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Yan S, Liu H, Yu Y, Han N, Du W. Changes of Serum Homocysteine and Vitamin B12, but Not Folate Are Correlated With Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis of Case-Control Studies. Front Psychiatry 2022; 13:754165. [PMID: 35615448 PMCID: PMC9124900 DOI: 10.3389/fpsyt.2022.754165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) a complex neuropsychiatric disorder, is characterized by irresistible obsessive thinking and compulsive behavior. Folate is a member of water-soluble vitamins in the human body and sustains many normal daily activities (e.g., exercise, sleep, and memory). Homocysteine, a sulfur-containing non-essential amino acid, has been investigated in numerous psychiatric disorders (e.g., OCD). Vitamin B12 is a type of complex organic compound with cobalt contained. Moreover, vitamin B12 and folate deficiency and high levels of homocysteine were found to have an effect on brain functions and also lead to non-specific psychiatric symptoms. OBJECTIVES This study aimed to confirm the epidemiological evidence of OCD and investigate whether vitamin B12, folate, and homocysteine have an effect on the etiology of OCD. METHODS A systematic search was conducted on eight databases (i.e., PubMed, Embase, Web of Science, the Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database), and the retrieval time was up to March 2021. The available articles involving patients with OCD with/without abnormal serum levels of vitamin B12, folate, and homocysteine were comprehensively reviewed and analyzed. RESULTS A total of 5 studies involving 309 patients were included in this meta-analysis, including 172 cases in the experimental group and 137 in the control group. The content of folate in the OCD group was not significantly different from that in the control group (SMD = -0.089, 95%CI -0.755 to 0.577, p = 0.794). And serum homocysteine was significantly higher in the patients with OCD (SMD = 1.132, 95%CI 0.486 to 1.778, p = 0.001). Vitamin B12 was significantly lower in patients with OCD (SMD = -0.583, 95%CI -0.938 to -0.229, p = 0.001). CONCLUSIONS This meta-analysis shows serum high levels of homocysteine, low levels of vitamin B12, and normal folate level are closely correlated with OCD. However, high-quality case-control studies should be further conducted to explore the correlation between serum levels of vitamin B12, folate, homocysteine, and OCD. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021262161; PROSPERO (Number CRD#42021262161).
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Affiliation(s)
- Sirui Yan
- Department of Psychiatry, Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, China
| | - Hailong Liu
- Department of Psychiatry, Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, China
| | - Yaqiong Yu
- Department of Psychiatry, Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, China
| | - Nashu Han
- Department of Psychiatry, Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, China
| | - Wenzhi Du
- Department of Psychiatry, Mental Health Institute of Inner Mongolia Autonomous Region, Hohhot, China
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Zhao M, Liu T, Qi S, Li W, Liu X, Li X, Xun G. Individuals with Bipolar Disorder Have a Higher Level of Homocysteine Than Major Depressive Disorder: A Retrospective Chart Review and Observational Study. Neuropsychiatr Dis Treat 2022; 18:2671-2682. [PMID: 36411779 PMCID: PMC9675348 DOI: 10.2147/ndt.s387063] [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: 08/30/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Previous studies suggest that homocysteine (Hcy) may be involved in the pathogenesis of bipolar disorder (BD) and major depressive disorder (MDD) by influencing glutamatergic transmission, inflammation, and other mechanisms. There are no established biomarkers to distinguish BD from MDD. This study aims to compare Hcy levels between BD and MDD. PATIENTS AND METHODS We collected medical records of patients aged 14-75 admitted to the hospital from January 1 to July 1, 2022 with a discharge diagnosis of MDD or BD, including all examinations of patients at admission (acute phase) and discharge (non-acute phase). We measured Hcy levels in healthy controls (HC). RESULTS The analysis included 104 patients with MDD, 103 patients with BD, and 80 HC. Hcy levels were higher in the MDD and BD group than in the HC group and higher in the BD group than in the MDD group, both in the acute and non-acute phases (all P < 0.05). There was no significant difference in Hcy levels between the psychotropic medication users and non-users in the BD or MDD group (all P > 0.05). Multivariate logistic regression analysis only for the MDD and BD group indicated that the likelihood of BD diagnosis was significantly associated with Hcy levels (in the acute phase: OR = 1.052, P = 0.016; in the non-acute phase: OR = 1.101, P < 0.001) after controlling for gender, age, and metabolic indicators. CONCLUSION Our study suggests that Hcy levels were elevated in MDD and BD patients and were higher in BD patients than in MDD patients, which provides evidence for a possible relationship between one-carbon metabolism and the pathogenesis of BD. Besides, Hcy may be one of the potential biomarkers to distinguish BD from MDD.
