Major depressive disorder

The real-world impact of cariprazine on short- and long-term disability outcomes among commercially insured patients in the United States

AIM

To compare all-cause and mental health (MH)-related short-term and long-term disability leaves and associated costs among patients in the United States with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia spectrum disorders (SCZ) before versus after cariprazine initiation.

METHODS

Merative MarketScan Commercial and Health and Productivity Management (HPM) databases (January 2016 to December 2021) were utilized to identify adults diagnosed with BP, MDD, or SCZ with ≥2 pharmacy cariprazine claims (first claim = index), ≥3 months of cariprazine use (adjunctively for MDD), and continuous commercial insurance coverage and HPM eligibility during baseline (12 months pre-index) and ≥3 months post-index. Observation continued until cariprazine discontinuation, insurance or HPM eligibility end, 1 year post-index, or HPM data availability end. All-cause and MH-related disability claims, days, and costs were evaluated. Baseline versus post-index rates of disability claims (events) and days were compared using rate ratios (RR); costs were compared using mean cost differences. Comparisons were calculated from generalized estimating equation models. Analyses were replicated separately across indications.

RESULTS

There were 489 patients overall (BP = 238, MDD = 233, SCZ = 18; mean age = 43.3 years; 60.7% female; mean follow-up = 7.6 months). All-cause rates of disability events and days following cariprazine initiation were 29% (RR = 0.71 [95% CI = 0.57, 0.86]) and 28% (0.72 [0.53, 0.94]) lower than baseline, respectively (both p < .05). MH-related rates of disability events and days were 40% (0.60 [0.43, 0.80]) and 43% (0.57 [0.34, 0.84]) lower, respectively (both p < .01). All-cause disability costs were $2,917 lower and MH-related disability costs were $2,482 lower than baseline (40% and 51% decrease, respectively; both p < .01). Results were similar for indication-specific analyses.

LIMITATIONS

Limited generalizability to patients who are unemployed, uninsured, or have public insurance.

CONCLUSIONS

Rates of disability events, days, and mean costs were significantly lower after versus before cariprazine initiation. These results can help contextualize cariprazine's role in managing disability for these patients.

Alterations in magnetic susceptibility correlate with higher cerebral blood flow in the right amygdala of patients with major depressive disorder

BACKGROUND

The amygdala plays a crucial role in emotion processing and is a key target for understanding the mechanisms underlying major depressive disorder (MDD). This study aimed to investigate the magnetic susceptibility of the amygdala in MDD and examine its association with structural and cerebral blood flow (CBF) changes.

METHODS

A total of 158 individuals were included in the study, comprising 86 patients with MDD and 72 healthy controls. Depression severity was assessed using Hamilton Depression Rating Scale. Quantitative susceptibility mapping (QSM), T1-weighted, and arterial spin labeling scans were conducted to measure amygdala magnetic susceptibility, volume, and CBF, respectively. Group differences were compared, and associations between susceptibility, volume, and CBF were examined.

RESULTS

The median susceptibility of the amygdala was significantly higher in MDD patients than in controls (all p < 0.01). In the MDD group, increased QSM value in the right amygdala was associated with higher CBF (r = 0.28, p = 0.01), whereas no significant correlation was found between QSM value and volume (p = 0.76). Increased QSM value in the right amygdala was associated with worse depressed mood (r = 0.30, p < 0.01).

LIMITATION

Retrospective cross-sectional study conducted at a single center.

CONCLUSION

The magnetic susceptibility of the amygdala was higher in MDD patients with than in controls. QSM changes in the right amygdala correlated with increased CBF and worse depressed mood, indicating both microstructural and functional alterations. Our results encourage further use of the QSM technique in the elucidation of MDD pathophysiology.

The real-world safety profile of sertraline: Pharmacovigilance analysis of the FAERS database

OBJECTIVE

Sertraline is a widely used antidepressant, and its safety characteristics in elderly and adolescent patients have not been fully clarified. The purpose of this study was to comprehensively evaluate the characteristics of adverse effects of sertraline through a large-scale analysis of real-world data and to add to the evidence in the elderly and adolescent populations.

METHODS

The data were extracted from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database from the first quarter (Q1) 2004 to Q1 2024 for data cleaning and analysis. Adverse drug events were analyzed using the Reporting Odds Ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), Proportional Reporting Ratio (PRR), and Multi-Item Gamma Poisson Shrinker (MGPS) methods.

RESULTS

A total of 49,359 sertraline-related adverse event reports were included in this study. In addition to known adverse events (AEs), the study identified new potential safety signals for bruxism, microscopic colitis and genital anaesthesia. Intentional self-injury was the common adverse event in patients under 18 years of age and hyponatremia in patients 65 years of age and older. 26.77 % of adverse reactions occurred within one week of administration.

CONCLUSION

Sertraline requires special attention to the risks associated with neurologic, psychiatric, and congenital disorders in clinical use. In addition to common AEs such as nausea, and tremor, newly identified adverse reactions such as genital anaesthesia, bruxism, and microscopic colitis should be guarded against. For adolescents, suicide risk monitoring should be strengthened. In elderly patients, the risk of falls and electrolyte disturbances should be emphasized.

Inflammation molecular network alterations in a depressive-like primate model

At present, there are no definitive biomarkers for major depressive disorder (MDD). Previous studies prompted that neuroimmunoinflammation is involved in the pathogenesis of depression and its factors become potential diagnostic biomarkers. Non-human primates exhibit depression-like behavior similar to humans in chronically stressed environments. Therefore, in the present study, after completing Whole transcriptome sequencing of peripheral blood, neurology-related and inflammatory molecules in plasma and cerebrospinal fluid were measured by Olink proximity extension assay technology simultaneously in 4 natural depressive-like (DL) cynomolgus monkeys and 4 normal controls to screen potential biological markers. Further, postmortem brain tissues and peripheral blood RNA sequencing data from MDD patients available in the Gene Expression Omnibus (GEO) database were used for cross-species validation. Compared to control monkeys, depressive-like monkeys exhibited elevated levels of neurocan (NCAN). RNA sequencing revealed Toll-like receptor 4 (TLR4) and the interacting S100 calcium-binding protein A family as key molecules in the inflammatory gene network. GEO brain tissue data showed up-regulation of S100A8 and S100A9 in the anterior cingulate cortex of MDD patients. These findings suggest that depressive-like monkeys are in a state of chronic low-grade inflammation and identify NCAN and TLR4 inflammatory network molecules as potential biomarkers of MDD.

Associations between major depressive disorders and Parkinson's Disease and impact of their comorbidity sequence

BACKGROUND

The comorbidity of major depressive disorder (MDD) and Parkinson's disease (PD) were prevalent and has a profound impact on patients. However, whether this comorbidity results from specific pathological processes or a mutual cause-and-effect relationship was largely controversial. Additionally, although MDD can appear before or after PD, the health impact of the comorbidity sequence is poorly understood.

METHODS

We used mendelian randomization (MR) and UK biobank (UKB) cohort to explore the associations between MDD and PD. MR was also utilized to investigate potential confounders. By classifying UKB patients into MDD first and PD first groups, we evaluated the health impact of the comorbidity sequence using Cox regression.

RESULTS

Bidirectional MR and cohort study showed conflicting results. MR did not find associations between MDD followed by PD (odds ratio [OR] = 1.28, 95 % confidence interval [CI] = 0.85-1.94) or PD followed by MDD (OR = 0.99, 95 % CI = 0.97-1.01). However, the cohort study found a significant effect of MDD on PD (hazard ratio [HR] = 1.75, 95 % CI = 1.55-1.97) and PD on MDD (HR = 4.35, 95 % CI = 3.65-5.19). By performing MR on 4709 proteins, we identified ESD, LEAP2, NDRG3, NRXN3, and PLXNB2 as potential common causes of MDD and PD. Additionally, PD first group had higher risks of all-cause mortality (HR = 1.65, 95 % CI = 1.03-1.90), dementia (HR = 1.88, 95 % CI = 1.16-3.04), and aspiration pneumonia (HR = 1.89, 95 % CI = 1.09-3.27).

CONCLUSIONS

Our study suggested the comorbidity of MDD and PD is likely the result of certain pathological processes. Additionally, patients with PD first had higher risks of several adverse outcomes.

Association of branched-chain amino acids with major depressive disorder: A bidirectional Mendelian randomization study

BACKGROUND

Recent studies have linked branched-chain amino acids (BCAAs) metabolism with the risk of major depressive disorder (MDD). However, it is unclear whether associations of plasma BCAA levels with MDD are causal or driven by reverse causality.

METHODS

Mendelian randomization (MR) was used to investigate the causal association of genetically determined BCAA levels with the risk of MDD. The large genome-wide association study (GWAS) datasets on plasma BCAA levels (n = 115,051) were obtained from the UK Biobank. The summary GWAS dataset for MDD was obtained from the Psychiatric Genomics Consortium (n = 1,035,760). We applied the inverse variance-weighted (IVW) method to explore the causal relationships between BCAA levels and MDD, followed by multiple pleiotropy and heterogeneity tests.

RESULTS

Our results demonstrated that genetically determined circulating total BCAAs (odds ratio (OR): 1.05, 95 % confidence interval (CI): 1.01-1.10, P = 0.016), leucine (OR: 1.06, 95 % CI: 1.02-1.11, P = 7.22 × 10-3), and isoleucine (OR: 1.08, 95 % CI: 1.01-1.16, P = 0.032) levels were associated with an increased risk of MDD. There was suggestive evidence supporting the causal effect of valine levels on MDD (OR: 1.04, 95 % CI: 1.00-1.08, P = 0.075). Bidirectional MR analysis did not provide evidence of reverse causality.

