when tested using a 2-level hierarchical linear model across two time points (b = -0.14, t = -3.46, df = 264, P ≤ 0.001). CONCLUSIONS These results are consistent with the social zeitgeber hypothesis proposing that mood disorders are sensitive to life events that disrupt social rhythms.
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Affiliation(s)
- Piyumi Kahawage
- Centre for Mental Health, 3783Swinburne University of Technology, Melbourne, Australia
| | - Ben Bullock
- Centre for Mental Health, 3783Swinburne University of Technology, Melbourne, Australia
| | - Denny Meyer
- Centre for Mental Health, 3783Swinburne University of Technology, Melbourne, Australia
| | - John Gottlieb
- Department of Psychiatry and Behavioural Sciences, 12244Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marie Crowe
- Department of Psychological Medicine, 2494University of Otago, Christchurch, New Zealand
| | - Holly A Swartz
- Department of Psychiatry, 6614University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, 8166University of British Columbia, Vancouver, Canada
| | - Maree Inder
- Department of Psychological Medicine, 2494University of Otago, Christchurch, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, 2494University of Otago, Christchurch, New Zealand
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, 2348Massachusetts General Hospital, 1811Harvard Medical School, Boston, MA, USA
| | - Ybe Meesters
- Department of Psychiatry Groningen, 3647University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marijke Gordijn
- Chrono@Work & Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - Bartholomeus C M Haarman
- Department of Psychiatry Groningen, 3647University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Greg Murray
- Centre for Mental Health, 3783Swinburne University of Technology, Melbourne, Australia
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Soreca I. The role of circadian rhythms in Obstructive Sleep Apnea symptoms and novel targets for treatment. Chronobiol Int 2021; 38:1274-1282. [PMID: 34027758 DOI: 10.1080/07420528.2021.1929281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/09/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
Obstructive Sleep Apnea (OSA) is a common disorder that is associated with disability, premature mortality and lost quality of life. Excessive daytime sleepiness and depressive symptoms confer a great portion of the disability and lost quality of life associated with the disorder. While showing robust rates of response and symptoms resolutions, current treatments aimed at correcting the respiratory disturbances are not universally successful and a non-negligible proportion of patients who are correctly using available therapies do not experience symptomatic relief, suggesting that mechanisms beyond the respiratory disturbances may be involved in the pathogenesis of symptoms. A growing body of literature concerning animal and human models suggests that the sleep and respiratory disturbances commonly seen in OSA, namely sleep fragmentation, partial sleep deprivation, intermittent hypoxia, can promote shifts in circadian rhythms ultimately leading to misalignment between sleep-wake rhythms and the internal clock, as well as desynchrony amongst peripheral clocks and peripheral and central clock. This manuscript reviews the current evidence in support of a circadian disturbance underlying OSA symptomatology and proposes new applications for existing chronotherapeutic interventions with the potential for improving symptoms and quality of life for those patients that do not find symptomatic relief with currently available treatments.
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Affiliation(s)
- Isabella Soreca
- Department of Sleep Medicine, Mental Illness Research, Clinical, Education Centers of Excellence (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
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Filatova EV, Shadrina MI, Slominsky PA. Major Depression: One Brain, One Disease, One Set of Intertwined Processes. Cells 2021; 10:cells10061283. [PMID: 34064233 PMCID: PMC8224372 DOI: 10.3390/cells10061283] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/18/2023] Open
Abstract
Major depressive disorder (MDD) is a heterogeneous disease affecting one out of five individuals and is the leading cause of disability worldwide. Presently, MDD is considered a multifactorial disease with various causes such as genetic susceptibility, stress, and other pathological processes. Multiple studies allowed the formulation of several theories attempting to describe the development of MDD. However, none of these hypotheses are comprehensive because none of them can explain all cases, mechanisms, and symptoms of MDD. Nevertheless, all of these theories share some common pathways, which lead us to believe that these hypotheses depict several pieces of the same big puzzle. Therefore, in this review, we provide a brief description of these theories and their strengths and weaknesses in an attempt to highlight the common mechanisms and relationships of all major theories of depression and combine them together to present the current overall picture. The analysis of all hypotheses suggests that there is interdependence between all the brain structures and various substances involved in the pathogenesis of MDD, which could be not entirely universal, but can affect all of the brain regions, to one degree or another, depending on the triggering factor, which, in turn, could explain the different subtypes of MDD.
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Wang XL, Wang DQ, Jiao FC, Ding KM, Ji YB, Lu L, Yuan K, Gao GF, Li SX. Diurnal rhythm disruptions induced by chronic unpredictable stress relate to depression-like behaviors in rats. Pharmacol Biochem Behav 2021; 204:173156. [PMID: 33675839 DOI: 10.1016/j.pbb.2021.173156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/20/2021] [Accepted: 02/21/2021] [Indexed: 11/15/2022]
Abstract
The relationship between circadian rhythms and mood disorders has been established. Circadian dysregulations are believed to exacerbate the severity of mood disorders and vice versa. Although many studies on diurnal changes of clock genes in animal model of depression have been performed from the RNA level, only a few studies have been carried out from the protein level. In this study, we investigated the diurnal changes induced by chronic unpredictable stress (CUS) using free-running wheel test and Western Blotting (WB). Besides, we examined the depression-like behaviors of rats by sucrose preference test (SPT) and forced swim test (FST). We found that CUS induced significant reductions in the quantity of free-running wheel activity and rhythmic disruptions of clock proteins in hippocampus. Furthermore, we found that the amplitude of PER1 in CA1 was positively related to the severity of depression-like behaviors. These results suggest that CUS results in both changes in diurnal rhythms and in depression-like behaviors and that it is suggested that these changes are related.
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Affiliation(s)
- Xin-Ling Wang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 101408, China; National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China
| | - De-Quan Wang
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China
| | - Fu-Chao Jiao
- Qingdao Agricultural University, Qingdao 266109, China
| | - Kai-Mo Ding
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China; Zhenjiang Mental Health Center, Zhenjiang, Jiangsu Province, China
| | - Yan-Bin Ji
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China; Center of Psychiatry, Anhui Medical University, Mental Health Center of Anhui Province, Hefei 230032, China
| | - Lin Lu
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 101408, China; National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China; Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - George Fu Gao
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 101408, China; Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China; Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing 100191, China.
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Malhi GS, Bell E, Bassett D, Boyce P, Bryant R, Hazell P, Hopwood M, Lyndon B, Mulder R, Porter R, Singh AB, Murray G. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry 2021; 55:7-117. [PMID: 33353391 DOI: 10.1177/0004867420979353] [Citation(s) in RCA: 246] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. METHODS Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. RESULTS The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. CONCLUSION The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. MOOD DISORDERS COMMITTEE Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.