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Affiliation(s)
- Miao Zhao
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Tengteng Liu
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Sufang Qi
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Wenjie Li
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Xin Liu
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Xinming Li
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
| | - Guanglei Xun
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, People's Republic of China
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Pano O, Martínez-Lapiscina EH, Sayón-Orea C, Martinez-Gonzalez MA, Martinez JA, Sanchez-Villegas A. Healthy diet, depression and quality of life: A narrative review of biological mechanisms and primary prevention opportunities. World J Psychiatry 2021; 11:997-1016. [PMID: 34888169 PMCID: PMC8613751 DOI: 10.5498/wjp.v11.i11.997] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/19/2021] [Accepted: 08/27/2021] [Indexed: 02/06/2023] Open
Abstract
Unipolar depressive disorder (UDD) affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030. It is imperative for leading economies to implement preventive strategies targeted towards UDD, given consistent policies are currently lacking. Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field. It is believed that dietary practices could potentially reduce the incidence of depression; similar to their effects on metabolism. Thus, the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD. Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees. Interestingly, a common factor of UDD is the production and overall effects of inflammatory cytokines, such as interleukin-6, tumor necrosis factor-α, and C-reactive protein. These compounds have been associated with depressive symptoms, disturbances in neuroendocrine function, leaky gut, monoamine activity and brain function, while also being key factors in the development of cardiometabolic diseases. The Mediterranean diet (MD) in particular, is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations. In one of the few clinical trials investigating these associations, the PREDIMED trial, individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41% relative risk reduction for developing depression. Lastly, there is a need to include health related quality of life as an indicator of physical and mental well-being, considering its putative associations with depression and suicide risk. Going forward, focusing on clinical trials, using precise nutritional assessments, and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.
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Affiliation(s)
- Octavio Pano
- Preventive Medicine and Public Health, University of Navarre, Pamplona 31008, Spain
| | - Elena H Martínez-Lapiscina
- Department of Neurology Center of Neuroimmunology, Hospital Clinic of Barcelona, Institut d’Investigacions Biomèdiques August Pi Sunyer, Barcelona 08036, Spain
| | - Carmen Sayón-Orea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona 31008, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona 31008, Spain
- Department of Public Health, Navarra Institute of Public Health and Epidemiology, Pamplona 31003, Spain
| | - Miguel Angel Martinez-Gonzalez
- Preventive Medicine and Public Health, University of Navarre, Pamplona 31008, Spain
- CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid 28049, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Jose Alfredo Martinez
- IdiSNA, Navarra Institute for Health Research, Pamplona 31008, Spain
- CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid 28049, Spain
- Department of Food Sciences and Physiology, University of Navarre, Pamplona 31008, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food Institute, Madrid 28049, Spain
| | - Almudena Sanchez-Villegas
- CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid 28049, Spain
- Department of Clinical Sciences, University of Las Palmas Gran Canaria, Las Palmas Gran Canaria 35080, Spain
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Moradi F, Lotfi K, Armin M, Clark CCT, Askari G, Rouhani MH. The association between serum homocysteine and depression: A systematic review and meta-analysis of observational studies. Eur J Clin Invest 2021; 51:e13486. [PMID: 33423269 DOI: 10.1111/eci.13486] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hyperhomocysteinaemia is known to interfere with neurological functions; however, there is a controversy regarding the relationship between homocysteine and depression. MATERIALS AND METHODS Science Direct, MEDLINE and ISI Web of Science were searched to find relevant articles, published up to August 2020. Studies were included if they compared homocysteine levels in healthy subjects with subjects with depression. Also, articles that reported the association between hyperhomocysteinaemia and risk of depression were included. Odds ratios of depression and means of homocysteine were used to ascertain the overall effect size. RESULTS Homocysteine level was higher in subjects with depression in comparison with healthy controls (weight mean difference = 2.53 µmol/L, 95% confidence interval: 1.77, 3.30), and the depression diagnostic tool was a source of heterogeneity. Homocysteine level was significantly higher in subjects with depression in studies that used Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), Geriatric Depression Scale (GDS), Zung Self-Rating Depression Scale (ZDRS) and Beck Depression Index II (BDI-II) as depression diagnostic tools. Also, participants with hyperhomocysteinaemia had a higher chance of depression (Pooled risk = 1.34, 95% confidence interval: 1.19, 1.52), where the depression diagnostic tool was a source of heterogeneity. In contrast to ZDRS and Patient Health Questionnaire (PHQ) subgroups, hyperhomocysteinaemia yielded a significantly higher risk of depression in DSM-IV, GDS and 'other' subgroups. CONCLUSION Homocysteinemia level is higher in individuals with depression. However, the depression diagnostic tool used is instrumental in influencing their association, and thus, future studies should focus on the tools for depression assessment.