CONCLUSIONS

We report evidence supporting the causal role of BCAAs in the development of MDD. This study offers new insights into the mechanisms and treatment of MDD.

Non-aversive handling in laboratory animals and its effects on depressive-like and anxiety-related behaviors: A scoping review

Stress is an adaptive response to environmental demands, but increased intensity and frequency can lead to impaired adaptive functions. Stress is considered a risk factor for Major Depressive Disorder, a multifactorial disorder that often coexists with anxiety. Picking up laboratory mice by the tail is the most common method for animal capture and may create background stress. Non-aversive handling (NAH) includes capturing the animal with the help of a tunnel or by capturing the animal with cupped hands. Given the importance of stress-induced models in the investigation of depressive-like and anxiety-related behaviors, we conducted a literature review to investigate the current knowledge on the behavioral effects of NAH in laboratory animals. While the ability of NAH to counteract depressive-like behavior has yielded mixed results, its ability to induce anxiolytic-like effects in mice has been confirmed by several studies. Some of the studies also investigated the impact of NAH on stress-related molecules (e.g. corticosterone) and physiological parameters (i.e. adrenal gland mass and body weight). The anxiolytic-like effect elicited by NAH seems to be well established in the literature, but little is known about the biochemical pathways underlying it and its antidepressant potential.

Association between dietary patterns and suicide ideation among depressed adults: Insights from NHANES 2007-2020

BACKGROUND

Dietary patterns are strongly linked to the risk of major depressive disorder (MDD). However, research on the relationship between dietary patterns and MDD with suicidal ideation (MDD + SI) are limited. The Healthy Eating Index (HEI)-2015, Dietary Inflammatory Index (DII), Comprehensive Dietary Antioxidant Index (CDAI), Oxidative Balance Score (OBS), and Dietary Index for Gut Microbiota (DI-GM) are five validated tools for assessing dietary patterns based on inflammation, antioxidant capacity, and gut microbiota diversity. This study aims to investigate the association between these dietary indices and MDD + SI.

METHODS

A total of 23,621 participants from the 2007-2020 National Health and Nutrition Examination Survey were included in this study. MDD and SI were assessed using the PHQ-9. Weighted multivariable logistic regression, subgroup analyses, and restricted cubic spline (RCS) models were applied to analyze the relationships between five dietary indices and the risks of MDD and MDD + SI.

RESULTS

All five dietary indices showed associations with MDD to varying degrees; however, only DI-GM exhibited a significant negative association with MDD + SI after adjustment for confounding factors. Subgroup and stratified linear trend analyses revealed that this association was stronger among former smokers, obese individuals and those with hypertension or diabetes. RCS analysis showed a significant non-linear relationship between DI-GM and MDD, while a significant linear dose-response relationship was observed for DI-GM and MDD + SI.

LIMITATIONS

Cross-sectional study designs cannot establish causality.

CONCLUSION

The findings of this study revealed a significant association between DI-GM and MDD + SI. Dietary interventions that promote gut microbiota diversity may help reduce the risk of MDD + SI.

The Gut Microbiome in Anxiety Disorders

PURPOSE OF REVIEW

We aim to update readers on the latest evidence regarding the role of the gut microbiome in generalized anxiety disorder (GAD), panic disorder (PD), agoraphobia, and social anxiety disorder (SAD). This review summarises the literature on microbiome composition and function in these conditions, provides insights about causality and mechanisms and evaluates current evidence for microbiome-based interventions in anxiety disorders.

RECENT FINDINGS

Most studies exploring the microbiome in anxiety disorders are small, cross-sectional studies. Nevertheless, some consistent findings emerge. Bacterial taxa such as Eubacterium, Coprococcus and Faecalibacterium may be depleted in GAD. Studies in PD and SAD are scarce and, to our knowledge, there have been no studies conducted in agoraphobia. Probiotics may help reduce anxiety symptoms, although the majority of studies have been in non-clinical cohorts. Large, prospective studies are required to further elucidate the role of the microbiome-gut-brain axis in anxiety disorders. Microbiome-based interventions hold promise, but randomised controlled trials in clinical populations with relevant diagnoses are now warranted and urgently required.

Glymphatic function and choroid plexus volume is associated with systemic inflammation and oxidative stress in major depressive disorder

BACKGROUND

Inflammatory processes were recognized as key factors in the pathophysiology of major depressive disorder (MDD). The choroid plexus (ChP) and glymphatic system played central roles in immune interactions between the brain and periphery. However, their specific roles in MDD and their relationship with systemic inflammation and oxidative stress remained unclear.

METHODS

This study finally included 665 MDD patients and 338 healthy controls. Clinical data and MRI scans were collected, and some patients also underwent blood routine and biochemical tests. ChP volume was manually segmented, and the diffusion tensor imaging along the perivascular space (DTI-ALPS) index, reflecting glymphatic function, was obtained through the FSL pipeline. The differences in these dices between groups were compared, and their associations with systemic inflammation and oxidative stress were analyzed.

RESULTS

MDD patients showed increased ChP volume (total: d = 0.316, p < 0.001; left: d = 0.317, p < 0.001; right: d = 0.268, p = 0.003) and decreased DTI-ALPS index (d = -0.144, p = 0.022), with a negative correlation between them (ρ = -0.135, p < 0.001). In MDD patients, lower DTI-ALPS index was correlated with higher LHR (ρ = -0.107, p = 0.025) and MHR (ρ = -0.126, p = 0.008). Larger right ChP volume was associated with higher MLR (ρ = 0.107, p = 0.009), SIRI (ρ = 0.086, p = 0.036), PIV (ρ = 0.086, p = 0.036), MHR (ρ = 0.136, p = 0.004), and PHR (ρ = 0.126, p = 0.008), while larger total ChP volume was correlated with higher MHR (ρ = 0.097, p = 0.042) and PHR (ρ = 0.114, p = 0.017).

CONCLUSION

MDD appeared to be accompanied by an increase in ChP volume and a decrease in glymphatic function, and these changes were related to systemic inflammation and oxidative stress.

Gray matter structural alterations in first-episode drug-naïve adolescents with major depressive disorder: a comprehensive morphological analysis study

BACKGROUND

Major depressive disorder (MDD) tends to emerge during adolescence; however, neurobiological research in adolescents has lagged behind that in adults. This study aimed to characterize gray matter (GM) structural alterations in adolescents with MDD using comprehensive morphological analyses.

METHODS

This study included 93 adolescent MDD patients and 77 healthy controls. Voxel-based morphometry (VBM), deformation-based morphometry (DBM), and surface-based morphometry (SBM) methods were used to analyze GM morphological alterations in adolescent MDD patients. Sex-by-group and age-by-group interactions, as well as the relationships between altered GM structure and clinical characteristics were also analyzed.

RESULTS

Whole-brain VBM and DBM analyses revealed GM atrophy in the left thalamus and bilateral midbrain in adolescent MDD patients. Whole-brain SBM analysis revealed that adolescent MDD patients, relative to controls, showed decreased thickness in the left postcentral gyrus and left precentral gyrus; increased thickness in the bilateral superior temporal gyrus, left parahippocampal gyrus and right lateral orbitofrontal gyrus; and decreased fractal dimension in the right lateral occipital gyrus. A significant sex-by-group interaction effect was found in the fractal dimension of the left lateral occipital gyrus. The volume of the left thalamus and the thickness of the left superior temporal gyrus were correlated with the duration of disease in adolescent MDD patients.

CONCLUSIONS

This study suggested that adolescent MDD had GM morphological abnormalities in the frontal-limbic, subcortical, perceptual network and midbrain regions, with some morphological abnormalities associated with disease duration and sex differences. These findings provide new insight into the neuroanatomical substrates underlying adolescent MDD.

Machine learning-driven risk prediction and feature identification for major depressive disorder and its progression: an exploratory study based on five years of longitudinal data from the US national health survey

BACKGROUND

Major depressive disorder (MDD) presents significant public health challenges due to its increasing prevalence and complex risk factors. This study systematically analyzed data from 2019 to 2023 to explore trends in MDD incidence, symptom progression, and multidimensional influencing factors.

OBJECTIVE

The study aimed to identify key risk factors and mechanisms of MDD progression through multidimensional variable analysis and machine learning model evaluation, optimizing predictive models to provide a scientific basis for early screening, targeted interventions, and public health policy formulation.

METHODS

Data from the U.S. National Health Interview Survey (NHIS) were analyzed using LASSO regression for feature selection and various machine learning models (e.g., AdaBoost, Gradient Boosting, Gaussian NB, Extra Trees) for risk prediction. SHAP value analysis was employed to interpret the models and identify key predictors across psychological, social, and biological domains.

RESULTS

Depression risk was closely associated with psychological health (e.g., PHQ82, ANXLEVEL), social support (e.g., DISCRIM1, PCNTADLT), and biological health (e.g., COGMEMDFF, DEPEV). AdaBoost, Gradient Boosting, Gaussian NB, and Extra Trees demonstrated superior performance in different tasks, with SHAP analysis highlighting the critical role of psychological health in risk prediction and the importance of social support and cognitive deficits in symptom progression.

CONCLUSIONS

This study provides a scientific foundation for early screening of MDD, personalized intervention strategies, and public health policy optimization. Future research should expand data coverage, optimize models, and incorporate causal inference methods to enhance the precision and applicability of depression risk prediction.