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Affiliation(s)
- Gin S Malhi
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Erica Bell
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia.,Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | | | - Philip Boyce
- Department of Psychiatry, Westmead Hospital and the Westmead Clinical School, Wentworthville, NSW, Australia.,Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Philip Hazell
- Discipline of Psychiatry, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne and Professorial Psychiatry Unit, Albert Road Clinic, Melbourne, VIC, Australia
| | - Bill Lyndon
- The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, NSW, Australia
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Ajeet B Singh
- The Geelong Clinic Healthscope, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
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11
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Crowe M, Inder M, Porter R, Wells H, Jordan J, Lacey C, Eggleston K, Douglas K. Patients' Perceptions of Functional Improvement in Psychotherapy for Mood Disorders. Am J Psychother 2020; 74:22-29. [PMID: 33302704 DOI: 10.1176/appi.psychotherapy.202020200017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to examine participants' experiences of interpersonal and social rhythm therapy, with or without cognitive remediation, and the impact of this intervention on their functioning. METHODS This qualitative study drew data from follow-up interviews of 20 participants who completed the 12-month intervention as part of a randomized controlled trial. The qualitative data were collected through semistructured interviews and were analyzed with thematic analysis. RESULTS The 20 participants (11 men, 9 women, ages 22-55, median age=32) reported that interpersonal and social rhythm therapy (content and process) as an adjunct to medication, alone or in combination with cognitive remediation, was effective in improving their functioning. They described these improvements as facilitated by a new sense of control and confidence, ability to focus, new communication and problem-solving skills, and better daily routines. CONCLUSIONS Participants with recurrent mood disorders described improved functioning related to therapies that formulate their mood disorder in terms of a model, such as interpersonal and social rhythm therapy with or without cognitive remediation, that provides an understandable and evidence-based rationale, facilitates a sense of control and confidence by supporting the person in undertaking practical routines that can be integrated into daily life, focuses on communication and problem-solving skills, and engenders a sense of hope by working with the person to develop self-management strategies relevant to their specific symptom experiences and the life they choose to live.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Maree Inder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Hayley Wells
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Kate Eggleston
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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12
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Aly J, Engmann O. The Way to a Human's Brain Goes Through Their Stomach: Dietary Factors in Major Depressive Disorder. Front Neurosci 2020; 14:582853. [PMID: 33364919 PMCID: PMC7750481 DOI: 10.3389/fnins.2020.582853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Globally, more than 250 million people are affected by depression (major depressive disorder; MDD), a serious and debilitating mental disorder. Currently available treatment options can have substantial side effects and take weeks to be fully effective. Therefore, it is important to find safe alternatives, which act more rapidly and in a larger number of patients. While much research on MDD focuses on chronic stress as a main risk factor, we here make a point of exploring dietary factors as a somewhat overlooked, yet highly promising approach towards novel antidepressant pathways. Deficiencies in various groups of nutrients often occur in patients with mental disorders. These include vitamins, especially members of the B-complex (B6, B9, B12). Moreover, an imbalance of fatty acids, such as omega-3 and omega-6, or an insufficient supply with minerals, including magnesium and zinc, are related to MDD. While some of them are relevant for the synthesis of monoamines, others play a crucial role in inflammation, neuroprotection and the synthesis of growth factors. Evidence suggests that when deficiencies return to normal, changes in mood and behavior can be, at least in some cases, achieved. Furthermore, supplementation with dietary factors (so called "nutraceuticals") may improve MDD symptoms even in the absence of a deficiency. Non-vital dietary factors may affect MDD symptoms as well. For instance, the most commonly consumed psychostimulant caffeine may improve behavioral and molecular markers of MDD. The molecular structure of most dietary factors is well known. Hence, dietary factors may provide important molecular tools to study and potentially help treat MDD symptoms. Within this review, we will discuss the role of dietary factors in MDD risk and symptomology, and critically discuss how they might serve as auxiliary treatments or preventative options for MDD.
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Affiliation(s)
- Janine Aly
- Faculty of Medicine, Friedrich Schiller Universität, Jena, Germany
| | - Olivia Engmann
- Institute for Human Genetics, Jena University Hospital, Jena, Germany
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13
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Trautmann C, Burek D, Hübner CA, Girault JA, Engmann O. A regulatory pathway linking caffeine action, mood and the diurnal clock. Neuropharmacology 2020; 172:108133. [PMID: 32413367 DOI: 10.1016/j.neuropharm.2020.108133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/28/2020] [Accepted: 05/08/2020] [Indexed: 11/29/2022]
Abstract
Depression is a leading cause of disability worldwide. Circadian abnormalities and mood changes are symptoms of depression. The psychostimulant caffeine alters wakefulness and alleviates other depression-related symptoms during chronic intake, but the underlying mechanisms are unclear. It is not known, whether and how acute caffeine administration affects mood. Molecular approaches, transgenic mouse models, pharmacological intervention and behavioral analysis were combined to uncover a regulatory pathway, which connects caffeine action with diurnal signaling via the key dopaminergic protein DARPP-32 and alters mood-related phenotypes in mice, which are often assessed in the context of antidepressant action. We observed that Thr75-DARPP-32 binds to the circadian regulator CLOCK and disrupts CLOCK:BMAL1 chromatin binding, thereby affecting gene expression. T75A-DARPP-32 mutant mice show reduced caffeine effects on CLOCK:BMAL1 and lack caffeine-induced effects on mood. This study provides a link between caffeine, diurnal signaling and mood-related behaviors, which may open new perspectives for our understanding of antidepressant mechanisms in the mouse brain.
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Affiliation(s)
- Charlotte Trautmann
- Institute of Human Genetics, Jena University Hospital, Am Klinikum 1, Thüringen, 07747, Germany
| | - Dominika Burek
- Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian A Hübner
- Institute of Human Genetics, Jena University Hospital, Am Klinikum 1, Thüringen, 07747, Germany
| | - Jean-Antoine Girault
- Inserm, Institut du Fer à Moulin UMR-S 1270, Paris, 75005, France; Sorbonne Université, Paris, 75005, France
| | - Olivia Engmann
- Institute of Human Genetics, Jena University Hospital, Am Klinikum 1, Thüringen, 07747, Germany; Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Inserm, Institut du Fer à Moulin UMR-S 1270, Paris, 75005, France; Sorbonne Université, Paris, 75005, France; Laboratory of Neuroepigenetics, University of Zürich and ETH Zürich, Center for Neuroscience Zürich, Brain Research Institute, CH-8057 Zürich, Switzerland.
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14
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Porcu A, Vaughan M, Nilsson A, Arimoto N, Lamia K, Welsh DK. Vulnerability to helpless behavior is regulated by the circadian clock component CRYPTOCHROME in the mouse nucleus accumbens. Proc Natl Acad Sci U S A 2020; 117:13771-13782. [PMID: 32487727 PMCID: PMC7306774 DOI: 10.1073/pnas.2000258117] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The nucleus accumbens (NAc), a central component of the midbrain dopamine reward circuit, exhibits disturbed circadian rhythms in the postmortem brains of depressed patients. We hypothesized that normal mood regulation requires proper circadian timing in the NAc, and that mood disorders are associated with dysfunctions of the NAc cellular circadian clock. In mice exhibiting stress-induced depression-like behavior (helplessness), we found altered circadian clock function and high nighttime expression of the core circadian clock component CRYPTOCHROME (CRY) in the NAc. In the NAc of helpless mice, we found that higher expression of CRY is associated with decreased activation of dopamine 1 receptor-expressing medium spiny neurons (D1R-MSNs). Furthermore, D1R-MSN-specific CRY-knockdown in the NAc reduced susceptibility to stress-induced helplessness and increased NAc neuronal activation at night. Finally, we show that CRY inhibits D1R-induced G protein activation, likely by interacting with the Gs protein. Altered circadian rhythms and CRY expression were also observed in human fibroblasts from major depressive disorder patients. Our data reveal a causal role for CRY in regulating the midbrain dopamine reward system, and provide a mechanistic link between the NAc circadian clock and vulnerability to depression.
