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Mizuno Y, Ashok AH, Bhat BB, Jauhar S, Howes OD. Dopamine in major depressive disorder: A systematic review and meta-analysis of in vivo imaging studies. J Psychopharmacol 2023; 37:1058-1069. [PMID: 37811803 PMCID: PMC10647912 DOI: 10.1177/02698811231200881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of global disability. Several lines of evidence implicate the dopamine system in its pathophysiology. However, the magnitude and consistency of the findings are unknown. We address this by systematically reviewing in vivo imaging evidence for dopamine measures in MDD and meta-analysing these where there are sufficient studies. METHODS Studies investigating the dopaminergic system using positron emission tomography or single photon emission computed tomography in MDD and a control group were included. Demographic, clinical and imaging measures were extracted from each study, and meta-analyses and sensitivity analyses were conducted. RESULTS We identified 43 studies including 662 patients and 801 controls. Meta-analysis of 38 studies showed no difference in mean or mean variability of striatal D2/3 receptor availability (g = 0.06, p = 0.620), or combined dopamine synthesis and release capacity (g = 0.19, p = 0.309). Dopamine transporter (DAT) availability was lower in the MDD group in studies using DAT selective tracers (g = -0.56, p = 0.006), but not when tracers with an affinity for serotonin transporters were included (g = -0.21, p = 0.420). Subgroup analysis showed greater dopamine release (g = 0.49, p = 0.030), but no difference in dopamine synthesis capacity (g = -0.21, p = 0.434) in the MDD group. Striatal D1 receptor availability was lower in patients with MDD in two studies. CONCLUSIONS The meta-analysis indicates striatal DAT availability is lower, but D2/3 receptor availability is not altered in people with MDD compared to healthy controls. There may be greater dopamine release and lower striatal D1 receptors in MDD, although further studies are warranted. We discuss factors associated with these findings, discrepancies with preclinical literature and implications for future research.
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Affiliation(s)
- Yuya Mizuno
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Abhishekh Hulegar Ashok
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Imperial College London, London, UK
- Department of Radiology, University of Cambridge, Cambridge, UK
- Department of Radiology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Sameer Jauhar
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Imperial College London, London, UK
- Psychiatric Imaging Group, Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
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Gontijo BR, Possatti I, Fratelli CF, Pereira ASR, Bonasser LSS, de Souza Silva CM, Rodrigues da Silva IC. The 3'UTR VNTR SLC6A3 Genetic Variant and Major Depressive Disorder: A Systematic Review. Biomedicines 2023; 11:2270. [PMID: 37626766 PMCID: PMC10452352 DOI: 10.3390/biomedicines11082270] [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: 06/20/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Major Depressive Disorder (MDD) is a disabling and particularly persistent mental disorder that is considered to be a priority public health problem. The active human dopamine transporter (DAT), which is encoded by the SLC6A3 gene, regulates the dopamine concentration in the synaptic cleft. In this sense, this neurotransmitter is primordial in modulating human emotions. This systematic review aims to verify the SLC6A3 (DAT1) 3'UTR VNTR (rs28363170) gene variant's SS (9R/9R) genotype and S (9R) allele frequency fluctuation and its influence on the modulation of pharmacotherapy in MDD. For this purpose, we searched different databases, and after applying the eligibility criteria, six articles were selected. Studies have shown an association between the SS (9R/9R) genotypic and S (9R) allelic presence with the risk of developing MDD, in addition to influencing the decrease in response to antidepressant therapy. However, despite the findings, disagreements were observed between other studies. For this reason, further studies with the SLC6A3 3'UTR VNTR (rs28363170) variant in different populations are necessary to understand this polymorphism's role in the onset of this disease.
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Affiliation(s)
- Bruna Rodrigues Gontijo
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
| | - Isabella Possatti
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
| | - Caroline Ferreira Fratelli
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
| | - Alexandre Sampaio Rodrigues Pereira
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
| | | | - Calliandra Maria de Souza Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
| | - Izabel Cristina Rodrigues da Silva
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasilia, Federal District, Brasilia 72220-900, Brazil; (B.R.G.); (I.P.); (C.F.F.); (A.S.R.P.); (C.M.d.S.S.)