Depressive disorders attributable to childhood sexual abuse and bullying victimization: Temporal trends and socio-demographic inequalities

BACKGROUND

Childhood sexual abuse and bullying victimization are critical risk factors for depressive disorders, contributing significantly to the global health burden. This study evaluates the global, regional, and national burden of depressive disorders attributable to these factors from 1990 to 2021, focusing on trends, age and sex disparities, and socio-demographic inequalities.

METHODS

Using Global Burden of Disease 2021 data from 204 countries, we measured the burden in disability-adjusted life years (DALYs) with 95 % uncertainty intervals (UI). Temporal trends were assessed via estimated annual percentage change (EAPC), with COVID-19-related changes represented by percentage change. Socio-demographic influences were examined using the Socio-demographic Index and inequality indices. Future trends were forecasted using Bayesian models.

RESULTS

The global age-standardized DALYs rate (ASDR) for depressive disorders attributable to childhood sexual abuse was 18.08 (95 % UI: 8.75-30.97) per 100,000 population, while bullying victimization accounted for 44.32 (95 % UI: 18.72-83.89). From 1990 to 2021, the burden linked to childhood sexual abuse decreased, whereas bullying victimization steadily increased. Females experienced a higher burden from childhood sexual abuse, while bullying-related depressive disorders peaked in males aged 15-24. In 2021, depressive disorders attributable to childhood sexual abuse displayed negative slope index of inequality values (-14.42, 95 % confidence intervals: -19.04 to -9.80). By 2035, ASDRs for both factors are projected to increase by 37-50 %.

CONCLUSIONS

This study highlights the substantial burden of depressive disorders due to childhood trauma, emphasizing the need for tailored interventions, equitable mental health care, and global collaboration to address these challenges.

Transcriptional Patterns of Nodal Entropy Abnormalities in Major Depressive Disorder Patients with and without Suicidal Ideation

Previous studies have indicated that major depressive disorder (MDD) patients with suicidal ideation (SI) present abnormal functional connectivity (FC) and network organization in node-centric brain networks, ignoring the interactions among FCs. Whether the abnormalities of edge interactions affect the emergence of SI and are related to the gene expression remains largely unknown. In this study, resting-state functional magnetic resonance imaging (fMRI) data were collected from 90 first-episode, drug-naive MDD with suicidal ideation (MDDSI) patients, 60 first-episode, drug-naive MDD without suicidal ideation (MDDNSI) patients, and 98 healthy controls (HCs). We applied the methodology of edge-centric network analysis to construct the functional brain networks and calculate the nodal entropy. Furthermore, we examined the relationships between nodal entropy alterations and gene expression. The MDDSI group exhibited significantly lower subnetwork entropy in the dorsal attention network (DAN) and significantly greater subnetwork entropy in the default mode network than the MDDNSI group. The visual learning score of the measurement and treatment research to improve cognition in schizophrenia (MATRICS) consensus cognitive battery was negatively correlated with the subnetwork entropy of DAN in the MDDSI group. The support vector machine model based on nodal entropy achieved an accuracy of 81.87% when distinguishing the MDDNSI and MDDSI. Additionally, the changes in SI-related nodal entropy were associated with the expression of genes in cell signaling and interactions, as well as immune and inflammatory responses. These findings reveal the abnormalities in nodal entropy between the MDDSI and MDDNSI groups, demonstrated their association with molecular functions, and provided novel insights into the neurobiological underpinnings and potential markers for the prediction and prevention of suicide.

Sex-Specific Association Between Polymorphisms in Estrogen Receptor Alpha Gene (ESR1) and Depression: A Genome-Wide Association Study of All of Us and UK Biobank Data

Major depressive disorder (MDD) is prevalent worldwide, substantially and negatively impacting both the quality and length of life of 280 million people globally. The genetic risk factors of MDD have been studied in various previous research, but the findings lack consistency. Sex/gender and racial/ethnic disparities have been reported; however, many previous genetic studies, represented by large-scale genome-wide association studies (GWASs) are known to lack diversity in the study cohorts. All of Us is a biorepository aiming to focus on the historically underrepresented groups. We perform GWASs for the MDD phenotype, using over 200,000 participants' genotypes and carry out sex- and racial/ethnic-specific subgroup studies. We identified a risk locus (chr6:151945242) in Estrogen Receptor Alpha Gene (ESR1) (p = 1.70 × 10 - 9 $1.70\times {10}^{-9}$ ), and further confirmed the genetic association is sex-specific. The single-nucleotide polymorphism (SNP) chr6:151945242 was significant only in the male group, but not in the female group. These findings were replicated in the UK Biobank and echo with existing studies on the ESR1 gene and depressive disorders. Our results indicate that the All of Us program is a reliable resource for GWAS, as well as shedding light on further investigation of sex- and racial/ethnic-specific genome association, especially in underrepresented groups of the US population.

DNA methylation of core clock genes in patients with major depressive disorder: Association with air pollution exposure and disease severity

BACKGROUND

Major Depressive Disorder (MDD) is a multifactorial disease which could be influenced by exposure to air pollution through disruption of sleep-wake cycles and other circadian-related behaviors. Our study aimed to investigate the interplay between air pollution exposure, DNA methylation of core clock genes involved in circadian rhythms, and MDD severity.

METHODS

Four hundred sixteen MDD patients (64 % females) agreed to participate and donated a blood sample to measure DNA methylation of the core clock genes CRY1, PER1, PER2, CLOCK, BMAL1. MDD severity and functioning was assessed using five rating scales. Daily mean estimates of particulate matter with diameter ≤ 2.5 μm (PM2.5) and nitrogen dioxide (NO2) were assigned to study participants based on their residential address, and averaged to estimate different cumulative exposure windows. Multivariate regression models were applied to assess associations between air pollutants and core clock genes methylation and between DNA methylation of those same genes and MDD severity.

RESULTS

PM2.5 exposure in the six months preceding recruitment was associated with CLOCK hypomethylation (β=-0.11, 95 % confidence interval [CI]:0.20; -0.02) and CRY1 hypermethylation (β=0.32, 95 %CI: 0.06; 0.58). All NO2 exposure windows were associated with CRY1 hypermethylation. Increasing methylation of CLOCK was associated with lower MDD severity considering several scales (e.g., Hamilton Depression Rating Scale: β=-7.21, 95 %CI:3.97; -0.44).

CONCLUSIONS

Taken together our findings shed some light on the complex mechanism underlying the pathogenesis of MDD, with a potentially relevant role of the environment and of its impact on epigenetic mechanisms altering the expression of core clock genes.

The characteristics of anhedonia in depression: a review from a clinically oriented perspective

Anhedonia, as one of the core symptoms of major depressive disorder (MDD), has been regarded as a potential endophenotype of the disease. Multiple studies have evaluated the potential mechanisms of anhedonia in MDD, and found that MDD patients with anhedonia showed different functions in clinical features. In this review, we focus on the clinical research to explore the differences between MDD patients with and without anhedonia in the clinical manifestations and biological alterations, and elaborate the treatments and prognosis of anhedonia. It is demonstrated that anhedonia is associated with adverse outcomes including more severe depressive episode and suicidality, and poor prognosis in patients with MDD. At the biological level, MDD patients with anhedonia seem to present higher levels of inflammatory factors, abnormal metabolic function and hypermetabolism of BDNF. In brain imaging studies, there are some structural and/ or functional changes in multiple brain regions of subcortical and cortical areas, as well as the limbic system in MDD patients with anhedonia. Meanwhile, preliminary research findings have also indicated that there are associations between intestinal flora imbalance and anhedonia. Moreover, evidence indicated the benefit of some selective serotonin reuptake inhibitors seemed limited on anhedonia, and other treatments including psychotherapy, physical therapy and probiotic interventions has remained to be explored but has interesting potential. Therefore, increased awareness of the anhedonic symptoms and the unique clinical features would benefit improved early diagnosis and therapeutic effects in MDD.

The effects of exercise interventions on depressive symptoms in stroke patients: a systematic review and meta-analysis

Purpose

This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on depressive symptoms in stroke patients.

Methods

Following PRISMA guidelines, We conducted searches in PubMed, Embase, CENTRAL, and Web of Science. The topic was the effect of exercise on depression levels in stroke patients. Patient's performance on depression scales after exercise was assessed using standardized mean difference (SMD) and 95% confidence intervals (95% CI). A random effects model (RE) was used to conduct a meta-analysis and compare the results between subgroups conducted based on adherence to ACSM guidelines and the length of exercise interventions.

Results

The analysis included 24 randomized controlled trials (RCTs) involving 1,757 participants. The meta-analysis revealed that exercise interventions had a significant positive effect on reducing depressive symptoms in stroke patients, with a standardized mean difference (SMD) of -0.43 (95% CI: 0.65, -0.21). Subgroup analysis indicated that high compliance with ACSM guidelines resulted in a more substantial reduction in depressive symptoms (SMD = -0.79, 95% CI: 1.10, -0.49), compared with low or uncertain compliance (SMD = -0.03, 95% CI: 0.16, 0.10). Longer exercise intervention was associated with greater mitigation of depressive symptoms. The differences between intervention groups of different lengths were statistically significant (p < 0.05).

Conclusion

These findings support the integration of tailored exercise programs into post-stroke care to optimize mental health outcomes. Compliance to ACSM-recommended exercise dosages significantly ameliorate depression levels in stroke patients. Further research is warranted to explore standardized exercise regimens in larger, multicenter trials.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#recordDetails, identifier PROSPERO(CRD42024579095).