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Affiliation(s)
- Alessandra Porcu
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161;
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92037
| | - Megan Vaughan
- Department of Molecular Medicine, Scripps Research, La Jolla, CA 92037
| | - Anna Nilsson
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92037
| | - Natsuko Arimoto
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92037
| | - Katja Lamia
- Department of Molecular Medicine, Scripps Research, La Jolla, CA 92037
| | - David K Welsh
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92037
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92037
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15
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Wang XL, Wang DQ, Jiao FC, Ding KM, Ji YB, Lu L, Yuan K, Gao GF, Li SX. Diurnal rhythm disruptions induced by chronic unpredictable stress relate to depression-like behaviors in rats. Pharmacol Biochem Behav 2020; 194:172939. [PMID: 32437704 DOI: 10.1016/j.pbb.2020.172939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 11/27/2022]
Abstract
The relationship between circadian rhythms and mood disorders has been established, circadian dysregulations are believed to exacerbate the severity of mood disorders and vice versa. Although many studies on diurnal changes of clock genes in animal model of depression have been performed from the RNA level, only a few studies have been carried out from the protein level. In this study, we investigated the diurnal changes induced by chronic unpredictable stress (CUS) using various methods, including free-running wheel test, enzyme-linked immunosorbent assay (ELISA) and Western Blotting (WB). Besides, we examined the depression-like behaviors of rats by sucrose preference test (SPT) and forced swim test (FST). We found that CUS induced significant reductions in the quantity of free-running wheel activity and the amplitude of melatonin secretion rhythm. We also found that CUS induced rhythmic disruptions of clock proteins in hippocampus. Furthermore, we found that the amplitude of PER1 in CA1 was positively related to the severity of depression-like behaviors. These results suggest that stress results in both changes in circadian rhythms and in depression-like behaviors and that it is suggested that these changes are related.
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Affiliation(s)
- Xin-Ling Wang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing101408, China; National Institute on Drug Dependence, Peking University, Beijing100191, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China
| | - De-Quan Wang
- National Institute on Drug Dependence, Peking University, Beijing100191, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China
| | - Fu-Chao Jiao
- Qingdao Agricultural University, Qingdao266109, China
| | - Kai-Mo Ding
- National Institute on Drug Dependence, Peking University, Beijing100191, China; Zhenjiang Mental Health Center, Zhenjiang, Jiangsu Province, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China
| | - Yan-Bin Ji
- National Institute on Drug Dependence, Peking University, Beijing100191, China; Center of Psychiatry, Anhui Medical University, Mental Health Center of Anhui Province, Hefei230032, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China
| | - Lin Lu
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing101408, China; National Institute on Drug Dependence, Peking University, Beijing100191, China; Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Peking University, Beijing100191, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China; Peking University Sixth Hospital, Peking University, Beijing100191, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Peking University, Beijing100191, China; Peking University Sixth Hospital, Peking University, Beijing100191, China
| | - George Fu Gao
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing101408, China; Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing100101, China; Chinese Center for Disease Control and Prevention, Beijing102206, China.
| | - Su-Xia Li
- National Institute on Drug Dependence, Peking University, Beijing100191, China; Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing100191, China.
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16
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Crowe M, Inder M, Douglas K, Carlyle D, Wells H, Jordan J, Lacey C, Mulder R, Beaglehole B, Porter R. Interpersonal and Social Rhythm Therapy for Patients With Major Depressive Disorder. Am J Psychother 2020; 73:29-34. [DOI: 10.1176/appi.psychotherapy.20190024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Maree Inder
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Katie Douglas
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Dave Carlyle
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Hayley Wells
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Ben Beaglehole
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
| | - Richard Porter
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand (all authors)
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17
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Heart rate variability (HRV): From brain death to resonance breathing at 6 breaths per minute. Clin Neurophysiol 2020; 131:676-693. [DOI: 10.1016/j.clinph.2019.11.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/14/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022]
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18
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Daniels S, Horman T, Lapointe T, Melanson B, Storace A, Kennedy SH, Frey BN, Rizvi SJ, Hassel S, Mueller DJ, Parikh SV, Lam RW, Blier P, Farzan F, Giacobbe P, Milev R, Placenza F, Soares CN, Turecki G, Uher R, Leri F. Reverse translation of major depressive disorder symptoms: A framework for the behavioural phenotyping of putative biomarkers. J Affect Disord 2020; 263:353-366. [PMID: 31969265 DOI: 10.1016/j.jad.2019.11.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/13/2019] [Accepted: 11/22/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reverse translating putative biomarkers of depression from patients to animals is complex because Major Depressive Disorder (MDD) is a highly heterogenous condition. This review proposes an approach to reverse translation based on relating relevant bio-behavioural functions in laboratory rodents to MDD symptoms. METHODS This systematic review outlines symptom clusters assessed by psychometric tests of MDD and antidepressant treatment response including the Montgomery-Åsberg Depression Rating Scale, the Hamilton Depression Rating Scale, and the Beck Depression Inventory. Symptoms were related to relevant behavioural assays in laboratory rodents. RESULTS The resulting battery of tests includes passive coping, anxiety-like behaviours, sleep, caloric intake, cognition, psychomotor functions, hedonic reactivity and aversive learning. These assays are discussed alongside relevant clinical symptoms of MDD, providing a framework through which reverse translation of a biomarker can be interpreted. LIMITATIONS Certain aspects of MDD may not be quantified by tests in laboratory rodents, and their biological significance may not always be of clinical relevance. CONCLUSIONS Using this reverse translation approach, it is possible to clarify the functional significance of a putative biomarker in rodents and hence translate its contribution to specific clinical symptoms, or clusters of symptoms.
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Affiliation(s)
- Stephen Daniels
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada
| | - Thomas Horman
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada
| | - Thomas Lapointe
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada
| | - Brett Melanson
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada
| | - Alexandra Storace
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada
| | - Sidney H Kennedy
- University of Toronto Health Network, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Sakina J Rizvi
- University of Toronto Health Network, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Daniel J Mueller
- The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Raymond W Lam
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Pierre Blier
- The Royal Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Faranak Farzan
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Peter Giacobbe
- University of Toronto Health Network, Toronto, Ontario, Canada
| | | | - Franca Placenza
- University of Toronto Health Network, Toronto, Ontario, Canada
| | | | | | - Rudolf Uher
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francesco Leri
- Department of Psychology and Neuroscience, University of Guelph, Guelph N1G 2W1, Ontario, Canada.
