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Sancassiani F, Cossu G, Cantone E, Romano F, Perra A, Urban A, Pinna S, Del Giacco S, Littera R, Firinu D, Chessa L, Tramontano E, Nardi AE, Carta MG. The Stability of Social and Behavioral Rhythms and Unexpected Low Rate of Relevant Depressive Symptoms in Old Adults during the COVID-19 Pandemic. J Clin Med 2024; 13:2005. [PMID: 38610769 PMCID: PMC11012795 DOI: 10.3390/jcm13072005] [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: 02/13/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The disruption of social rhythms was found to be associated with depressive disorders during the COVID-19 pandemic; lower rates of these disorders were surprisingly found in old adults. The present study aims to verify the stability of social rhythms during lockdown in a sample of elderly people. Methods: Controlled cohort study (secondary analyses) of a previous randomized-controlled trial with the first evaluation in April 2019 (T0) and then 48 weeks later (T1) during the lockdown. The regulation of social and behavioral rhythms was measured through the Brief Social Rhythms Scale (BSRS); the Patient Health Questionnaire-9 (PHQ9) was adopted to detect relevant depressive symptoms. Results: 93 elderlies (73.36 ± 4.97 years old, 50.5% females) were evaluated at T0 and T1. Neither the total score of BSRS nor any of the 10 items showed a statistically significant difference comparing the two survey periods. The frequency of relevant depressive symptoms was 5.3% at T0 and 6.4% at T1 (OR = 0.8, CI95% 0.2-24). Conclusions: Among elderlies who did not show an increased risk of depression during the lockdown, social and behavioral rhythms remained exceptionally stable during the same period. Considering previous evidence about rhythms dysregulation preceding depression, their stability may be considered a factor of resilience.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Roma, Italy;
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Antonio Urban
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
- University Hospital of Cagliari, 09124 Cagliari, Italy
| | - Samantha Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Roberto Littera
- Medical Genetics, “R. Binaghi” Hospital, 09126 Cagliari, Italy;
- AART-ODV (Association for the Advancement of Research on Transplantation), 09131 Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Enzo Tramontano
- Department of Life and Environmental Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Antonio Egidio Nardi
- Institute of Psychiatry-IPUB, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil;
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
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Ren S, Zhu J, Xie X, Liu X, Jiang H, Ying C, Hu J, Di H, Hu N. The visual stimulation in disorders of consciousness. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-8. [PMID: 38104423 DOI: 10.1080/23279095.2023.2292244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Severe brain damage usually leads to disorders of consciousness (DOC), which include coma, unresponsive wakefulness syndrome (UWS) and a minimally conscious state (MCS). Visual stimulation is widely used, especially in the diagnosis and treatment and treatment of DOC. Researchers have indicated that tests based on visual stimulation including visual pursuit, when used in conjunction with the Coma Recovery Scale-Revised, are able to differentiate between UWS from an MCS. Recently, targeting patients' circadian rhythms has been proposed to be a possible treatment target for DOC. Indeed, light therapy has been applied in some other fields, including treating seasonal affective disorder, sleep problems, and Parkinson's disease. However, at present, although visual stimulation and light therapy are frequently used in DOC, there is still no international unified standard. Therefore, we recommend the development of an international consensus in regard to the definitions, operational criteria and assessment procedures of visual stimulation and light therapy. This review combines visual stimulation, circadian rhythm recovery, and light therapy in DOC patients and presents the mechanisms and current advances in applications related to light therapy and visual stimulation in an attempt to provide additional ideas for future research and treatment of DOC.