Can dextromethorphan-bupropion reduce mental pain in depressed individuals? A generating hypothesis overview perspective

Globally, major depressive disorder, or MDD, is a leading cause of disability. It negatively impacts social interactions and significantly limits daily functioning, ultimately reducing life satisfaction. The prevalence rate is about twice as high in women as in males. It is believed that the genesis of major depressive disorder is complicated and includes biological, genetic, environmental, and psychological factors. Mental pain, although distinguishable, constitutes a crucial framework in major depressive disorder (MDD) as the pair may precipitate suicide risk. Mental pain, as conceptualized in Panksepp's emotional theory, is especially relevant when considering the key role of the opioid system, which can influence feelings tied to grief and separation. There has been a renewed interest in targeting the opioid system for antidepressant treatment in MDD and to soothe mental pain. Antidepressant drugs endowed with partial mu-opioid receptor (MOR) agonism and kappa-opioid receptor (KOR) antagonism might represent novel pharmacological tools to address unmet needs in MDD patients. The combination of dextromethorphan and bupropion is a well-tolerated, rapid-acting treatment option for adults affected by MDD. We hypothesized that dextromethorphan-bupropion could impact the reduction of mental pain in MDD patients by targeting the opioid system, as supported by Panksepp's theory. The combination of dextromethorphan with bupropion might deal with various aspects of mental pain, possibly improving treatment results.

Navigating the intersection of mental health and kidney health: a systematic review of antidepressant safety in renal impairment

Depression is a prevalent mental health condition that significantly impacts adults with impaired renal function, yet the safety and efficacy of antidepressants in this population remain inadequately explored. Understanding how renal impairment affects antidepressant pharmacokinetics and clinical outcomes is essential for optimizing treatment strategies. This systematic review adhered to PRISMA 2020 guidelines, conducting a comprehensive literature search across multiple databases, including PubMed, ScienceDirect, ClinicalTrial.gov, and Medline. Studies were included if they evaluated the use of antidepressants in adults with renal impairment, assessing both safety and efficacy outcomes. The review identified 11 studies that met the inclusion criteria, with sample sizes ranging from 30 to 101,409 participants, yielding a total sample size of 192,684. The quality assessment of the included studies was conducted based on the type of study design, focusing on methodological rigor and relevance to the research question. While certain antidepressants demonstrate efficacy, their pharmacokinetic profiles necessitate careful monitoring and dose adjustments in patients with different levels of renal impairment. These insights underscore the need for individualized treatment approaches and highlight areas for future research to enhance care for this vulnerable population.

Increased individual variability in functional connectivity of the default mode network and its genetic correlates in major depressive disorder

Major depressive disorder (MDD) is a highly heterogeneous psychiatric disorder characterized with considerable individual variability in clinical manifestations which may correspond to brain alterations including the default mode network (DMN). This study analyzed resting-state functional magnetic resonance imaging (rs-fMRI) data from 796 MDD patients and 823 healthy controls (HC) to investigate individual variability in functional connectivity (IVFC) between the DMN and 108 non-DMN regions. We aimed to identify MDD-related IVFC abnormalities and their clinical relevance, alongside exploring gene expression correlations. The results revealed similar spatial patterns of IVFC within the DMN in both groups, yet significantly increased IVFC values in MDD patients were observed in regions such as the ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex, fusiform gyrus, and occipital cortex. Notably, the mean IVFC in the DMN and fusiform gyrus was positively correlated with Hamilton Rating Scale for Depression (HAMD) scores in MDD patients. Gene expression analyses explained 47.0% of the variance in MDD-related IVFC alterations, with the most associated genes enriched in processes including membrane potential regulation, head development, synaptic transmission, and dopaminergic synapse. These findings highlight the clinical importance of IVFC variability in the DMN and suggest its potential role as a biomarker in MDD.

Astrocytic pleiotrophin deficiency in the prefrontal cortex contributes to stress-induced depressive-like responses in male mice

Astrocytes are closely linked to depression, and the prefrontal cortex (PFC) is an important brain region involved in major depressive disorder (MDD). However, the underlying mechanism by which astrocytes within PFC contribute to MDD remains unclear. Using single-nucleus RNA sequencing analyses, we show a significant reduction in astrocytes and attenuated pleiotrophin-protein tyrosine phosphatase receptor type Z1 (PTN-PTPRZ1) signaling in astrocyte-to-excitatory neuron communication in the PFC of male MDD patients. We find reduced astrocytes and PTN in the dorsomedial PFC of male mice with depression induced by chronic restraint and social defeat stress. Knockdown of astrocytic PTN induces depression-related responses, which is reversed by exogenous PTN supplementation or overexpression of astrocytic PTN. The antidepressant effects exerted by astrocytic PTN require interaction with PTPRZ1 in excitatory neurons, and PTN-PTPRZ1 activates the AKT signaling pathway to regulate depression-related responses. Our findings indicate the PTN-PTPRZ1-AKT pathway may be a potential therapeutic target for MDD.

Role of FPR2 antagonism in alleviating social isolation-induced depression and protecting blood-brain barrier integrity

Social isolation (SI) is a prevalent issue in modern society, particularly exacerbated during the COVID-19 pandemic, and it is a significant contributor to depressive disorders. Inflammation-related markers are upregulated in patients with major depressive disorder (MDD) unresponsive to first-line selective serotonin reuptake inhibitor (SSRI) antidepressants. This study investigates the role of formyl peptide receptor 2 (FPR2), a G-protein coupled receptor expressed in central and peripheral immune cells, in SI-induced depression. We developed a mouse model of SI by housing mice individually for three weeks. SI mice exhibited increased capillary-associated microglia (CAMs) with upregulated FPR2 expression in the prefrontal cortex (PFC) and hippocampus compared to group-housed controls. Notably, subcutaneous administration of the FPR2 antagonist WRW4 alleviated depressive and anxiety-like behaviors in SI mice, reducing microglial activation and neuronal damage. WRW4 treatment decreased CAM numbers and their FPR2 expression. RNA sequencing revealed that SI primarily induced changes in genes associated with blood-brain barrier (BBB) function, followed by alterations in genes related to hormone activity, immune activation, and neuronal function. Transcriptomic changes in brain endothelial cells from SI mice resembled those observed in animal models of several neurological disorders and in MDD patients. WRW4 treatment partially reversed these transcriptomic alterations and restored compromised BBB integrity. Additionally, intracerebroventricular (ICV) injection of WRW4 also alleviated depressive and anxiety-like behaviors in SI mice. Finally, our analysis of public transcriptome databases indicates FPR2 upregulation in the orbital ventral PFC of MDD patients and peripheral blood mononuclear cells of those in severe depressive episodes. These findings suggest that the pharmacological targeting of FPR2 may rescue SI-induced pathology in mice by protecting BBB integrity.

The Insulin-like Growth Factor Family as a Potential Peripheral Biomarker in Psychiatric Disorders: A Systematic Review

Psychiatric disorders (PDs), including schizophrenia (SZ), major depressive disorder (MDD), bipolar disorder (BD), autism spectrum disorder (ASD), among other disorders, represent a significant global health burden. Despite advancements in understanding their biological mechanisms, there is still no reliable objective and reliable biomarker; therefore, diagnosis remains largely reliant on subjective clinical assessments. Peripheral biomarkers in plasma or serum are interesting due to their accessibility, low cost, and potential to reflect central nervous system processes. Among these, the insulin-like growth factor (IGF) family, IGF-1, IGF-2, and IGF-binding proteins (IGFBPs), has gained attention for its roles in neuroplasticity, cognition, and neuroprotection, as well as for their capability to cross the blood-brain barrier. This review evaluates the evidence for IGF family alterations in PDs, with special focus on SZ, MDD, and BD, while also addressing other PDs covering almost 40 years of history. In SZ patients, IGF-1 alterations have been linked to metabolic dysregulation, treatment response, and hypothalamic-pituitary-adrenal axis dysfunction. In MDD patients, IGF-1 appears to compensate for impaired neurogenesis, although findings are inconsistent. Emerging studies on IGF-2 and IGFBPs suggest potential roles across PDs. While promising, heterogeneity among studies and methodological limitations highlights the need for further research to validate IGFs as reliable psychiatric biomarkers.

Major depressive disorder on a neuromorphic continuum

The heterogeneity of major depressive disorder (MDD) has hindered clinical translation and neuromarker identification. Biotyping facilitates solving the problems of heterogeneity, by dissecting MDD patients into discrete subgroups. However, interindividual variations suggest that depression may be conceptualized as a "continuum," rather than as a "category." We use a Bayesian model to decompose structural MRI features of MDD patients from a multisite cross-sectional cohort into three latent disease factors (spatial pattern) and continuum factor compositions (individual expression). The disease factors are associated with distinct neurotransmitter receptors/transporters obtained from open PET sources. Increases cortical thickness in sensory and decreases in orbitofrontal cortices (Factor 1) associate with norepinephrine and 5-HT2A density, decreases in the cingulo-opercular network and subcortex (Factor 2) associate with norepinephrine and 5-HTT density, and increases in social and affective brain systems (Factor 3) relate to 5-HTT density. Disease factor patterns can also be used to predict depressive symptom improvement in patients from the longitudinal cohort. Moreover, individual factor expressions in MDD are stable over time in a longitudinal cohort, with differentially expressed disease controls from a transdiagnostic cohort. Collectively, our data-driven disease factors reveal that patients with MDD organize along continuous dimensions that affect distinct sets of regions.