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19
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Lorenz N, Spada J, Sander C, Riedel-Heller SG, Hegerl U. Circadian skin temperature rhythms, circadian activity rhythms and sleep in individuals with self-reported depressive symptoms. J Psychiatr Res 2019; 117:38-44. [PMID: 31279242 DOI: 10.1016/j.jpsychires.2019.06.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/25/2019] [Accepted: 06/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Disturbed circadian rhythms have been associated with depression. New body-worn devices allow the objective recording of circadian parameters such as physical activity, skin temperature and sleep. The objective of this study was to investigate whether circadian skin temperature and circadian activity rhythms are altered in depressed individuals. METHODS Data on skin temperature, physical activity and sleep were available for 1610 subjects from a population-based cohort study. In a matching process two groups were formed for analysis: 121 participants with pronounced depression symptoms (CES-D Score > 21) and n = 121 matched non-depressed controls (CES-D Score < 15). Circadian rhythms were investigated by analyzing non-parametric rhythm indicators of 24-h skin temperature and physical activity data. Sleep timing, continuity and quantity were calculated from actigraphy. RESULTS No differences between the groups were found when all participants were considered. After excluding antidepressant medicated participants, the depression group was found to have a lower skin temperature amplitude t(208) = 2.45, p = .015 and a less stable skin temperature rhythm t(208) = 2.40, p = .017. The amplitude predicted the group status (beta = -5.529, p = .016). No effects were found for activity or sleep. CONCLUSION The results indicate that skin-temperature rhythms are blunted in unmedicated depressed individuals. This could be a promising non-invasive marker for further analysis.
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Affiliation(s)
- Noah Lorenz
- Medical Faculty, Department of Psychiatry and Psychotherapy, University Leipzig, Leipzig, DE, Germany; Research Centre of the German Depression Foundation, Leipzig, DE, Germany.
| | - Janek Spada
- University of Leipzig, Department of Psychology, Leipzig, DE, Germany
| | - Christian Sander
- Medical Faculty, Department of Psychiatry and Psychotherapy, University Leipzig, Leipzig, DE, Germany; Research Centre of the German Depression Foundation, Leipzig, DE, Germany
| | - Steffie G Riedel-Heller
- University of Leipzig, Institute of Social Medicine, Occupational Health and Public Health, Leipzig, DE, Germany
| | - Ulrich Hegerl
- Research Centre of the German Depression Foundation, Leipzig, DE, Germany; Department of Psychiatry, Psychosomatics and Psychotherapie, Goethe-University, Frankfurt, Germany
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20
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Bilu C, Einat H, Barak O, Zimmet P, Vishnevskia-Dai V, Govrin A, Agam G, Kronfeld-Schor N. Linking type 2 diabetes mellitus, cardiac hypertrophy and depression in a diurnal animal model. Sci Rep 2019; 9:11865. [PMID: 31413352 PMCID: PMC6694156 DOI: 10.1038/s41598-019-48326-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/02/2019] [Indexed: 12/28/2022] Open
Abstract
It was recently suggested that the Metabolic Syndrome should be renamed to "Circadian Syndrome". In this context, we explored the effects of living under standard laboratory conditions, where light is the only cycling variable (relevant to human modern life), in a diurnal mammal, on the relationships between affective-like pathology, type 2 diabetes mellitus (T2DM), and cardiac hypertrophy. After 20 weeks, some of the animals spontaneously developed T2DM, depressive and anxiety-like behavior and cardiac hypertrophy. There were significant correlations between levels of anxiety-like behavior and glucose tolerance, and between heart/total body weight ratio and glucose tolerance. Our data suggest a relationship between the development of T2DM, emotional and cardiac pathology as seen in diurnal humans. Furthermore, our data show a possible relationship between reduced daily cycling cues in the laboratory and what has been regularly termed "Metabolic Syndrome" and recently proposed by us to be renamed to "Circadian Syndrome".
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Affiliation(s)
- Carmel Bilu
- School of Zoology, Tel-Aviv University, Tel Aviv, Ramat Aviv, Israel
- Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Haim Einat
- Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer Sheva, Israel
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | - Orly Barak
- School of Zoology, Tel-Aviv University, Tel Aviv, Ramat Aviv, Israel
| | - Paul Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - Vicktoria Vishnevskia-Dai
- Ocular Oncology and Autoimmune service, The Goldschleger Eye Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Amanda Govrin
- School of Zoology, Tel-Aviv University, Tel Aviv, Ramat Aviv, Israel
| | - Galila Agam
- Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, Beer Sheva, Israel
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21
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Tao S, Chattun MR, Yan R, Geng J, Zhu R, Shao J, Lu Q, Yao Z. TPH-2 Gene Polymorphism in Major Depressive Disorder Patients With Early-Wakening Symptom. Front Neurosci 2018; 12:827. [PMID: 30519155 PMCID: PMC6251472 DOI: 10.3389/fnins.2018.00827] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/23/2018] [Indexed: 12/13/2022] Open
Abstract
Background: Sleep disturbances, such as early wakening, are frequently observed in patients with major depressive disorder (MDD). The suprachiasmatic nuclei (SCN), which controls circadian rhythm, is innervated by the raphe nucleus, a region where Tryptophan hydroxylase-2 (TPH-2) gene is primarily expressed. Although TPH-2 is often implicated in the pathophysiology of depression, few studies have applied a genetic and imaging technique to investigate the mechanism of early wakening symptom in MDD. We hypothesized that TPH-2 variants could influence the function of SCN in MDD patients with early wakening symptom. Methods: One hundred and eighty five MDD patients (62 patients without early wakening and 123 patients with early wakening) and 64 healthy controls participated in this study. Blood samples were collected and genotyping of rs4290270, rs4570625, rs11178998, rs7305115, rs41317118, and rs17110747 were performed by next-generation sequencing (NGS) technology. Logistic regression model was employed for genetic data analysis using the PLINK software. Based on the allele type, rs4290270, which was significant in the early wakening MDD group, participants were categorized into two groups (A allele and T carrier). All patients underwent whole brain resting-state functional magnetic resonance imaging (rs-fMRI) scanning and a voxel-wise functional connectivity comparison was performed between the groups. Results: rs4290270 was significantly linked to MDD patients who exhibited early wakening symptom. The functional connectivities of the right SCN with the right fusiform gyrus and right middle frontal gyrus were increased in the T carrier group compared to the A allele group. In addition, the functional connectivities of the left SCN with the right lingual gyrus and left calcarine sulcus were decreased in the T carrier group compared to the A allele group. Conclusion: These findings suggested that the TPH-2 gene variant, rs4290270, affected the circadian regulating function of SCN. The altered functional connectivities, observed between the SCN and right fusiform gyrus, right middle frontal gyrus, the right lingual gyrus and left calcarine sulcus, could highlight the neural mechanism by which SCN induces sleep-related circadian disruption in T carrier MDD patients. Hence, rs4290270 could potentially serve as a reliable biomarker to identify MDD patients with early wakening symptom.