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Affiliation(s)
- Fatemeh Moradi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Armin
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Gholamreza Askari
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Tao H, Chen X, Zhou H, Fu J, Yu Q, Liu Y. Changes of Serum Melatonin, Interleukin-6, Homocysteine, and Complement C3 and C4 Levels in Patients With Depression. Front Psychol 2020; 11:1271. [PMID: 32655450 PMCID: PMC7324806 DOI: 10.3389/fpsyg.2020.01271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/14/2020] [Indexed: 12/26/2022] Open
Abstract
Objectives Cytokine activation and low complement levels are common in depression patients. This study is aimed at investigating the clinical significance of changes in serum concentrations of melatonin (MT), interleukin-6 (IL-6), homocysteine (hcy), and complement C3 and C4 in depression patients and relationships of them with depression activity. Methods A total of 95 depression patients, including first-episode group (n = 43) and recurrent group (n = 52), and 45 age- and gender-matched healthy controls (HC) were recruited. Serum levels of MT, IL-6, hcy, C3, and C4 in all samples were measured by using enzyme-linked immunosorbent assay (ELISA), chemiluminescence method, enzyme circulation method, and immuno-scatter turbidimetric assay, respectively. Results The serum MT, IL-6, and hcy levels in the first-episode group (113.08 ± 5.06 pg/ml, 2.06 ± 0.12 ng/L, and 13.87 ± 0.45 μmol/L), and recurrent group (117.63 ± 4.63 pg/ml, 2.20 ± 0.12 ng/L, and 13.61 ± 0.46 μmol/L) were significantly higher than those in the control group (89.50 ± 5.10 pg/ml, 1.57 ± 0.06 ng/L, and 11.34 ± 0.40 μmol/L). The serum levels of C3 in the first-episode group (0.95 ± 0.02 ng/L) were significantly lower than those in the recurrent group (1.05 ± 0.03 ng/L) and control group (1.12 ± 0.03 ng/L). There was no significant difference in serum C4 level between each group. Conclusion These results suggest that higher serum MT, IL-6, and hcy levels were correlated with pathogenesis of depression.
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Affiliation(s)
- Huai Tao
- School of Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xia Chen
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hongfei Zhou
- School of Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Jinhua Fu
- Department of Psychiatry, Hunan Provincial Brain Hospital, Changsha, China
| | - Qi Yu
- School of Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Yong Liu
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, The Second Xiangya Hospital of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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Salagre E, Vizuete A, Leite M, Brownstein D, McGuinness A, Jacka F, Dodd S, Stubbs B, Köhler C, Vieta E, Carvalho A, Berk M, Fernandes B. Homocysteine as a peripheral biomarker in bipolar disorder: A meta-analysis. Eur Psychiatry 2020; 43:81-91. [DOI: 10.1016/j.eurpsy.2017.02.482] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/13/2022] Open
Abstract
AbstractBackground:Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.Methods:This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.Results:Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g= 0.98, 95% CI: 0.8–1.17,P< 0.001,n= 495) and a small effect in the euthymia group (g= 0.3, 95% CI: 0.11–0.48,P= 0.002,n= 1052).Conclusions:Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.
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Tolahunase MR, Sagar R, Dada R. 5-HTTLPR and MTHFR 677C>T polymorphisms and response to yoga-based lifestyle intervention in major depressive disorder: A randomized active-controlled trial. Indian J Psychiatry 2018; 60:410-426. [PMID: 30581206 PMCID: PMC6278208 DOI: 10.4103/psychiatry.indianjpsychiatry_398_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is growing evidence suggesting that both genetic and environmental factors modulate treatment outcome in, a highly heterogeneous, major depressive disorder (MDD). 5-HTTLPR variant of the serotonin transporter gene (SLC6A4) and MTHFR 677C>T polymorphisms have been linked to the pathogenesis of MDD, and antidepressant treatment response. The evidence is lacking on the clinical utility of yoga in patients with MDD who have 5-HTTLPR and MTHFR 677C>T polymorphisms and less likely to respond to medications (SSRIs). AIMS We aimed to examine the impact of YBLI in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are less likely to drug therapy with SSRIs. SETTINGS AND DESIGN In a 12 week randomized active-controlled trial, MDD patients (n = 178) were randomized to receive YBLI or drug therapy. METHODS Genotyping was conducted using PCR-based methods. The clinical remission was defined as BDI-II score ≤ 9. STATISTICAL ANALYSIS USED An intent-to-treat analysis was performed, and the association of genotype with treatment remission consisted of the logistic regression model. A P value of <0.05 was considered statistically significant. RESULTS Multivariate logistic regression models for remission including either 5-HTTLPR or MTHFR 677C>T genotypes showed statistically significant odds of remission in YOGA arm vs. DRUG arm. Neither 5-HTTLPR nor MTHFR 677C>T genotype showed any influence on remission to YBLI (P = 0.73 and P = 0.64, respectively). Further analysis showed childhood adversity interact with 5-HTTLPR and MTHFR 677C>T polymorphisms to decrease treatment response in DRUG treatment arm, but not in YOGA arm. CONCLUSIONS YBLI provides MDD remission in those who have susceptible 5-HTTLPR and MTHFR 677C>T polymorphisms and are resistant to SSRIs treatment. YBLI may be therapeutic for MDD independent of heterogeneity in its etiopathogenesis.