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Affiliation(s)
- Siyan Ren
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Jiajie Zhu
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai Key Laboratory of Birth Defect, Shanghai, China
| | - Xiangyu Xie
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Ximeng Liu
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Hui Jiang
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Chenxi Ying
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Jia Hu
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Haibo Di
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Nantu Hu
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
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McCarthy MJ, Gottlieb JF, Gonzalez R, McClung CA, Alloy LB, Cain S, Dulcis D, Etain B, Frey BN, Garbazza C, Ketchesin KD, Landgraf D, Lee H, Marie‐Claire C, Nusslock R, Porcu A, Porter R, Ritter P, Scott J, Smith D, Swartz HA, Murray G. Neurobiological and behavioral mechanisms of circadian rhythm disruption in bipolar disorder: A critical multi-disciplinary literature review and agenda for future research from the ISBD task force on chronobiology. Bipolar Disord 2022; 24:232-263. [PMID: 34850507 PMCID: PMC9149148 DOI: 10.1111/bdi.13165] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM Symptoms of bipolar disorder (BD) include changes in mood, activity, energy, sleep, and appetite. Since many of these processes are regulated by circadian function, circadian rhythm disturbance has been examined as a biological feature underlying BD. The International Society for Bipolar Disorders Chronobiology Task Force (CTF) was commissioned to review evidence for neurobiological and behavioral mechanisms pertinent to BD. METHOD Drawing upon expertise in animal models, biomarkers, physiology, and behavior, CTF analyzed the relevant cross-disciplinary literature to precisely frame the discussion around circadian rhythm disruption in BD, highlight key findings, and for the first time integrate findings across levels of analysis to develop an internally consistent, coherent theoretical framework. RESULTS Evidence from multiple sources implicates the circadian system in mood regulation, with corresponding associations with BD diagnoses and mood-related traits reported across genetic, cellular, physiological, and behavioral domains. However, circadian disruption does not appear to be specific to BD and is present across a variety of high-risk, prodromal, and syndromic psychiatric disorders. Substantial variability and ambiguity among the definitions, concepts and assumptions underlying the research have limited replication and the emergence of consensus findings. CONCLUSIONS Future research in circadian rhythms and its role in BD is warranted. Well-powered studies that carefully define associations between BD-related and chronobiologically-related constructs, and integrate across levels of analysis will be most illuminating.
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Affiliation(s)
- Michael J. McCarthy
- UC San Diego Department of Psychiatry & Center for Circadian BiologyLa JollaCaliforniaUSA
- VA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - John F. Gottlieb
- Department of PsychiatryFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Robert Gonzalez
- Department of Psychiatry and Behavioral HealthPennsylvania State UniversityHersheyPennsylvaniaUSA
| | - Colleen A. McClung
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Lauren B. Alloy
- Department of PsychologyTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Sean Cain
- School of Psychological Sciences and Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
| | - Davide Dulcis
- UC San Diego Department of Psychiatry & Center for Circadian BiologyLa JollaCaliforniaUSA
| | - Bruno Etain
- Université de ParisINSERM UMR‐S 1144ParisFrance
| | - Benicio N. Frey
- Department Psychiatry and Behavioral NeuroscienceMcMaster UniversityHamiltonOntarioCanada
| | - Corrado Garbazza
- Centre for ChronobiologyPsychiatric Hospital of the University of Basel and Transfaculty Research Platform Molecular and Cognitive NeurosciencesUniversity of BaselBaselSwitzerland
| | - Kyle D. Ketchesin
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Dominic Landgraf
- Circadian Biology GroupDepartment of Molecular NeurobiologyClinic of Psychiatry and PsychotherapyUniversity HospitalLudwig Maximilian UniversityMunichGermany
| | - Heon‐Jeong Lee
- Department of Psychiatry and Chronobiology InstituteKorea UniversitySeoulSouth Korea
| | | | - Robin Nusslock
- Department of Psychology and Institute for Policy ResearchNorthwestern UniversityChicagoIllinoisUSA
| | - Alessandra Porcu
- UC San Diego Department of Psychiatry & Center for Circadian BiologyLa JollaCaliforniaUSA
| | | | - Philipp Ritter
- Clinic for Psychiatry and PsychotherapyCarl Gustav Carus University Hospital and Technical University of DresdenDresdenGermany
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastleUK
| | - Daniel Smith
- Division of PsychiatryUniversity of EdinburghEdinburghUK
| | - Holly A. Swartz
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Greg Murray