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Affiliation(s)
- Shiwan Tao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiting Geng
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rongxin Zhu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Junneng Shao
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Southeast University, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Medical School of Nanjing University, Nanjing Brain Hospital, Nanjing, China
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Wyse CA, Zhang X, McLaughlin M, Biello SM, Hough D, Bellingham M, Curtis AM, Robinson JE, Evans NP. Circadian rhythms of melatonin and behaviour in juvenile sheep in field conditions: Effects of photoperiod, environment and weaning. Physiol Behav 2018; 194:362-370. [PMID: 29894760 DOI: 10.1016/j.physbeh.2018.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 11/19/2022]
Abstract
Entrainment of circadian rhythms (CR) to the light dark cycle has been well described under controlled, experimental conditions. However, studies in rodents have reported that rhythms in the laboratory are not always reproduced under field conditions. The aim of this study was to characterise the CR of sheep maintained under conditions of standard UK farm animal husbandry and to investigate the effects of environmental challenges presented by season, weaning and changes in housing on CR. Male sheep (n = 9) were kept at pasture, or group housed in barns, under natural photoperiod for one year. CR in locomotor activity were monitored using accelerometry, and 24 h patterns in plasma cortisol and melatonin were measured every 4 h by ELISA. CR was measured before and after weaning, in summer and winter, and at pasture and by barn housing. Cosinor analysis revealed high amplitude, diurnal rhythms in locomotor activity that were disrupted by weaning and by barn housing. Rhythms in winter showed an interrupted night time activity pattern, but only when the sheep were kept at pasture. Cortisol and melatonin secretion followed typical circadian patterns in winter and summer. The CR of the sheep under the field conditions of this study were strikingly robust under basal conditions, but easily disrupted by environmental challenges. Interrupted patterns of activity during the long nights of wintertime, not previously reported for sheep kept in experimental conditions were recorded. Based on these findings, we propose that animals require exposure to more complex environments than the laboratory in order to exhibit their true circadian phenotype.
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Affiliation(s)
- C A Wyse
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom; Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in, Ireland, 123, St Stephens Green, Dublin.
| | - X Zhang
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - M McLaughlin
- School of Veterinary Medicine, University of Glasgow, G61 1QH, United Kingdom
| | - S M Biello
- School of Psychology, 58 Hillhead Street, Glasgow G12 8QB, United Kingdom
| | - D Hough
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - M Bellingham
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - A M Curtis
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in, Ireland, 123, St Stephens Green, Dublin
| | - J E Robinson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - N P Evans
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, United Kingdom
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23
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Jarczok MN, Aguilar-Raab C, Koenig J, Kaess M, Borniger JC, Nelson RJ, Hall M, Ditzen B, Thayer JF, Fischer JE. The Heart´s rhythm 'n' blues: Sex differences in circadian variation patterns of vagal activity vary by depressive symptoms in predominantly healthy employees. Chronobiol Int 2018. [PMID: 29543518 DOI: 10.1080/07420528.2018.1439499] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Successful regulation of emotional states is positively associated to mental health, while difficulties in regulating emotions are negatively associated to overall mental health and in particular associated with anxiety or depression symptoms. A key structure associated to socio-emotional regulatory processes is the central autonomic network. Activity in this structure is associated to vagal activity can be indexed noninvasively and simply by measures of peripheral cardiac autonomic modulations such as heart rate variability. Vagal activity exhibits a circadian variation pattern, with a maximum during nighttime. Depression is known to affect chronobiology. Also, depressive symptoms are known to be associated with decreased resting state vagal activity, but studies investigating the association between circadian variation pattern of vagal activity and depressive symptoms are scarce. We aim to examine these patterns in association to symptom severity of depression using chronobiologic methods. METHODS Data from the Manheim Industrial Cohort Studies (MICS) were used. A total of 3,030 predominantly healthy working adults underwent, among others, ambulatory 24-h hear rate-recordings, detailed health examination and online questionnaires and were available for this analysis. The root mean sum of successive differences (RMSSD) was used as an indicator of vagally mediated heart rate variability. Three individual-level cosine function parameters (MESOR, amplitude, acrophase) were estimated to quantify circadian variation pattern. Multivariate linear regression models including important covariates such as age, sex, and lifestyle factors as well as an interaction effect of sex with depressive symptoms were used to estimate the association of circadian variation pattern of vagal activity with depressive symptoms simultaneously. RESULTS The analysis sample consisted of 20.2% females and an average age 41 with standard deviation of 11 years. Nonparametric bivariate analysis revealed significant MESOR and amplitude differences between the 90th percentile split, but not on acrophase. Multivariate linear regression models estimated depressive symptoms to be negatively associated with the 24h mean (MESOR) and oscillation amplitude in men but positively associated in women. This pattern of findings indicates a blunted day-night rhythm of vagal activity in men with greater depressive symptoms as well as a moderation effect of sex in the association of CVP and depressive symptoms. CONCLUSIONS This is the first study investigating circadian variation pattern by mild depressive symptoms in a large, rather healthy occupational sample. Depressive symptoms were associated with decreased circadian variation pattern of vagal activity in men but with increased circadian variation pattern in women. The possible underlying mechanism(s) are discussed using the neurovisceral integration model. These findings may have implications for the knowledge on etiology, diagnosis, course, and treatment of depressive symptoms and thus may be of significant public health relevance.
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Affiliation(s)
- Marc N Jarczok
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,b Clinic for Psychosomatic Medicine and Psychotherapy , Ulm University Medical Center , Ulm , Germany
| | - Corina Aguilar-Raab
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany
| | - Julian Koenig
- c Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry , Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,d University Hospital of Child and Adolescent Psychiatry and Psychotherapy , University of Bern , Bern , Switzerland
| | - Michael Kaess
- c Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry , Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany.,d University Hospital of Child and Adolescent Psychiatry and Psychotherapy , University of Bern , Bern , Switzerland
| | - Jeremy C Borniger
- e Department of Psychiatry & Behavioral Sciences , Stanford University School of Medicine , CA , USA
| | - Randy J Nelson
- f Department of Neuroscience , The Ohio State University Medical Center , Columbus , OH , USA
| | - Martica Hall
- g Department of Psychiatry , University of Pittsburgh , Pittsburgh , PA , USA
| | - Beate Ditzen
- a Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University , Heidelberg , Germany
| | - Julian F Thayer
- h Department of Psychology , The Ohio State University , Columbus , OH , USA
| | - Joachim E Fischer
- i Mannheim Institute of Public Health, Social and Preventive Medicine, Medical School Mannheim, Heidelberg University , Germany
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24
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Mendoza J. Circadian neurons in the lateral habenula: Clocking motivated behaviors. Pharmacol Biochem Behav 2017; 162:55-61. [PMID: 28666896 DOI: 10.1016/j.pbb.2017.06.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/30/2017] [Accepted: 06/26/2017] [Indexed: 12/31/2022]
Abstract
The main circadian clock in mammals is located in the hypothalamic suprachiasmatic nucleus (SCN), however, central timing mechanisms are also present in other brain structures beyond the SCN. The lateral habenula (LHb), known for its important role in the regulation of the monoaminergic system, contains such a circadian clock whose molecular and cellular mechanisms as well as functional role are not well known. However, since monoaminergic systems show circadian activity, it is possible that the LHb-clock's role is to modulate the rhythmic activity of the dopamine, serotonin and norephinephrine systems, and associated behaviors. Moreover, the LHb is involved in different pathological states such as depression, addiction and schizophrenia, states in which sleep and circadian alterations have been reported. Thus, perturbations of circadian activity in the LHb might, in part, be a cause of these rhythmic alterations in psychiatric ailments. In this review the current state of the LHb clock and its possible implications in the control of monoaminergic systems rhythms, motivated behaviors (e.g., feeding, drug intake) and depression (with circadian disruptions and altered motivation) will be discussed.