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Affiliation(s)
- Madhuri R Tolahunase
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rima Dada
- Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
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Berrett AN, Gale SD, Erickson LD, Brown BL, Hedges DW. Helicobacter pylori moderates the association between 5-MTHF concentration and cognitive function in older adults. PLoS One 2018; 13:e0190475. [PMID: 29364915 PMCID: PMC5783346 DOI: 10.1371/journal.pone.0190475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/11/2017] [Indexed: 01/02/2023] Open
Abstract
Objective To explore potential interactions between folate-cycle factors and Helicobacter pylori seropositivity in the prediction of cognitive function. Methods We used data obtained from the 1999–2000 continuous National Health and Nutrition Examination Survey produced by the United States’ Centers for Disease Control and Prevention. Using Ordinary Least Squares regression, we tested for associations between multiple folate-cycle factors, Helicobacter pylori seropositivity, and cognitive function assessed by the digit symbol coding subtest of the Wechsler Adult Intelligence Scale-III. We then tested for interactions between each of the folate-cycle factors and Helicobacter pylori in the prediction of cognitive function. Results Although Helicobacter pylori seropositivity, 5-methyltetrahydrofolate, vitamin B-12, and homocysteine were not associated with performance on the digit symbol coding task, Helicobacter pylori seropositivity interacted with 5-methyltetrahydrofolate concentration to predict performance on the digit symbol coding task. The Helicobacter pylori seropositive group performed worse on the digit symbol coding task as 5-methyltetrahydrofolate concentration decreased. Conclusion The interaction between Helicobacter pylori seropositivity and reduced folate-cycle factor 5-methyltetrahydrofolate might impair aspects of cognitive function.
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Affiliation(s)
- Andrew N Berrett
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Shawn D Gale
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
| | - Lance D Erickson
- Department of Sociology, Brigham Young University, Provo, Utah, United States of America
| | - Bruce L Brown
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Dawson W Hedges
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
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Bender A, Hagan KE, Kingston N. The association of folate and depression: A meta-analysis. J Psychiatr Res 2017; 95:9-18. [PMID: 28759846 DOI: 10.1016/j.jpsychires.2017.07.019] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Previous research suggested that folate levels play an important role in the etiology and course of depression. However, the literature has been inconsistent with regard to differences in folate level between individuals with and without depression. The present meta-analysis synthesized the results of previous studies to examine whether individuals with depression had lower levels of folate than individuals without depression. METHODS Meta-analytic procedures were conducted in accordance with PRISMA guidelines. Studies evaluating folate levels in individuals with and without depression via red blood cell folate, serum folate, or dietary intake of folate methods were identified via PsycINFO and PubMed. Random-effects meta-analysis was conducted using Hedge's g, and moderation analysis was used for both folate measurement method and population type. Study heterogeneity was assessed with I2 and publication bias was qualitatively assessed via funnel plot and quantitatively assessed with the trim-and-fill method and Begg's adjusted rank test. RESULTS We found a significant, small effect size, such that individuals with depression had lower folate levels than those without depression, Hedge's g = -0.24 (95% CI = -0.31, -0.16), p < 0.001. Study heterogeneity was high (I2 = 84.88%), and neither folate measurement method nor population accounted for study heterogeneity. CONCLUSIONS Individuals with depression have lower serum levels of folate and dietary folate intake than individuals without depression. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, future research on folate supplementation in depression is warranted and clinicians may wish to consider folate supplementation for patients with depression.