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
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Faltraco F, Palm D, Coogan A, Simon F, Tucha O, Thome J. Molecular Link between Circadian Rhythmicity and Mood Disorders. Curr Med Chem 2021; 29:5692-5709. [PMID: 34620057 DOI: 10.2174/0929867328666211007113725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The internal clock is driven by circadian genes [e.g., Clock, Bmal1, Per1-3, Cry1-2], hormones [e.g., melatonin, cortisol], as well as zeitgeber ['synchronisers']. Chronic disturbances in the circadian rhythm in patients diagnosed with mood disorders have been recognised for more than 50 years. OBJECTIVES The aim of this review is to summarise the current knowledge and literature regarding circadian rhythms in the context of mood disorders, focussing on the role of circadian genes, hormones, and neurotransmitters. METHOD The review presents the current knowledge and literature regarding circadian rhythms in mood disorders using the Pubmed database. Articles with a focus on circadian rhythms and mood disorders [n=123], particularly from 1973 to 2020, were included. RESULTS The article suggests a molecular link between disruptions in the circadian rhythm and mood disorders. Circadian disturbances, caused by the dysregulation of circadian genes, hormones, and neurotransmitters, often result in a clinical picture resembling depression. CONCLUSION Circadian rhythms are intrinsically linked to affective disorders, such as unipolar depression and bipolar disorder.
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Affiliation(s)
- Frank Faltraco
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock. Germany
| | - Denise Palm
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock. Germany
| | - Andrew Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth. Ireland
| | - Frederick Simon
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock. Germany
| | - Oliver Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock. Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock. Germany
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5
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Affiliation(s)
- Samet Kose
- Psychiatry and Clinical Psychopharmacology, Psychiatry and Behavioral Sciences, Franklin, TN, USA
| | - Mesut Cetin
- Psychiatry &Clinical Psychopharmacology and Psychiatry and Behavioral Sciences, Istanbul, Turkey
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Sullivan K, Pantazopoulos H, Liebson E, Woo TUW, Baldessarini RJ, Hedreen J, Berretta S. What can we learn about brain donors? Use of clinical information in human postmortem brain research. HANDBOOK OF CLINICAL NEUROLOGY 2018; 150:181-196. [PMID: 29496141 DOI: 10.1016/b978-0-444-63639-3.00014-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Postmortem studies on the human brain reside at the core of investigations on neurologic and psychiatric disorders. Ground-breaking advances continue to be made on the pathologic basis of many of these disorders, at molecular, cellular, and neural connectivity levels. In parallel, there is increasing emphasis on improving methods to extract relevant demographic and clinical information about brain donors and, importantly, translate it into measures that can reliably and effectively be incorporated in the design and data analysis of postmortem human investigations. Here, we review the main source of information typically available to brain banks and provide examples on how this information can be processed. In particular, we discuss approaches to establish primary and secondary diagnoses, estimate exposure to therapeutic treatment and substance abuse, assess agonal status, and use time of death as a proxy in investigations on circadian rhythms. Although far from exhaustive, these considerations are intended as a contribution to ongoing efforts from tissue banks and investigators aimed at establishing robust, well-validated methods for collecting and standardizing information about brain donors, further strengthening the scientific rigor of human postmortem studies.
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Affiliation(s)
- Kathleen Sullivan
- Harvard Brain Tissue Resource Center, McLean Hospital, Belmont, MA, United States
| | - Harry Pantazopoulos
- Traslational Neuroscience Laboratory, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Elizabeth Liebson
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
| | - T-U W Woo
- Harvard Brain Tissue Resource Center, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Laboratory of Cellular Neuropathology, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ross J Baldessarini
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Psychotic and Bipolar Disorders Research, McLean Hospital, Belmont, MA, United States
| | - John Hedreen
- Harvard Brain Tissue Resource Center, McLean Hospital, Belmont, MA, United States
| | - Sabina Berretta
- Harvard Brain Tissue Resource Center, McLean Hospital, Belmont, MA, United States; Traslational Neuroscience Laboratory, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Program in Neuroscience, Harvard Medical School, Boston, MA, United States.