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Affiliation(s)
- Jorge Mendoza
- Institute of Cellular and Integrative Neuroscience, CNRS-UPR 3212 Strasbourg France, 5 rue Blaise Pascal, 67084 cedex Strasbourg, France.
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25
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Maletic V, Eramo A, Gwin K, Offord SJ, Duffy RA. The Role of Norepinephrine and Its α-Adrenergic Receptors in the Pathophysiology and Treatment of Major Depressive Disorder and Schizophrenia: A Systematic Review. Front Psychiatry 2017; 8:42. [PMID: 28367128 PMCID: PMC5355451 DOI: 10.3389/fpsyt.2017.00042] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/01/2017] [Indexed: 12/11/2022] Open
Abstract
Norepinephrine (NE) is recognized as having a key role in the pathophysiology of major depressive disorder (MDD) and schizophrenia, although its distinct actions via α-adrenergic receptors (α-ARs) are not well defined. We performed a systematic review examining the roles of NE and α-ARs in MDD and schizophrenia. PubMed and ProQuest database searches were performed to identify English language papers published between 2008 and 2015. In total, 2,427 publications (PubMed, n = 669; ProQuest, n = 1,758) were identified. Duplicates, articles deemed not relevant, case studies, reviews, meta-analyses, preclinical reports, or articles on non-target indications were excluded. To limit the review to the most recent data representative of the literature, the review further focused on publications from 2010 to 2015, which were screened independently by all authors. A total of 16 research reports were identified: six clinical trial reports, six genetic studies, two biomarker studies, and two receptor studies. Overall, the studies provided indirect evidence that α-AR activity may play an important role in aberrant regulation of cognition, arousal, and valence systems associated with MDD and schizophrenia. Characterization of the NE pathway in patients may provide clinicians with information for more personalized therapy of these heterogeneous diseases. Current clinical studies do not provide direct evidence to support the role of NE α-ARs in the pathophysiology of MDD and schizophrenia and in the treatment response of patients with these diseases, in particular with relation to specific valence systems. Clinical studies that attempt to define associations between specific receptor binding profiles of psychotropics and particular clinical outcomes are needed.
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Affiliation(s)
- Vladimir Maletic
- Department of Neuropsychiatry and Behavioral Science, University of South Carolina , Columbia, SC , USA
| | - Anna Eramo
- Medical Affairs - Psychiatry, Lundbeck LLC , Deerfield, IL , USA
| | - Keva Gwin
- Medical Affairs - Psychiatry, Lundbeck LLC , Deerfield, IL , USA
| | - Steve J Offord
- Medical Affairs, Otsuka Pharmaceutical Development and Commercialization, Inc. , Princeton, NJ , USA
| | - Ruth A Duffy
- Medical Affairs, Otsuka Pharmaceutical Development and Commercialization, Inc. , Princeton, NJ , USA
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26
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Scott J, Naismith S, Grierson A, Carpenter J, Hermens D, Scott E, Hickie I. Sleep-wake cycle phenotypes in young people with familial and non-familial mood disorders. Bipolar Disord 2016; 18:642-649. [PMID: 27882644 DOI: 10.1111/bdi.12450] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/21/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Converging evidence identifies that the offspring of parents with bipolar disorder (BD), individuals at clinical high risk of BD, and young people with recent onset BD may differ from other clinical cases or healthy controls in terms of sleep-wake profiles. However, it is possible that these differences may reflect current mental state, subtype of mood disorder, or familial traits. This study aimed to determine objective and subjective sleep-wake profiles in individuals aged 15-25 years with a current major depressive episode, in relation to familial traits. METHODS Frequency matching was employed to ensure that each individual with a confirmed family history of BD (FH+) could be compared to four controls who did not have a familial mood disorder (FH-). Pre-selected objective actigraphy and subjective Pittsburgh Sleep Quality Index (PSQI) ratings were compared using one-way analysis of variance (ANOVA) and applying the Benjamini-Hochberg (BH) correction for false discoveries. RESULTS The sample comprised 60 individuals with a mean age of 19 years. The FH+ (n=12) and FH- groups (n=48) differed on three key sleep parameters: mean sleep duration on week nights (P=.049), variability in waking after sleep onset (P=.038), and daily disturbances (PSQI dimension of sleep disturbance and daytime dysfunction; P=.01). CONCLUSIONS The sleep profiles we identified in this study, especially the daily disturbances phenotype, provide support for research into endophenotypes for BD. Also, the findings may offer the opportunity for more tailored, personalized interventions that target specific components of the sleep-wake cycle in individuals with a family history of BD.
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Affiliation(s)
- Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Sharon Naismith
- Charles Perkins Centre, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Ashlee Grierson
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Joanne Carpenter
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Daniel Hermens
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Elizabeth Scott
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.,Notre Dame University, Sydney, Australia
| | - Ian Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Christiansen SL, Bouzinova EV, Fahrenkrug J, Wiborg O. Altered Expression Pattern of Clock Genes in a Rat Model of Depression. Int J Neuropsychopharmacol 2016; 19:pyw061. [PMID: 27365111 PMCID: PMC5137278 DOI: 10.1093/ijnp/pyw061] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Abnormalities in circadian rhythms may be causal factors in development of major depressive disorder. The biology underlying a causal relationship between circadian rhythm disturbances and depression is slowly being unraveled. Although there is no direct evidence of dysregulation of clock gene expression in depressive patients, many studies have reported single-nucleotide polymorphisms in clock genes in these patients. METHODS In the present study we investigated whether a depression-like state in rats is associated with alternations of the diurnal expression of clock genes. The validated chronic mild stress (CMS) animal model of depression was used to investigate rhythmic expression of three clock genes: period genes 1 and 2 (Per1 and Per2) and Bmal1. Brain and liver tissue was collected from 96 animals after 3.5 weeks of CMS (48 control and 48 depression-like rats) at a 4h sampling interval within 24h. We quantified expression of clock genes on brain sections in the prefrontal cortex, nucleus accumbens, pineal gland, suprachiasmatic nucleus, substantia nigra, amygdala, ventral tegmental area, subfields of the hippocampus, and the lateral habenula using in situ hybridization histochemistry. Expression of clock genes in the liver was monitored by real-time quantitative polymerase chain reaction (PCR). RESULTS We found that the effect of CMS on clock gene expression was selective and region specific. Per1 exhibits a robust diurnal rhythm in most regions of interest, whereas Bmal1 and in particular Per2 were susceptible to CMS. CONCLUSION The present results suggest that altered expression of investigated clock genes is likely associated with the induction of a depression-like state in the CMS model.