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Oliva F, Coppola M, Mondola R, Ascheri D, Cuniberti F, Nibbio G, Picci RL. Blood homocysteine concentration and mood disorders with mixed features among patients with alcohol use disorder. BMC Psychiatry 2017; 17:181. [PMID: 28494779 PMCID: PMC5427552 DOI: 10.1186/s12888-017-1342-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/30/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Blood homocysteine concentration (BHC) is higher in patients with alcohol use disorder (AUD). Previous studies have found a relationship between depressive symptoms severity and BHC in AUD patients and recently some authors have found high BHC among patients with bipolar disorder, both during manic and depressive episodes and in euthymic state. However, BHC in patients with mixed mood episode has not yet been investigated. The aim of this study was to evaluate the BHC of patients with AUD and mixed mood episode. METHODS A sample of AUD outpatients was assessed by Mini-International Neuropsychiatric Interview (MINI Plus): those with a DSM-IV-TR mood disorder with mixed features were included in the MIXED group (n = 45), whereas those without mood episode were gathered in the NO MOOD group (n = 23). Two subgroups, MIXMANIA and MIXDEPRESSION, were formed according to the prevalence of manic or depressive symptoms, assessed by Young Mania Rating Scale (YMRS), and Hamilton Rating Scale for Depression (HDRS). The Alcohol Use Disorder Identification Test (AUDIT) was used to appraise the AUD. BHC was determined by High-Performance Liquid Chromatography. RESULTS The MIXED group showed greater severity of both depressive (26.35 ± 9.96 vs. 4.77 ± 0.92; p < 0.001) and manic (22.35 ± 3.30 vs. 6.14 ± 1.12; p < 0.001) symptoms, and higher BHC (28.80 ± 11.47 vs. 10.83 ± 2.81; p < 0.001), than the NO MOOD group. BHC was strongly correlated to the HDRS, YMRS and AUDIT scores, just as HDRS was to YMRS, and AUDIT was to both HDRS and YMRS, in the MIXED group only (p < 0.001). The MIXDEPRESSION subgroup showed higher BHC than the MIXMANIA subgroup (Mdn = 42.96, IQR = 10.44 vs. Mdn = 19.77, IQR = 5.93; p < 0.001). A linear regression model conducted on the MIXED group found a significant predictive value for BHC of both HDRS (β = 0.560, t = 2.43, p = 0.026) and AUDIT (β = 0.348, t = 2.17, p = 0.044). CONCLUSIONS Depressive symptoms seem to be mainly implicated in the BHC elevation among patients with both mixed features mood disorder and AUD.
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Affiliation(s)
- Francesco Oliva
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
| | - Maurizio Coppola
- 0000 0004 1755 6398grid.476863.8Addiction Department, Azienda Sanitaria Locale CN2, Alba, CN Italy
| | | | - Daniele Ascheri
- 0000 0001 2336 6580grid.7605.4Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano, TO Italy
| | - Francesco Cuniberti
- 0000 0001 2336 6580grid.7605.4Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy
| | - Gabriele Nibbio
- 0000 0001 2336 6580grid.7605.4Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano, TO Italy
| | - Rocco Luigi Picci
- 0000 0001 2336 6580grid.7605.4Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano, TO Italy
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Mocking RJT, Figueroa CA, Rive MM, Geugies H, Servaas MN, Assies J, Koeter MWJ, Vaz FM, Wichers M, van Straalen JP, de Raedt R, Bockting CLH, Harmer CJ, Schene AH, Ruhé HG. Vulnerability for new episodes in recurrent major depressive disorder: protocol for the longitudinal DELTA-neuroimaging cohort study. BMJ Open 2016; 6:e009510. [PMID: 26932139 PMCID: PMC4785288 DOI: 10.1136/bmjopen-2015-009510] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) is widely prevalent and severely disabling, mainly due to its recurrent nature. A better understanding of the mechanisms underlying MDD-recurrence may help to identify high-risk patients and to improve the preventive treatment they need. MDD-recurrence has been considered from various levels of perspective including symptomatology, affective neuropsychology, brain circuitry and endocrinology/metabolism. However, MDD-recurrence understanding is limited, because these perspectives have been studied mainly in isolation, cross-sectionally in depressed patients. Therefore, we aim at improving MDD-recurrence understanding by studying these four selected perspectives in combination and prospectively during remission. METHODS AND ANALYSIS In a cohort design, we will include 60 remitted, unipolar, unmedicated, recurrent MDD-participants (35-65 years) with ≥ 2 MDD-episodes. At baseline, we will compare the MDD-participants with 40 matched controls. Subsequently, we will follow-up the MDD-participants for 2.5 years while monitoring recurrences. We will invite participants with a recurrence to repeat baseline measurements, together with matched remitted MDD-participants. Measurements include questionnaires, sad mood-induction, lifestyle/diet, 3 T structural (T1-weighted and diffusion tensor imaging) and blood-oxygen-level-dependent functional MRI (fMRI) and MR-spectroscopy. fMRI focusses on resting state, reward/aversive-related learning and emotion regulation. With affective neuropsychological tasks we will test emotional processing. Moreover, we will assess endocrinology (salivary hypothalamic-pituitary-adrenal-axis cortisol and dehydroepiandrosterone-sulfate) and metabolism (metabolomics including polyunsaturated fatty acids), and store blood for, for example, inflammation analyses, genomics and proteomics. Finally, we will perform repeated momentary daily assessments using experience sampling methods at baseline. We will integrate measures to test: (1) differences between MDD-participants and controls; (2) associations of baseline measures with retro/prospective recurrence-rates; and (3) repeated measures changes during follow-up recurrence. This data set will allow us to study different predictors of recurrence in combination. ETHICS AND DISSEMINATION The local ethics committee approved this study (AMC-METC-Nr.:11/050). We will submit results for publication in peer-reviewed journals and presentation at (inter)national scientific meetings. TRIAL REGISTRATION NUMBER NTR3768.