Ginsenoside Rg1 alleviates chronic stress-induced depression in rats by targeting Cx43-YAP axis

Although significant progress has been made in the development of antidepressants, a large subpopulation of individuals remains unresponsive to existing treatments. Ginsenoside Rg1 (Rg1), a natural compound with well-defined antidepressant effects and low-cost administrations, holds therapeutic promise but requires mechanistic elucidation for clinical translation. Based on our previous finding that Rg1 rescued astrocytic connexin43 (Cx43) downregulation in depression models, we investigated its brain-wide effects and molecular mechanisms in chronic unpredictable stress (CUS)-induced rats. Male rats subjected to CUS received Rg1 (40 mg· kg-1 ·d-1, i.g.) for 8 weeks. Multimodal neuroimaging (fMRI and PET/CT) revealed that Rg1 restored functional connectivity and ameliorated neuroinflammation in CUS rats, with the prelimbic area identified as a critical target region. Through integrated proteomic profiling, molecular docking, and surface plasmon resonance analyses, we pinpointed Cx43-mediated gap junction as the primary target underlying Rg1's therapeutic action. Mechanistically, we showed that Yes-associated protein (YAP), the primary effector of the Hippo pathway, was translocated into the nucleus to promote the expression of specific genes including those involved in inflammation. Notably, we demonstrated that Rg1 potentiated the Cx43-YAP interaction in the cytoplasm and restricted YAP nuclear translocation activity. The degradation of Cx43 and potentiation of YAP nuclear translocation might represent a novel mechanism for the pathogenesis of depression. Specific blockade of Cx43-based gap junctions, knockdown of Cx43 expression in primary cultured astrocytes, and conditional knockout of astrocytic Cx43 in mice promoted YAP nuclear translocation and retarded the antidepressant effects of Rg1. Accordingly, the Cx43-YAP connection may represent a potential therapeutic target for the antidepressant mechanism of Rg1.

Agomelatine as adjunctive therapy with SSRIs or SNRIs for major depressive disorder: a multicentre, double-blind, randomized, placebo-controlled trial

BACKGROUND

In general, traditional antidepressants often have limited efficacy in patients with major depressive disorder (MDD). Agomelatine, as an antidepressant with a different mechanism of action, might have adjunctive effects on traditional antidepressants. This study aimed to investigate the augmentation effect of agomelatine versus placebo in treating MDD patients who failed to respond to selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs).

METHODS

This is an 8-week, multi-centred, double-blinded, randomized, and placebo-controlled trial. Participants diagnosed with MDD and demonstrated inadequate response to SSRI or SNRI lasting at least 2 weeks were randomly allocated to receive either agomelatine or placebo in conjunction with SSRIs or SNRIs. The 17 items of the Hamilton Depression Scale (HAMD-17) were employed to assess depression severity. The primary outcome is the total score of HAMD-17 at week 8. Secondary outcomes included HAMD-17 scores at weeks 2 and 4 and clinical remission and response over 8 weeks. Adverse events (AEs) reported in both groups were recorded. A linear mixed model was established for both primary and secondary outcomes.

RESULTS

A total of 123 eligible participants were included, among which 60 were randomized into the agomelatine group, and 63 were randomized into the placebo group. The between-group difference in HAMD-17 score reduction from baseline to week 8 was not significant (difference = - 0.12, 95% CI = - 3.94 to 3.70, P = 0.90; Cohen's d = 0.022). In addition, we did not observe significant differences between the two treatment groups for secondary outcomes, including response remission, and AEs.

CONCLUSIONS

This study did not obtain significant findings in favour of the augmentation effect of agomelation for MDD patients. However, agomelatine was generally well tolerated and demonstrated a favourable safety profile when used in combination with SSRIs and SNRIs.

TRIAL REGISTRATION

This trial is registered at ClinicalTrials.gov ( https://clinicaltrials.gov ), the registration number is NCT04589143.

Comorbidity of attention deficit hyperactivity disorder in young adults who had major depressive disorder

BACKGROUND

The comorbidity of Major Depressive Disorder (MDD) and Attention Deficit Hyperactivity Disorder (ADHD) in adults is well recognized. The role of ADHD in the etiology of MDD, as well as the overlap of genetic and environmental factors between these two disorders, is an area of research. ADHD symptoms are considered risk factors for MDD.

OBJECTIVES

The study aimed to examine the relationship between MDD in young adults with history of ADHD.

DESIGN

Retrospective and observational study.

SETTINGS

Outpatient clinic of a tertiary hospital.

PATIENTS AND METHODS

Data of young adults diagnosed with MDD, aged 18-25 years and seen between January 2017 and May 2023, were included. Individuals with comorbidities other than ADHD in adulthood were excluded from the study. The sociodemographic and clinical data of a total of 489 cases, as well as data on childhood psychiatric referrals, diagnoses, and treatment histories, were retrospectively examined.

MAIN OUTCOME MEASURES

ADHD diagnosis history and clinical impact in adults diagnosed with MDD.

SAMPLE SIZE

489.

RESULTS

A total of 489 cases (68.9% female) with a mean age of 21.14 years were included in the study. It was determined that 8% of the cases had ADHD in adulthood, 13.3% in childhood, and 31.9% had at least one mental health diagnosis during childhood. The rate of ADHD diagnosis was significantly higher in males than females in both adulthood and childhood. Additionally, the age of diagnosis of MDD was lower in individuals with ADHD diagnosis and/or those who have discontinued ADHD treatment.

CONCLUSIONS

In young adults diagnosed with MDD, the comorbidity of ADHD should also be considered. It is important to acknowledge that ADHD is not just a childhood disorder but a lifelong disorder due to its negative consequences, and to develop appropriate strategies in this regard.

LIMITATİONS

Retrospective observational design and the single-center setting, which may affect the generalizability of the findings.

Biological mechanism and functional verification of key genes related to major depressive disorder and type 2 diabetes mellitus

Major depressive disorder (MDD) and type 2 diabetes (T2D) have been shown to be linked, but a comprehensive understanding of the underlying molecular mechanisms remains elusive. The purpose of this study was to explore the biological relationship between MDD and T2D and verify the functional roles of key genes. We used the Gene Expression Omnibus database to investigate the targets associated with MDD and T2D. Using linear models for microarray data, differentially expressed genes associated with MDD and T2D were identified in GSE76826 and GSE95849, respectively, and 126 shared genes were significantly upregulated. Weighted gene coexpression network analysis identified modules associated with MDD and T2D in the GSE38206 and GSE20966 datasets and identified 8 common genes. Functional enrichment analysis revealed that these genes were enriched in cell signaling, enzyme activity, cell structure and amino acid biosynthesis and involved in cell death pathways. Finally, combined with the CTD and GeneCards databases, lysophosphatidylglycerol acyltransferase 1 (LPGAT1) was identified as a key gene. LPGAT1 was validated in GSE201332 and GSE182117, and the subject operating characteristic curve showed good diagnostic potential for MDD and T2D. Additionally, we used an in vitro model of MDD related to T2D to verify the expression of LPGAT1. A subsequent gene knockdown assay revealed that the downregulation of LPGAT1 improved mitochondrial function and reduced apoptosis in damaged neurons. Taken together, our results highlight the role of LPGAT1 in the connection between MDD and T2D, and these findings provide new insights into potential therapeutic targets for depression associated with diabetes.

Esketamine-mediated alleviation of electroconvulsive shock-induced memory impairment is associated with the regulation of mGluR5 in depressive-like rats

Electroconvulsive therapy (ECT) is recognized as one of the most efficacious interventions for depression. However, it is associated with impairments in learning and memory functions. Ketamine has demonstrated potential in mitigating cognitive deficits. Notably, the metabotropic glutamate system is hypothesized to play a pivotal role in cognitive process regulation. Nevertheless, the involvement of the metabotropic glutamate system in esketamine-mediated alleviation of electroconvulsive shock (ECS, an animal analogue of ECT)-induced memory impairment remains to be elucidated. In this study, a depressive rat model was established using chronic unpredictable mild stress. The depressive-like behavior and cognitive performance of the rats were evaluated using the sucrose preference test, the open field test, and the Morris water maze test, respectively. The expression levels of type-5 metabotropic glutamate receptor (mGluR5) and N-methyl-d-aspartate receptor 1 (NMDAR1) were quantified through immunofluorescence and real-time PCR techniques. Long-term potentiation (LTP) of hippocampal Schaffer collateral (SC)-CA1 synapses was observed in electrophysiological experiments. The results of this investigation revealed that a low dose of esketamine administration upregulated the expression of mGluR5 and NMDAR1 in the hippocampus of stressed rats, alleviated ECS-induced cognitive impairment, and ameliorated depressive-like behavior. Conversely, the mGluR5 antagonist MTEP effectively reversed esketamine-mediated changes in the rat hippocampus and counteracted its protective effect on learning and memory functions following ECS. In conclusion, the findings of this study support the hypothesis that esketamine upregulates mGluR5 and NMDAR1 expression, thereby enhancing NMDAR activation in the hippocampus. This mechanism may be responsible for the protective effects on spatial learning and memory function observed in depressed rats subjected to ECS.

Using multiomic integration to improve blood biomarkers of major depressive disorder: a case-control study

BACKGROUND

Major depressive disorder (MDD) is a leading cause of disability, with a twofold increase in prevalence in women compared to men. Over the last few years, identifying molecular biomarkers of MDD has proven challenging, reflecting interactions among multiple environmental and genetic factors. Recently, epigenetic processes have been proposed as mediators of such interactions, with the potential for biomarker development.