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Affiliation(s)
| | | | | | - O Wiborg
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark (Drs Christiansen, Bouzinova, and Wiborg); Department of Clinical Biochemistry, Faculty of Health Sciences, University of Copenhagen, Denmark (Dr Fahrenkrug).
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28
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Loss of VGLUT3 Produces Circadian-Dependent Hyperdopaminergia and Ameliorates Motor Dysfunction and l-Dopa-Mediated Dyskinesias in a Model of Parkinson's Disease. J Neurosci 2016; 35:14983-99. [PMID: 26558771 DOI: 10.1523/jneurosci.2124-15.2015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
UNLABELLED The striatum is essential for many aspects of mammalian behavior, including motivation and movement, and is dysfunctional in motor disorders such as Parkinson's disease. The vesicular glutamate transporter 3 (VGLUT3) is expressed by striatal cholinergic interneurons (CINs) and is thus well positioned to regulate dopamine (DA) signaling and locomotor activity, a canonical measure of basal ganglia output. We now report that VGLUT3 knock-out (KO) mice show circadian-dependent hyperlocomotor activity that is restricted to the waking cycle and is due to an increase in striatal DA synthesis, packaging, and release. Using a conditional VGLUT3 KO mouse, we show that deletion of the transporter from CINs, surprisingly, does not alter evoked DA release in the dorsal striatum or baseline locomotor activity. The mice do, however, display changes in rearing behavior and sensorimotor gating. Elevation of DA release in the global KO raised the possibility that motor deficits in a Parkinson's disease model would be reduced. Remarkably, after a partial 6-hydroxydopamine (6-OHDA)-mediated DA depletion (∼70% in dorsal striatum), KO mice, in contrast to WT mice, showed normal motor behavior across the entire circadian cycle. l-3,4-dihydroxyphenylalanine-mediated dyskinesias were also significantly attenuated. These findings thus point to new mechanisms to regulate basal ganglia function and potentially treat Parkinson's disease and related disorders. SIGNIFICANCE STATEMENT Dopaminergic signaling is critical for both motor and cognitive functions in the mammalian nervous system. Impairments, such as those found in Parkinson's disease patients, can lead to severe motor deficits. Vesicular glutamate transporter 3 (VGLUT3) loads glutamate into secretory vesicles for neurotransmission and is expressed by discrete neuron populations throughout the nervous system. Here, we report that the absence of VGLUT3 in mice leads to an upregulation of the midbrain dopamine system. Remarkably, in a Parkinson's disease model, the mice show normal motor behavior. They also show fewer abnormal motor behaviors (dyskinesias) in response to l-3,4-dihydroxyphenylalanine, the principal treatment for Parkinson's disease. The work thus suggests new avenues for the development of novel treatment strategies for Parkinson's disease and potentially other basal-ganglia-related disorders.
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29
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Donev R, Alawam K. Alterations in Gene Expression in Depression: Prospects for Personalize Patient Treatment. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2015; 101:97-124. [PMID: 26572977 DOI: 10.1016/bs.apcsb.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The number of people around the world suffering from depression has dramatically increased in last few decades. It has been predicted that by 2020 depression will become the second most common cause of disability. Furthermore, depression is often misdiagnosed and confused with other psychiatric disorders showing similar symptoms, i.e., anxiety and bipolar disorder, due to the fact that diagnosing is often carried out by medical workers who are not psychiatrically trained. These facts prompt us to prepare this review which focuses on alterations in gene expression in depression. We believe that an in-depth knowledge of molecular bases of behavior in depression and other mood disorders would be of a great benefit for the correct diagnosing of these disorders, as well as for prescribing a treatment that best suits each individual depending on expression alterations in depression-related genes. Therefore, the main aim of this review is to promote further translational research on the biochemistry of mood disorders and take the results further for the design of new targeted therapeutics that can be used for personalized treatment with minimal adverse effects.
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Affiliation(s)
| | - Khaled Alawam
- Forensic Medicine Department, Ministry of Interior, Kuwait City, Kuwait
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30
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Spulber S, Conti M, DuPont C, Raciti M, Bose R, Onishchenko N, Ceccatelli S. Alterations in circadian entrainment precede the onset of depression-like behavior that does not respond to fluoxetine. Transl Psychiatry 2015; 5:e603. [PMID: 26171984 PMCID: PMC5068723 DOI: 10.1038/tp.2015.94] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 06/03/2015] [Accepted: 06/04/2015] [Indexed: 12/17/2022] Open
Abstract
Growing evidence links adverse prenatal conditions to mood disorders. We investigated the long-term behavioral alterations induced by prenatal exposure to excess glucocorticoids (dexamethasone--DEX). At 12 months, but not earlier, DEX-exposed mice displayed depression-like behavior and impaired hippocampal neurogenesis, not reversible by the antidepressant fluoxetine (FLX). Concomitantly, we observed arrhythmic glucocorticoid secretion and absent circadian oscillations in hippocampal clock gene expression. Analysis of spontaneous activity showed progressive alterations in circadian entrainment preceding depression. Circadian oscillations in clock gene expression (measured by means of quantitative PCR) were also attenuated in skin fibroblasts before the appearance of depression. Interestingly, circadian entrainment is not altered in a model of depression (induced by methylmercury prenatal exposure) that responds to FLX. Altogether, our results suggest that alterations in circadian entrainment of spontaneous activity, and possibly clock gene expression in fibroblasts, may predict the onset of depression and the response to FLX in patients.