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7
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Dubovsky SL. The Limitations of Genetic Testing in Psychiatry. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:129-35. [PMID: 27043036 DOI: 10.1159/000443512] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/20/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Steven L Dubovsky
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, N.Y., and Departments of Psychiatry and Medicine, University of Colorado, Denver, Colo., USA
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8
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Sridhar GR, Sanjana NSN. Sleep, circadian dysrhythmia, obesity and diabetes. World J Diabetes 2016; 7:515-522. [PMID: 27895820 PMCID: PMC5107711 DOI: 10.4239/wjd.v7.i19.515] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/12/2016] [Accepted: 08/29/2016] [Indexed: 02/05/2023] Open
Abstract
Synchrony of biological processes with environmental cues developed over millennia to match growth, reproduction and senescence. This entails a complex interplay of genetic, metabolic, chemical, light, hormonal and hedonistic factors across life forms. Sleep is one of the most prominent rhythms where such a match is established. Over the past 100 years or so, it has been possible to disturb the synchrony between sleep-wake cycle and environmental cues. Development of electric lights, shift work and continual accessibility of the internet has disrupted this match. As a result, many non-communicable diseases such as obesity, insulin resistance, type 2 diabetes, coronary artery disease and malignancies have been attributed in part to such disruption. In this presentation a review is made of the origin and evolution of sleep studies, the pathogenic mediators for such asynchrony, clinical evidence and relevance and suggested management options to deal with the disturbances.
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Su CC, Su PY, Wang SY, Lin CC. Circadian rhythm mediates the relationship between physical activity and quality of life in younger and older cancer survivors. Chronobiol Int 2015; 32:1417-26. [PMID: 26588724 DOI: 10.3109/07420528.2015.1102150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Increasing evidence suggests that physical activity (PA) improves the quality of life (QoL) of cancer survivors. However, the biological mechanisms underlying the relationship between PA and QoL are unclear. The purpose of this study was to determine whether the relationship between PA and QoL differs in younger and older cancer survivors and whether circadian rhythm (CR) mediates this relationship. We also explored the effect of the CR on QoL. The participants were 235 cancer survivors, comprising 143 younger and 92 older patients. Data were collected using the Taiwanese versions of the Physical Activity Scale for the Elderly and Short Form-36. The robustness and stability of the CR were measured using an actigraph. Mediation was tested using multiple mediation analyses. The CR mediated the relationship between PA and the physical domain of QoL in younger and older cancer survivors (23% and 59% mediating effects, respectively). The CR partially mediated the effect of PA on the mental dimension of QoL in older cancer survivors (36% mediating effect), but not in younger cancer survivors. Cancer survivors with a more robust CR had a significantly higher QoL, particularly in the physical functioning domain (d = 0.43, p < 0.001). The results provided evidence that the CR mediated the relationship between PA and QoL. Moreover, this mediating effect differed in younger and older cancer survivors. These results can serve as a reference for designing individualized PA programs for cancer survivors.
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Affiliation(s)
- Ching-Ching Su
- a Graduate Institute of Nursing, College of Nursing , Taipei Medical University , Taipei , Taiwan .,b School of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management , Chia Yi County , Taiwan
| | - Pei-Yuan Su
- c Department of Gastroenterology , Changhua Christian Hospital , Changhua , Taiwan
| | - Shu-Yi Wang
- d Loretto Heights School of Nursing, Regis University , Denver , CO , USA , and
| | - Chia-Chin Lin
- e School of Nursing, College of Nursing , Taipei Medical University , Taipei , Taiwan
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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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