METHODS

We characterised gene expression and two mechanisms of epigenomic regulation, DNA methylation (DNAm) and microRNAs (miRNAs), in blood samples from a cohort of individuals with MDD and healthy controls (n = 169). Case-control comparisons were conducted for each omic layer. We also defined gene coexpression networks, followed by step-by-step annotations across omic layers. Third, we implemented an advanced multiomic integration strategy, with covariate correction and feature selection embedded in a cross-validation procedure. Performance of MDD prediction was systematically compared across 6 methods for dimensionality reduction, and for every combination of 1, 2 or 3 types of molecular data. Feature stability was further assessed by bootstrapping.

FINDINGS

Results showed that molecular and coexpression changes associated with MDD were highly sex-specific and that the performance of MDD prediction was greater when the female and male cohorts were analysed separately, rather than combined. Importantly, they also demonstrated that performance progressively increased with the number of molecular datasets considered.

INTERPRETATION

Informational gain from multiomic integration had already been documented in other medical fields. Our results pave the way toward similar advances in molecular psychiatry, and have practical implications for developing clinically useful MDD biomarkers.

FUNDING

This work was supported by the Centre National de la Recherche Scientifique (contract UPR3212), the University of Strasbourg, the Université Sorbonne Paris Nord, the Université Paris Cité, the Fondation de France (FdF N° Engt:00081244 and 00148126; ECI, IY, RB, PEL), the French National Research Agency (ANR-18-CE37-0002, BE, CMC, ADD, PEL, ECI; ANR-18-CE17-0009, ADD; ANR-19-CE37-0010, PEL; ANR-21-RHUS-009, ADD, BE, CMC, CCB; ANR-22-PESN-0013, ADD), the Fondation pour la Recherche sur le Cerveau (FRC 2019, PEL), Fondation de France (2018, BE, CMC, ADD) and American Foundation for Suicide Prevention (AFSP YIG-1-102-19; PEL).

Does multimodal exercise reduce C-reactive protein levels in major depressive disorder? Preliminary results from a randomized controlled trial

This randomized controlled trial aimed to evaluate the adjunctive effects of an affect-based, supervised, multimodal, online, and home-based exercise intervention on C-reactive protein (CRP) levels and depressive symptoms by comparing it to pharmacotherapy alone (antidepressants) over a 12-week period. The study specifically focused on CRP levels and their association with depression outcomes. Depressive symptoms and blood samples were assessed before (baseline - t0), during (Week 5 - t1), and at end of treatment (Week 12 - t2). The exercise intervention was designed to optimize positive affect during and after exercise, and considered each participant's preferred exercise intensity to enhance perceived effort, pleasure, and enjoyment. The study enrolled 59 adults and randomly allocated them into two groups: exercise group (EG; n = 26,76.9% females, mean age 28.5 years) and control group (CG, n = 33, 78.7% females, mean age 25.9 years). CRP levels reduced in the EG at t2 compared with t0 [p = .019; d = .64 (CI 95% -.04,1.24)], while the CRP did not change during treatment in the CG [p = .116; d = -.35 (CI 95% -.93,.16)]. At t2, EG showed clinically meaningful reductions in CRP compared to CG: [p = .043; d = .50 (CI 95% .14,1.30)]. For EG, the anti-inflammatory response predicted reductions in self-reported depressive symptoms (t = 2.066, β = .438, p = .030). Given the significant role inflammation plays in modulating depression symptoms, our findings indicate that structured multimodal exercise programs, which can be delivered online, are effective in the management of depression and potentially have anti-inflammatory. TRIAL REGISTRATION NUMBER: Brazilian Registry of Clinical Trials (ReBEC: RBR-4pgd3ct); Date of registration: 10/19/2023.

Distinguished multimodal imaging features affected by COVID-19 in major depressive disorder patients

OBJECTIVES

Growing attention has been directed toward the structural and functional alterations among individuals infected with COVID-19. However, data on its impact on patients with Major Depressive Disorder (MDD) remain limited.

METHODS

This study investigates the effects of COVID-19 on patients with MDD and healthy controls (HCs) using MRI scans. Participants were categorized into four groups: MDD patients before (n = 165) and after COVID-19 infection (n = 70), HCs before (n = 108) and after COVID-19 infection (n = 57). All participants underwent T1-weighted imaging, diffusion tensor imaging (DTI), and resting-state functional MRI from January 2022 to August 2023.

RESULTS

Structural alterations associated with COVID-19 were predominantly observed in the white matter (WM) rather than the gray matter (GM), with specific involvement noted in the superior longitudinal fasciculus tract, Forceps minor tract, and cingulum-cingulate gyrus tract among patients with MDD. Functional changes were spread from GM to WM. The bilateral supplementary motor area, the left angular gyrus, the left subcortical regions (amygdala and parahippocampal gyrus), and various WM tracts showed significant infection-related changes across groups.

CONCLUSION

COVID-19 infection induces significant microstructural damage of WM in healthy individuals and exacerbates white matter microstructural injury of MDD. These findings suggest that WM might be more susceptible to COVID-19 effects than GM in both MDD patients and HCs.

Effects of prenatal cannabinoid use on the monoamine system in the fetoplacental unit: A systematic review of animal and human studies

BACKGROUND

The rapid increase in cannabis use during pregnancy-up by 170 % between 2009 and 2016-raises pressing concerns about its effects on fetal health, particularly on the delicate monoamine system within the fetoplacental unit, which is crucial for placental function and neurodevelopment.

OBJECTIVE

This systematic review explores the impact of prenatal cannabinoid exposure on the monoamine system within the fetoplacental unit, with a focus on its implications for fetal development through the lens of the Developmental Origins of Health and Disease (DOHaD) framework.

METHODS

A comprehensive search across multiple databases initially retrieved 18,252 papers. After rigorous screening, only 16 animal studies and 4 human studies met the inclusion criteria. Findings were synthesized to evaluate the effects of prenatal cannabis exposure on neurotransmitter regulation, receptor function, and gene expression.

RESULTS

Although no studies directly addressed the monoamine system in the placenta, animal models revealed significant disruptions in neurotransmitter regulation and neurodevelopmental changes following prenatal cannabis exposure. Human studies suggested potential cognitive and behavioral risks for offspring exposed in utero.

CONCLUSION

This review exposes a critical gap in the literature on cannabis' effects on the placental monoamine system. While evidence points to notable neurodevelopmental risks, the scarcity of focused research underscores the need for further investigation to fully understand the implications of prenatal cannabis exposure.

Nutritional Strategies in Major Depression Disorder: From Ketogenic Diet to Modulation of the Microbiota-Gut-Brain Axis

Major depressive disorder (MDD) is a leading cause of disability worldwide. While traditional pharmacological treatments are effective for many cases, a significant proportion of patients do not achieve full remission or experience side effects. Nutritional interventions hold promise as an alternative or adjunctive approach, especially for treatment-resistant depression. This review examines the potential role of nutrition in managing MDD through addressing biological deficits and modulating pathways relevant to its pathophysiology. Specifically, it explores the ketogenic diet and gut microbiome modulation through various methods, including probiotics, prebiotics, synbiotics, postbiotics, and fecal microbiota transplantation. Numerous studies link dietary inadequacies to increased MDD risk and deficiencies in nutrients like omega-3 s, vitamins D and B, magnesium, and zinc. These deficiencies impact neurotransmitters, inflammation, and other biological factors in MDD. The gut-brain axis also regulates mood, stress response, and immunity, and disruptions are implicated in MDD. While medications aid acute symptoms, nutritional strategies may improve long-term outcomes by preventing relapse and promoting sustained remission. This comprehensive review aims to provide insights into nutrition's multifaceted relationship with MDD and its potential for developing more effective integrated treatment approaches.

Engrams across diseases: Different pathologies - unifying mechanisms?

Memories are our reservoir of knowledge and thus, are crucial for guiding decisions and defining our self. The physical correlate of a memory in the brain is termed an engram and since decades helps researchers to elucidate the intricate nature of our imprinted experiences and knowledge. Given the importance that memories have for our lives, their impairment can present a tremendous burden. In this review we aim to discuss engram malfunctioning across diseases, covering dementia-associated pathologies, epilepsy, chronic pain and psychiatric disorders. Current neuroscientific tools allow to witness the emergence and fate of engram cells and enable their manipulation. We further suggest that specific mechanisms of mnemonic malfunction can be derived from engram cell readouts. While depicting the way diseases act on the mnemonic component - specifically, on the cellular engram - we emphasize a differentiation between forms of amnesia and hypermnesia. Finally, we highlight commonalities and distinctions of engram impairments on the cellular level across diseases independent of their pathogenic origins and discuss prospective therapeutic measures.

Plasma proteomics identifies proteins and pathways associated with incident depression in 46,165 adults

Proteomic alterations preceding the onset of depression offer valuable insights into its development and potential interventions. Leveraging data from 46,165 UK Biobank participants and 2920 plasma proteins profiled at baseline, we conducted a longitudinal analysis with a median follow-up of 14.5 years to explore the relationship between plasma proteins and incident depression. Linear regression was then used to assess associations between depression-related proteins and brain structures, genetic factors, and stress-related events. Our analysis identified 157 proteins associated with incident depression (P <1.71 × 10-5), including novel associations with proteins such as GAST, PLAUR, LRRN1, BCAN, and ITGA11. Notably, higher expression levels of GDF15 (P = 6.18 × 10-26) and PLAUR (P = 2.88 × 10-14) were linked to an increased risk of depression, whereas higher levels of LRRN1 (P = 4.28 × 10-11) and ITGA11 (P = 3.68 × 10-9) were associated with a decreased risk. Dysregulation of the 157 proteins is correlated with brain regions implicated in depression, including the hippocampus and middle temporal gyrus. Additionally, these protein alterations were strongly correlated with stress-related events, including self-harm events, adult, and childhood trauma. Biological pathway enrichment analysis highlighted the critical roles of the immune response. EGFR and TNF emerged as key proteins in the protein-protein interaction network. BTN3A2, newly linked to incident depression (P = 4.35 × 10-10), was confirmed as a causal factor through Mendelian randomization analysis. In summary, our research identified the proteomic signatures associated with the onset of depression, highlighting its potential for early intervention and tailored therapeutic avenues.