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Affiliation(s)
- S Spulber
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden,Department of Neuroscience, Karolinska Institutet, Retzius väg 8, 17177 Stockholm, Sweden. E-mail: or
| | - M Conti
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - C DuPont
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Raciti
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R Bose
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - N Onishchenko
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S Ceccatelli
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden,Department of Neuroscience, Karolinska Institutet, Retzius väg 8, 17177 Stockholm, Sweden. E-mail: or
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Duffy A, Jones S, Goodday S, Bentall R. Candidate Risks Indicators for Bipolar Disorder: Early Intervention Opportunities in High-Risk Youth. Int J Neuropsychopharmacol 2015; 19:pyv071. [PMID: 26116493 PMCID: PMC4772266 DOI: 10.1093/ijnp/pyv071] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/16/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Psychiatric illnesses like bipolar disorder are increasingly understood to be neurodevelopmental disorders with clinical, psychological, and biological indicators recognizable long before the emergence of the full-blown syndromes. METHODS This paper is a selective review of findings from studies of high-risk children of affected parents that inform the knowledge of illness risk and development markers of bipolar disorder. We specifically focus on candidate clinical, biological, and psychological risk indicators that could serve as targets for future early intervention and prevention studies. RESULTS There is convergent evidence from prospective studies that bipolar disorder typically debuts as depressive episodes after puberty. In some high-risk children, sleep and anxiety disorders precede mood disorders by several years and reflect an increased vulnerability. An association between early exposure to adversity (eg, exposure to parental illness, neglect from mother) and increased risk of psychopathology may be mediated through increased stress reactivity evident at both behavioral and biological levels. Inter-related psychological processes including reward sensitivity, unstable self-esteem, rumination, and positive self-appraisal are risk factors for mood disorders. Disturbances in circadian rhythm and immune dysfunction are associated with mood disorders and may be vulnerability markers influenced by these other risk factors. CONCLUSIONS There is accruing evidence of a number of measurable and potentially modifiable markers of vulnerability and developing illness in youth at familial risk for bipolar disorder. Longitudinal studies of multiple biological and psychological risk processes in high-risk offspring, both individually and together, will improve our understanding of illness onset and lead to the development of specific early interventions.
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Affiliation(s)
- Anne Duffy
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada (Dr Duffy); Mood Disorders Centre of Ottawa, Ottawa, Ontario, Canada (Dr Duffy); Lancaster University, Division of Health Research, Lancaster, United Kingdom (Dr Jones); Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (Ms Goodday, Dr Bentall); University of Liverpool, Institute of Psychology Health and Society, Liverpool, United Kingdom (Ms Goodday and Dr Bentall).
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Bunney BG, Li JZ, Walsh DM, Stein R, Vawter MP, Cartagena P, Barchas JD, Schatzberg AF, Myers RM, Watson SJ, Akil H, Bunney WE. Circadian dysregulation of clock genes: clues to rapid treatments in major depressive disorder. Mol Psychiatry 2015; 20:48-55. [PMID: 25349171 PMCID: PMC4765913 DOI: 10.1038/mp.2014.138] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 09/06/2014] [Accepted: 09/10/2014] [Indexed: 12/19/2022]
Abstract
Conventional antidepressants require 2-8 weeks for a full clinical response. In contrast, two rapidly acting antidepressant interventions, low-dose ketamine and sleep deprivation (SD) therapy, act within hours to robustly decrease depressive symptoms in a subgroup of major depressive disorder (MDD) patients. Evidence that MDD may be a circadian-related illness is based, in part, on a large set of clinical data showing that diurnal rhythmicity (sleep, temperature, mood and hormone secretion) is altered during depressive episodes. In a microarray study, we observed widespread changes in cyclic gene expression in six regions of postmortem brain tissue of depressed patients matched with controls for time-of-death (TOD). We screened 12 000 transcripts and observed that the core clock genes, essential for controlling virtually all rhythms in the body, showed robust 24-h sinusoidal expression patterns in six brain regions in control subjects. In MDD patients matched for TOD with controls, the expression patterns of the clock genes in brain were significantly dysregulated. Some of the most robust changes were seen in anterior cingulate (ACC). These findings suggest that in addition to structural abnormalities, lesion studies, and the large body of functional brain imaging studies reporting increased activation in the ACC of depressed patients who respond to a wide range of therapies, there may be a circadian dysregulation in clock gene expression in a subgroup of MDDs. Here, we review human, animal and neuronal cell culture data suggesting that both low-dose ketamine and SD can modulate circadian rhythms. We hypothesize that the rapid antidepressant actions of ketamine and SD may act, in part, to reset abnormal clock genes in MDD to restore and stabilize circadian rhythmicity. Conversely, clinical relapse may reflect a desynchronization of the clock, indicative of a reactivation of abnormal clock gene function. Future work could involve identifying specific small molecules capable of resetting and stabilizing clock genes to evaluate if they can rapidly relieve symptoms and sustain improvement.
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Affiliation(s)
- BG Bunney
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - JZ Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - DM Walsh
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - R Stein
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - MP Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - P Cartagena
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - JD Barchas
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - AF Schatzberg
- Department of Psychiatry, Stanford University, Palo Alto, CA, USA
| | - RM Myers
- HudsonAlpha, Institute for Biotechnology, Huntsville, AL, USA
| | - SJ Watson
- Department of Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - H Akil
- Department of Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - WE Bunney
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
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Logan RW, Williams WP, McClung CA. Circadian rhythms and addiction: mechanistic insights and future directions. Behav Neurosci 2014; 128:387-412. [PMID: 24731209 DOI: 10.1037/a0036268] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Circadian rhythms are prominent in many physiological and behavioral functions. Circadian disruptions either by environmental or molecular perturbation can have profound health consequences, including the development and progression of addiction. Both animal and humans studies indicate extensive bidirectional relationships between the circadian system and drugs of abuse. Addicted individuals display disrupted rhythms, and chronic disruption or particular chronotypes may increase the risk for substance abuse and relapse. Moreover, polymorphisms in circadian genes and an evening chronotype have been linked to mood and addiction disorders, and recent efforts suggest an association with the function of reward neurocircuitry. Animal studies are beginning to determine how altered circadian gene function results in drug-induced neuroplasticity and behaviors. Many studies suggest a critical role for circadian rhythms in reward-related pathways in the brain and indicate that drugs of abuse directly affect the central circadian pacemaker. In this review, we highlight key findings demonstrating the importance of circadian rhythms in addiction and how future studies will reveal important mechanistic insights into the involvement of circadian rhythms in drug addiction.
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Affiliation(s)
- Ryan W Logan
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Wilbur P Williams
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Colleen A McClung
- Department of Psychiatry, University of Pittsburgh School of Medicine
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Knapp DJ, Daws LC, Overstreet DH. Behavioral Characteristics of Pharmacologically Selected Lines of Rats: Relevance to Depression. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/wjns.2014.43026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Li JZ. Circadian rhythms and mood: opportunities for multi-level analyses in genomics and neuroscience: circadian rhythm dysregulation in mood disorders provides clues to the brain's organizing principles, and a touchstone for genomics and neuroscience. Bioessays 2013; 36:305-15. [PMID: 24853393 PMCID: PMC4033528 DOI: 10.1002/bies.201300141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the healthy state, both circadian rhythm and mood are stable against perturbations, yet they are capable of adjusting to altered internal cues or ongoing changes in external conditions. The dual demands of stability and flexibility are met by the collective properties of complex neural networks. Disruption of this balance underlies both circadian rhythm abnormality and mood disorders. However, we do not fully understand the network properties that govern the crosstalk between the circadian system and mood regulation. This puzzle reflects a challenge at the center of neurobiology, and its solution requires the successful integration of existing data across all levels of neural organization, from molecules, cells, circuits, network dynamics, to integrated mental function. This essay discusses several open questions confronting the cross-level synthesis, and proposes that circadian regulation, and its role in mood, stands as a uniquely tractable system to study the causal mechanisms of neural adaptation.
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Affiliation(s)
- Jun Z Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
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