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Sekiguchi H, Pavey G, Dean B. Altered levels of dopamine transporter in the frontal pole and the striatum in mood disorders: A postmortem study. J Affect Disord 2023; 320:313-318. [PMID: 36162690 DOI: 10.1016/j.jad.2022.09.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
Dopamine dysregulation is known to play a major role in the pathophysiology of major depressive disorders (MDD) and bipolar disorders (BD). The dopamine transporter (DAT) plays a critical role in regulating dopamine concentration at the synaptic cleft and therefore could have an important role in the molecular pathology of MDD and BD. To test this hypothesis, we measured levels of [3H]mazindol binding to DAT in Brodmann's area (BA) 10, BA 17 as well as in the dorsal and ventral striatum from 15 controls, 15 patients with MDD and 15 patients with BD, obtained postmortem, using in situ radioligand binding with autoradiography. Compared to controls, levels of [3H]mazindol binding to DAT was significantly higher in BA10 from patients with MDD but not BD. There was no significant difference in [3H]mazindol binding to DAT in BA 17 or the dorsal and ventral striatum from patients with MDD or BD. In addition, levels of [3H]mazindol binding show no correlation with donor age, postmortem interval, tissue pH, sex or duration of illness. In conclusion, our data suggest that changes in levels of DAT may be selectively affecting dopamine homeostasis in BA 10 in patients with MDD.
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Affiliation(s)
- Hirotaka Sekiguchi
- Okehazama Hospital Fujita Mental Care Centre, Japan; Department of Psychiatry, Nagoya University Graduate School of Medicine, Japan; The Florey Institute of Neuroscience and Mental Health, Australia.
| | - Geoff Pavey
- The Florey Institute of Neuroscience and Mental Health, Australia
| | - Brian Dean
- The Florey Institute of Neuroscience and Mental Health, Australia; The Centre for Mental Health, the Faculty of Health, Arts and Design, Swinburne University, Australia
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Frings L, Heimbach B, Meyer PT, Hellwig S. Intrinsic Alertness Is Impaired in Patients with Nigrostriatal Degeneration: A Prospective Study with Reference to [123I]FP-CIT SPECT and [18F]FDG PET. J Alzheimers Dis 2021; 78:1721-1729. [PMID: 33216022 DOI: 10.3233/jad-191277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Variations in alertness and attention are common in Lewy body diseases (LBD) and among the core features of dementia with Lewy bodies (DLB). Dopamine transporter SPECT is an accurate biomarker of nigrostriatal degeneration (NSD) in LBD. OBJECTIVE The present study investigated performance on a computerized alertness test as a potential measure of attention in patients with NSD compared to patients without NSD. METHODS Thirty-six patients with cognitive impairment plus at least one core feature of DLB referred for [123I]FP-CIT SPECT imaging were prospectively recruited. Performance in a computerized test of intrinsic alertness was compared between patients with and those without NSD as assessed by [123I]FP-CIT SPECT. RESULTS Reaction times to auditory stimuli (adjusted for age, sex, and education) were significantly longer in patients with NSD compared to those with a normal [123I]FP-CIT SPECT scan (p < 0.05). Statistical analyses revealed no significant differences comparing reaction times to visual stimuli or dispersion of reaction times between groups. Exploratory analysis in a subgroup of patients with available [18F]FDG PET revealed that longer reaction times were associated with decreased glucose metabolism in the prefrontal cortex (statistical parametric mapping, adjusted for age and sex; p < 0.005, cluster extent > 50 voxels). CONCLUSION Computerized assessment of auditory reaction times is able to detect alertness deficits in patients with NSD and might help to measure alertness deficits in patients with LBD and NSD. Future studies in larger samples are needed to evaluate the diagnostic utility of computerized alertness assessment for the differential diagnosis of LBD.
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Affiliation(s)
- Lars Frings
- Center of Geriatrics and Gerontology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Bernhard Heimbach
- Center of Geriatrics and Gerontology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Sabine Hellwig
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Abstract
PURPOSE OF REVIEW To give an update on recent imaging studies probing positron emission tomography (PET) as a tool for improving biomarker-guided diagnosis of neuropsychiatric disorders. RECENT FINDINGS Several studies confirmed the value of imaging of regional neuronal activity and imaging of dopaminergic, serotonergic, and other neuroreceptor function in the diagnostic process of neuropsychiatric disorders, particularly schizophrenia, depression/bipolar disorder, substance use disorders, obsessive compulsive disorders (OCD), and attention-deficit/hyperactivity disorder. Additionally, imaging brain microglial activation using translocator protein 18 kDa (TSPO) radiotracer allows for unique in-vivo insights into pathophysiological neuroinflammatory changes underlying schizophrenia, affective disorders, and OCD. SUMMARY The role of PET imaging in the biomarker-guided diagnostic process of neuropsychiatric disorders has been increasingly acknowledged in recent years. Future prospective studies are needed to define the value of PET imaging for diagnosis, treatment decisions, and prognosis in neuropsychiatric disorders.
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