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Affiliation(s)
- Roel J T Mocking
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Caroline A Figueroa
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Maria M Rive
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Hanneke Geugies
- University of Groningen, Neuroimaging Center, University Medical Center Groningen, The Netherlands
- Program for Mood and Anxiety Disorders, Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Michelle N Servaas
- University of Groningen, Neuroimaging Center, University Medical Center Groningen, The Netherlands
- Program for Mood and Anxiety Disorders, Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Johanna Assies
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Maarten W J Koeter
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Frédéric M Vaz
- Laboratory Genetic Metabolic Disease, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Marieke Wichers
- University of Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, The Netherlands
| | - Jan P van Straalen
- Laboratory of General Clinical Chemistry, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Rudi de Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Claudi L H Bockting
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Aart H Schene
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Henricus G Ruhé
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands
- University of Groningen, Neuroimaging Center, University Medical Center Groningen, The Netherlands
- Program for Mood and Anxiety Disorders, Department of Psychiatry, University of Groningen, University Medical Center Groningen, The Netherlands
- University of Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, The Netherlands
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12
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Ortbauer M, Ripper D, Fuhrmann T, Lassi M, Auernigg-Haselmaier S, Stiegler C, König J. Folate deficiency and over-supplementation causes impaired folate metabolism: Regulation and adaptation mechanisms in Caenorhabditis elegans. Mol Nutr Food Res 2016; 60:949-56. [PMID: 27061234 DOI: 10.1002/mnfr.201500819] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/11/2022]
Abstract
SCOPE Impaired folate metabolism increases the risk of birth defects, neurodegenerative and cardiovascular disease, osteoporosis and cancer. We used Caenorhabditis elegans to investigate impaired folate metabolism by RNA interference of key enzymes in the methionine synthase (MS) and thymidylate synthase (TS) cycle and by folate deficiency and over-supplementation feeding studies. METHODS AND RESULTS Folate status is influenced by genetic variations (polymorphisms), folate deficiency and supplementation. Single RNAi of dihydrofolate reductase (DHFR), methylenetetrahydrofolate reductase (MTHFR) and MS revealed that gene regulation is largely affected in both folate cycles. Adaptation requires a close transcriptional connection between TS and MS cycle. Coupled DHFR and MS expression is required to balance both cycles, but seems to reduce the overall rate of folate conversion. Feeding studies showed that folate over-supplementation to functioning metabolism inactivates MS and MTHFR expression and enhances TS activity, which favors DNA synthesis over methylation reactions. Folate deficiency disrupted homeostasis by favoring TS cycle and led to malformation in C. elegans offspring. Embryos show aneuploidy and are nonviable lacking DNA repair during meiotic stage of diakinesis. CONCLUSION Single gene silencing alters gene expression in both cycles and disrupts folate homeostasis. Folate over-supplementation and deficiency favors TS over MS cycle and causes prophase DNA damage.