Extracellular vesicles as drug and gene delivery vehicles in central nervous system diseases

Extracellular vesicles (EVs) are secreted by almost all cell types and contain DNA, RNA, proteins, lipids and other metabolites. EVs were initially believed to be cellular waste but now recognized for their role in cell-to-cell communication. Later, EVs from immune cells were discovered to function similarly to their parent cells, paving the way for their use as gene and drug carriers. EVs from different cell types or biological fluids carry distinct cargo depending on their origin, and they perform diverse functions. For instance, EVs derived from stem cells possess pluripotent properties, reflecting the cargo from their parent cells. Over the past two decades, substantial preclinical and clinical research has explored EVs-mediated drug and gene delivery to various organs, including the brain. Natural or intrinsic EVs may be effective for certain applications, but as drug or gene carriers, they demonstrate broader and more efficient potential across various diseases. Here, we review research on using EVs to treat central nervous system (CNS) diseases, such as Alzheimer's Disease, Parkinson diseases, depression, anxiety, dementia, and acute ischemic strokes. We first reviewed the naïve EVs, especially mesenchymal stem cell (MSC) derived EVs in CNS diseases and summarized the clinical trials of EVs in treating CNS diseases and highlighted the reports of two complete trials. Then, we overviewed the preclinical research of EVs as drug and gene delivery vehicles in CNS disease models, including the most recent two years' progress and discussed the mechanisms and new methods of engineered EVs for targeting CNS. Finally, we discussed challenges and future directions and of EVs as personalized medicine for CNS diseases.

Trans-ancestry Genome-Wide Analyses in UK Biobank Yield Novel Risk Loci for Major Depression

Most genome-wide association studies (GWASs) of depression focus on broad, heterogeneous outcomes, limiting the discovery of genomic risk loci specific to major depressive disorder (MDD). Previous UK Biobank (UKB) studies had limited ability to pinpoint MDD-associated loci due to a smaller sample with strictly defined MDD outcomes and further exclusion of many participants based on ancestry or relatedness, significantly underutilizing this resource's potential for elucidating the genetic architecture of MDD. Here, we present novel genomic insights into MDD by fully utilizing existing UKB data through (1) a trans-ancestry GWAS pipeline using two complementary approaches controlling for population structure and relatedness and (2) an increased sample with MDD symptom-level data across two mental health assessments. We identified strict MDD outcomes among 211,535 participants, representing a 38% increase in eligible participants from prior studies with only one assessment. Ancestrally inclusive analyses yielded 61 genomic risk loci across depression phenotypes, compared to 47 in the analyses restricted to participants genetically similar to European ancestry. Fourteen of these loci, including five novel, were associated with strict MDD phenotypes, whereas only one locus has been previously reported in UKB. MDD-associated genomic loci and predicted gene expression levels showed little overlap with broad depression, indicating higher specificity. Notably, polygenic scores based on these results were significantly associated with depression diagnoses across ancestry groups in the All of Us Research Program, highlighting the shared genetic architecture across populations. While the trans-ancestry analyses, which included non-European participants, increased the number of associated loci, the discovery of non-European ancestry-specific loci was limited, underscoring the need for larger, globally representative studies of MDD. Importantly, beyond these results, our GWAS pipeline will facilitate inclusive analyses of other traits and disorders, helping improve statistical power, representation, and generalizability in genomic studies.

Microwave-Assisted Synthesis of Morpholine-Based Chalcones as Reversible MAO-A Inhibitors in the Management of Mental Depression

Background: Depression is one of the most serious and common health problems among the youth population and is responsible for the initiation of many diseases. As per the World Health Organization, 3.8% of the population suffers from mental depression, globally. The monoamine oxidase-A (MAO-A) enzyme is responsible for the degradation of neurotransmitters leading to lower levels of neurotransmitters. Methods: Chalcones (C1-C15) were synthesized by reacting substituted acetophenone with various benzaldehydes in a basic ethanolic solvent at 80 °C under microwave irradiation conditions. To compare the reaction time and product yield, a conventional method of synthesis of chalcones was also performed. The synthesized chalcones (C1-C15) were spectroscopically characterized and screened initially for inhibitory activities against MAO-A and MAO-B. The best active compounds were undertaken for IC50 determination against MAO-A enzyme followed by the reversibility of inhibition analysis and the antioxidant assay. Moreover, in silico molecular docking and ADME pharmacokinetic investigations were accomplished. Results: Most of the compounds inhibited MAO-A, specifically, compounds C14 and C6 exhibited the highest inhibition at IC50 values of 7.91 ± 0.08 μM and 8.45 ± 0.19 μM, respectively. Both these compounds exhibited a reversible MAO-A inhibition displaying up to 60% recovery of enzymatic activity when diluted with substrate (Tyramine). The results of the in silico study indicated docking scores of -9.56 Kcal/mol (C14) and -9.45 Kcal/mol (C6) and exhibited a π-π stacking interaction with the crucial amino acid Trp-397. The compounds were determined to cross the blood-brain barrier (BBB) and displayed favorable gastrointestinal (GI) absorption. Further, the antioxidant assay results demonstrated that the synthesized compounds possess modest free radical scavenging potential. Conclusions: This study displayed the MAO-A inhibitory potential of morpholine-substituted chalcones as a promising pharmacophore for the development of novel antidepressant lead compounds.

Assessing Causality Between Androgenetic Alopecia with Depression: A Bidirectional Mendelian Randomization Study

Background

Androgenetic alopecia (AGA) is the most common form of alopecia globally, which exerts a negative impact on patients' self-esteem and overall quality of life. Previous observational studies have found a significant increase in the prevalence of depression in AGA patients, but the causal relationship remains to be elucidated.

Methods

In this study, we conducted a bidirectional Mendelian randomization (MR) using genome-wide association studies (GWAS) datasets. The available GWAS dataset of AGA was obtained from the Neale Lab consortium (n=154988). The dataset for depression was obtained from the ebi-a-GCST90038650 (n=484598). The main analysis method for determining the causal link between AGA and depression was inverse variance weighted (IVW). Subsequently, pleiotropy and heterogeneity tests were performed to determine the reliability of the results.

Results

Utilizing the IVW method, depression does not significantly contribute to the incidence of AGA (IVW odds ratio [OR] = 1.101, 95% confidence interval [CI] =0.890-1.362, P = 0.374). Conversely, the data suggested a statistically significant association where AGA may precipitate the development of depression, with a notable increase in risk (IVW OR = 1.015, 95% CI = 1.002-1.029, P = 0.020).

Conclusion

We are the first to use MR analysis to explore the causal relationship between AGA and depression, revealing an increased risk of depression in individuals with AGA.

Coding principles and mechanisms of serotonergic transmission modes

Serotonin-mediated intercellular communication has been implicated in myriad human behaviors and diseases, yet how serotonin communicates and how the communication is regulated remain unclear due to limitations of available monitoring tools. Here, we report a method multiplexing genetically encoded sensor-based imaging and fast-scan cyclic voltammetry, enabling simultaneous recordings of synaptic, perisynaptic, proximate and distal extrasynaptic serotonergic transmission. Employing this method alongside a genetically encoded sensor-based image analysis program (GESIAP), we discovered that heterogeneous firing patterns of serotonergic neurons create various transmission modes in the mouse raphe nucleus and amygdala, encoding information of firing pulse frequency, number, and synchrony using neurotransmitter quantity, releasing synapse count, and synaptic and/or volume transmission. During tonic and low-frequency phasic activities, serotonin is confined within synaptic clefts due to efficient retrieval by perisynaptic transporters, mediating synaptic transmission modes. Conversely, during high-frequency, especially synchronized phasic activities, or when transporter inhibition, serotonin may surpass transporter capacity, and escape synaptic clefts through 1‒3 outlet channels, leading to volume transmission modes. Our results elucidate a mechanism of how channeled synaptic enclosures, synaptic properties, and transporters collaborate to define the coding principles of activity pattern-dependent serotonergic transmission modes.

Activation of zona incerta gamma-aminobutyric acid-ergic neurons alleviates depression-like and anxiety-like behaviors induced by chronic restraint stress

BACKGROUND

Depression is a prevalent affective disorder, but its pathophysiology remains unclear. Dysfunction in the gamma-aminobutyric acid (GABA)-ergic system may contribute to its onset. Recently, antidepressants (e.g., brexanolone, zuranolone) targeting the GABA-A receptor were introduced. The zona incerta (ZI), an inhibitory subthalamic region mainly composed of GABAergic neurons, has been implicated in emotional regulation. Deep brain stimulation of the ZI in humans affects anxiety and depression symptoms, while activation of ZI neurons in mice can either worsen or alleviate anxiety. Currently, there is no direct evidence linking GABAergic neurons in the ZI to depression-like behaviors in rodents.

AIM

To explore the relationship between GABAergic neurons in the ZI and depression-like behaviors in mice.

METHODS

A chronic restraint stress (CRS) model was utilized to induce depression in mice. Whole-cell patch-clamp recordings assessed the excitability changes of GABAergic neurons in the ZI. Additionally, chemogenetic techniques were employed to modulate ZI GABAergic neurons. The performance of the mice in behavioral tests for depression and anxiety was observed.