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Affiliation(s)
- Martina Ortbauer
- Department of Nutritional Sciences, University of Vienna, Austria
| | - Doris Ripper
- Department of Nutritional Sciences, University of Vienna, Austria
| | - Thomas Fuhrmann
- Department of Nutritional Sciences, University of Vienna, Austria.,Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
| | - Maximilian Lassi
- Department of Nutritional Sciences, University of Vienna, Austria
| | | | | | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Austria
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13
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Sayadi MA, Achour O, Ezzaher A, Hellara I, Omezzine A, Douki W, Bousslama A, Gaha L, Najjar MF. CT genotype of 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is protector factor of major depressive disorder in the Tunisian population: a case control study. Ann Gen Psychiatry 2016; 15:18. [PMID: 27478487 PMCID: PMC4967526 DOI: 10.1186/s12991-016-0103-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 06/29/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a common psychiatric disorder with considerable mortality. Death from unnatural causes, largely suicidal or quasi-suicidal, has a particularly high risk for the functional disorders, especially depression and schizophrenia. One of the prospective risk factors for this disease is hyperhomocysteinemia and folate deficiency. The methylenetetrahydrofolate reductase (MTHFR) gene encodes for a 5-methylenetetrahydrofolate reductase involved in folate metabolism and neurotransmitter synthesis. The aim of this research is to study the association between the C677T polymorphism of MTHFR gene and depression in Tunisian population, to explore their relationship with clinical and therapeutic characteristics of this disease. And it may lead to discover a novel marker to identify a patient with a higher risk of development of depressive disorder to be. This marker can be used for better therapeutic management and prevent disease installation. METHODS Our study included 208 depressive patients, 187 controls aged between 44.1 ± 13.5 and 38.9 ± 13.2 years, respectively. MTHFR gene polymorphisms were determined by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). RESULTS No significant difference was detected in the distribution of the genotype frequencies of MTHFR C677T polymorphisms (χ (2) = 5.443, df = 2, p = 0.066) between patients and controls. But when we study the risk of these genotypes, CT genotype is significantly more frequent in controls compared to patients, it may be a protection from depression (OR = 0.655, CI 95 % = 0.432-0.995, p = 0.047, OR* = 0.638, CI 95 %* = 0.415-0.983, p* = 0.04, before and after adjustment). Women, TT Genotype can increase four times the risk to be depressive. Addictive behavior seems to be associated with CT genotype and there was no significant association between clinical and therapeutic characteristics and this polymorphism. CONCLUSION This paper is the first study to prove that CT genotype of MTHFR C677T polymorphism may protect from depression and TT genotype seems to be associated with women's depression. Further studies are required with other polymorphisms and biochemical factors that must be investigated to clarify the implication of MTHFR C677T polymorphism in the pathophysiology of depression.
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Affiliation(s)
- Mohamed Amine Sayadi
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia ; Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Ons Achour
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Asma Ezzaher
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia ; Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Ilham Hellara
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
| | - Asma Omezzine
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Wahiba Douki
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
| | - Ali Bousslama
- LR 12 SP 11, Biochemistry Department, Sahloul Sousse University Hospital, Sousse, Tunisia
| | - Lotfi Gaha
- Research Laboratory "Vulnerability to Psychotic disorders LR 05 ES 10", Department of Psychiatry, Monastir University Hospital, Monastir, Tunisia
| | - Mohamed Fadhel Najjar
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia
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14
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Assies J, Mocking RJT, Lok A, Koeter MWJ, Bockting CLH, Visser I, Pouwer F, Ruhé HG, Schene AH. Erythrocyte fatty acid profiles and plasma homocysteine, folate and vitamin B6 and B12 in recurrent depression: Implications for co-morbidity with cardiovascular disease. Psychiatry Res 2015; 229:992-8. [PMID: 26260568 DOI: 10.1016/j.psychres.2015.06.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/23/2015] [Accepted: 06/01/2015] [Indexed: 01/02/2023]
Abstract
Oxidative stress induced interactions between fatty acid (FA) and one-carbon metabolism may be involved in co-occurrence of major depressive disorder (MDD) and cardiovascular disease (CVD), which have been scarcely studied together. In 137 recurrent MDD-patients vs. 73 age- and sex-matched healthy controls, we simultaneously measured key components of one-carbon metabolism in plasma (homocysteine, folate, vitamins B6 and B12), and of FA-metabolism in red blood cell membranes [main polyunsaturated fatty acids (PUFAs) eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA) and structural FA-indices (chain length, unsaturation, peroxidation)]. Results show significant positive associations of folate with EPA, DHA, and the peroxidation index, which were similar in patients and controls. After correction for confounders, these associations were lost except for EPA. Associations between B-vitamins and FA-parameters were non-significant, but also similar in patients and controls. Homocysteine and DHA were significantly less negatively associated in patients than in controls. In conclusion, these data indicate similarities but also differences in associations between parameters of one-carbon and FA-metabolism in recurrent MDD patients vs. controls, which may reflect differences in handling of oxidative stress. Further research should test the consequences of these differences, particularly the premature development of CVD in MDD.
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Affiliation(s)
- Johanna Assies
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Roel J T Mocking
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anja Lok
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Maarten W J Koeter
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudi L H Bockting
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands; Department of Clinical and Health Psychology, University of Utrecht, Utrecht, The Netherlands
| | - Ieke Visser
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - François Pouwer
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands
| | - Henricus G Ruhé
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; University of Groningen, University Center for Psychiatry UMCG, Program for Mood and Anxiety Disorders, The Netherlands
| | - Aart H Schene
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
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15
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Gabriela Nielsen M, Congiu C, Bortolomasi M, Bonvicini C, Bignotti S, Abate M, Milanesi E, Conca A, Cattane N, Tessari E, Gennarelli M, Minelli A. MTHFR: Genetic variants, expression analysis and COMT interaction in major depressive disorder. J Affect Disord 2015; 183:179-86. [PMID: 26021967 DOI: 10.1016/j.jad.2015.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/04/2015] [Accepted: 05/04/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Methylenetetrahydrofolate reductase (MTHFR) genetic variations have been widely studied in major depressive disorder (MDD) and antidepressants outcome. An interaction with catechol-O-methyltransferase (COMT) has also been proved affecting depression. The aim of this study was to clarify the role of the most commonly studied single nucleotide polymorphisms (SNPs) of MTHFR gene in MDD and in treatment response mechanisms, along with the impact of the interaction with COMT. METHODS A total of 613 MDD patients, of whom 389 were classified as having treatment resistant depression (TRD), and 463 controls were enrolled. The A1298C, C677T and COMT Val158Met were genotyped. Genetic data were integrated with a transcriptional level analysis in peripheral blood cells (PBCs) and fibroblasts. RESULTS The A1298C CC homozygotes were more frequent in MDD patients compared to controls in women, increasing twice the genetic risk to develop depression. Moreover this genotype resulted in epistasis with COMT Met carriers in association with MDD. No significant effects were obtained concerning response to treatment. Transcriptional analyses highlighted a strong correlation between the mRNA levels of MTHFR in fibroblasts and COMT genotypes whereas no significant association with MDD was found. PBCs results revealed relevant influences of environmental factors. LIMITATION We did not measure folate and homocisteine levels. CONCLUSION This study showed the involvement of A1298C, Val158Met and their interaction in MDD. The transcriptional analyses supported the participation of COMT in the folate pathway, which partakes in the complex network of gene×gene and gene×environment interactions of MDD etiopathogenesis.
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Affiliation(s)
- Maria Gabriela Nielsen
- Psychiatric Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Chiara Congiu
- Department of Molecular and Translational Medicine, University of Brescia, Biology and Genetic Division, Viale Europa, 11, 25123 Brescia, Italy
| | | | - Cristian Bonvicini
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Stefano Bignotti
- Psychiatric Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Abate
- Psychiatric Hospital "Villa Santa Chiara", Verona, Italy
| | - Elena Milanesi
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andreas Conca
- Department of Psychiatry, Central Hospital of Bolzano, Bolzano, Italy
| | - Nadia Cattane
- Department of Molecular and Translational Medicine, University of Brescia, Biology and Genetic Division, Viale Europa, 11, 25123 Brescia, Italy
| | | | - Massimo Gennarelli
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Biology and Genetic Division, Viale Europa, 11, 25123 Brescia, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Biology and Genetic Division, Viale Europa, 11, 25123 Brescia, Italy.
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Moustafa AA, Hewedi DH, Eissa AM, Frydecka D, Misiak B. Homocysteine levels in schizophrenia and affective disorders-focus on cognition. Front Behav Neurosci 2014; 8:343. [PMID: 25339876 PMCID: PMC4186289 DOI: 10.3389/fnbeh.2014.00343] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/11/2014] [Indexed: 01/05/2023] Open
Abstract
Although homocysteine (Hcy) has been widely implicated in the etiology of various physical health impairments, especially cardiovascular diseases, overwhelming evidence indicates that Hcy is also involved in the pathophysiology of schizophrenia and affective disorders. There are several mechanisms linking Hcy to biological underpinnings of psychiatric disorders. It has been found that Hcy interacts with NMDA receptors, initiates oxidative stress, induces apoptosis, triggers mitochondrial dysfunction and leads to vascular damage. Elevated Hcy levels might also contribute to cognitive impairment that is widely observed among patients with affective disorders and schizophrenia. Supplementation of vitamins B and folic acid has been proved to be effective in lowering Hcy levels. There are also studies showing that this supplementation strategy might be beneficial for schizophrenia patients with respect to alleviating negative symptoms. However, there are no studies addressing the influence of add-on therapies with folate and vitamins B on cognitive performance of patients with schizophrenia and affective disorders. In this article, we provide an overview of Hcy metabolism in psychiatric disorders focusing on cognitive correlates and indicating future directions and perspectives.
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Affiliation(s)
- Ahmed A Moustafa
- School of Social Sciences and Psychology and Marcs Institute for Brain and Behaviour, University of Western Sydney Sydney, NSW, Australia
| | - Doaa H Hewedi
- Psychogeriatric Research Center, Department of Psychiatry, School of Medicine, Ain Shams University Cairo, Egypt
| | - Abeer M Eissa
- Psychogeriatric Research Center, Department of Psychiatry, School of Medicine, Ain Shams University Cairo, Egypt
| | - Dorota Frydecka
- Department and Clinic of Psychiatry, Wroclaw Medical University Wroclaw, Poland
| | - Błażej Misiak
- Department and Clinic of Psychiatry, Wroclaw Medical University Wroclaw, Poland ; Department of Genetics, Wroclaw Medical University Wroclaw, Poland
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