RESULTS

The findings indicated that GABAergic neurons in the ZI were closely associated with depression-like behaviors in mice. Twenty-eight days after the CRS model was established, depression-like and anxiety-like behaviors were observed in the mice. The excitability of GABAergic neurons in the ZI was reduced. Chemogenetic activation of these neurons alleviated CRS-induced depression-like and anxiety-like behaviors. Conversely, inhibition of GABAergic neurons in the ZI led to changes in emotion-related behavioral outcomes in mice.

CONCLUSION

Activity of GABAergic neurons in the ZI was closely associated with depression-like phenotypes in mice, suggesting that these neurons could be a potential therapeutic target for treating depression.

Multi-omics analysis reveals mechanisms of FMT in Enhancing antidepressant effects of SSRIs

OBJECTIVE

This study explores the behavioral and molecular biological impacts of Fecal Microbiota Transplantation (FMT) on depressive mice unresponsive to treatment with Selective Serotonin Reuptake Inhibitors (SSRIs).

METHODS

Healthy male C57BL/6 mice were used to establish a depression model through chronic restraint stress, treated with fluoxetine, and categorized into Response and Non-response groups. An FMT treatment was added to the Non-response group. Behavioral tests were conducted to assess symptoms of depression. The gut microbiome, plasma metabolites, and hippocampal tissue gene expression and function changes were analyzed using 16S rRNA gene sequencing, LC-MS, and RNA sequencing.

RESULTS

FMT significantly improved the depressive symptoms in SSRIs-resistant mice. There was a partial restoration in the diversity and structure of the gut microbiota in the FMT group. Compared to the Non-response group, significant changes were noted in the metabolomic profiles of the FMT group, identifying various differential metabolites. Functional annotations indicated that these metabolites are involved in multiple metabolic pathways. In the Non-response group, certain gene expression levels were significantly restored. GO and KEGG enrichment analyses revealed that these differential genes mainly involve cytokine activity, receptor signaling regulation, and NOD-like receptor signaling pathways. Joint analysis suggested that FMT may exert its effects through an increase in the abundance of g__Paraprevotella, leading to decreased baicalin content and increased Tal2 expression.

CONCLUSION

FMT has potential in improving depressive symptoms unresponsive to SSRIs treatment. Its mechanism may be related to the modulation of the gut microbiota and its metabolites, subsequently affecting gene expression.

Combined Detection of Serum Brain-Derived Neurotrophic Factor and Interleukin-6 for Evaluating Therapeutic Efficacy in Major Depressive Disorder

The assessment of major depressive disorder (MDD) treatment efficacy typically relies on clinician-rated scales of depressive symptoms with a notable absence of predictive biomarkers. In this study, a concentration ratio of serum brain-derived neurotrophic factor (BDNF) to interleukin-6 (IL-6) was identified as a promising predictive biomarker. To overcome the significant disparity in blood levels between BDNF (ng·mL-1 range) and IL-6 (pg·mL-1 range), a dual-pathway signal amplification method involving small carbon dots (Fe-CDs and Pb-CDs) was employed. Fe-CDs exhibited a nanozyme-like behavior, effectively enhancing the signal through solution reactions, rendering it ideal for IL-6 detection at low concentrations. Meanwhile, Pb-CDs, laden with numerous signal molecules, amplified signals via the surface pathway and were suitable for BDNF detection. This dual signal output approach met the distinct sensitivity needs for quantifying IL-6 and BDNF, achieving detection limits of 0.1 pg·mL-1 and 0.02 ng·mL-1, respectively. Analysis of clinical samples showed that the concentration ratio of BDNF to IL-6 not only effectively differentiates MDD patients from healthy controls but also strongly correlates with individual treatment responses, affirming its value as a biomarker for MDD diagnosis and treatment efficacy evaluation.

Psychological interventions for preventing relapse in individuals with partial remission of depression: a systematic review and individual participant data meta-analysis

Partial remission after major depressive disorder (MDD) is common and a robust predictor of relapse. However, it remains unclear to which extent preventive psychological interventions reduce depressive symptomatology and relapse risk after partial remission. We aimed to identify variables predicting relapse and to determine whether, and for whom, psychological interventions are effective in preventing relapse, reducing (residual) depressive symptoms, and increasing quality of life among individuals in partial remission. This preregistered (CRD42023463468) systematic review and individual participant data meta-analysis (IPD-MA) pooled data from 16 randomized controlled trials (n = 705 partial remitters) comparing psychological interventions to control conditions, using 1- and 2-stage IPD-MA. Among partial remitters, baseline clinician-rated depressive symptoms (p = .005) and prior episodes (p = .012) predicted relapse. Psychological interventions were associated with reduced relapse risk over 12 months (hazard ratio [HR] = 0.60, 95% confidence interval [CI] 0.43-0.84), and significantly lowered posttreatment depressive symptoms (Hedges' g = 0.29, 95% CI 0.04-0.54), with sustained effects at 60 weeks (Hedges' g = 0.33, 95% CI 0.06-0.59), compared to nonpsychological interventions. However, interventions did not significantly improve quality of life at 60 weeks (Hedges' g = 0.26, 95% CI -0.06 to 0.58). No moderators of relapse prevention efficacy were found. Men, older individuals, and those with higher baseline symptom severity experienced greater reductions in symptomatology at 60 weeks. Psychological interventions for individuals with partially remitted depression reduce relapse risk and residual symptomatology, with efficacy generalizing across patient characteristics and treatment types. This suggests that psychological interventions are a recommended treatment option for this patient population.

Characterizing metabolomic and proteomic changes in depression: a systematic analysis

Despite the widespread use of metabolomics and proteomics to explore the molecular landscape of depression, there is a lack of consensus regarding dysregulated molecules with replicable evidence. Thus, this study aimed to identify robust metabolomic and proteomic features in depression by integrating evidence from large-scale studies. In this study, a knowledge base-mining approach was adopted to compile a list of dysregulated molecules derived from metabolomic and proteomic studies. A vote-counting approach was performed to identify consistently altered molecules in the blood and urine samples of patients with depression. A total of 2398 molecular entries were selected, comprising 857 unique metabolites and 468 unique proteins from 143 metabolomic and 23 proteomic studies in depression. The results of vote-counting analyses revealed that 11 metabolites in blood and 5 metabolites in urine exhibited consistent disturbances across studies. Circulating levels of glutamic acid and phosphatidylcholine (32:0) were elevated in depressive patients, whereas the levels of tryptophan, kynurenic acid, kynurenine, acetylcarnitine, serotonin, creatinine, inosine, phenylalanine, and valine were lower. Urinary levels of isobutyric acid, alanine, and nicotinic acid were higher, whereas the levels of N-methylnicotinamide and tyrosine were lower. Moreover, analysis of the proteomic dataset identified only one circulating protein, ceruloplasmin, that was consistently dysregulated. Convergence comparison prioritized tryptophan as the top-ranked circulating metabolite, followed by kynurenic acid, acetylcarnitine, creatinine, serotonin, and valine. Collectively, robust evidence of metabolomic changes was observed in patients with depression, pointing to a role as potential biomarkers. Further investigation of consensus proteomic features for depression is necessitated.

Discovery of potential female-specific biomarkers for major depressive disorder by LC-MS-based metabolomics

The prevalence of major depressive disorder (MDD) is higher in females than males, emphasizing the need to identify gender-specific biomarkers to improve diagnosis accuracy. In this study, a cross-sectional investigation with 258 samples was conducted to evaluate the discriminative power of potential gender-specific biomarkers for MDD. Eighteen MDD-related differential metabolites have been identified, involving pathways of phospholipids, glycerolipids, fatty acids, sphingolipids, cholesterol, vitamin E, and heme. A potential biomarker combination consisting of palmitelaidic acid, gamma carboxyethyl hydroxychroman (gamma-CEHC), and lysoPE(16:0) was confirmed for predicting depression in women using binary logistic regression analysis. To evaluate the panel's specificity, nine generalized anxiety disorder (GAD) samples, which share highly similar clinical symptoms with MDD, were included in the validation set. The discovery and validation sets yielded an area under the receiver operating characteristic curve of 0.86 and 0.83, respectively. All nine female GAD samples were correctly predicted as non-MDD, demonstrating the panel's specificity in diagnosing female MDD. Remarkably, this composite panel achieved a 75 % prediction accuracy in female samples in both the discovery and validation sets, but it did not reach 60 % prediction accuracy in male samples in either set. Our findings highlight the importance of gender-specific molecular diagnostics in developing practical and accurate diagnostic methods for MDD.

Dynamic Impact of the Sleep Disorder, Depression and Anxiety on the Cognitive Function in the First-Episode Depressive Patients

Background

Sleep disorder is closely related to depressive and anxious status as well as cognitive symptoms.

Materials and Methods

A total of 173 cases with the first-episode major depressive disorder (MDD) were involved in this study. The Hamilton Depression Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and Repeatable battery for the Assessment of Neuropsychological Status (RBANS) were used to assess the patients. Three visits were set at baseline at the 4th and the 8th weeks. Latent Growth Curve Models (LGCM) were used to analyze the changing tendency and correlation between sleep disorder, depression, anxiety status, and cognitive function in patients with MDD.

Results

Baseline sleep status in patients with MDD could predict cognitive function (p=0.043) and changes in cognitive function (p=0.016), and changes in depressive symptoms could negatively predict cognitive function (p=0.021). Changes in depressive status negatively predictability of its cognitive function (p=0.005). Changes in sleep status negatively predict cognitive function (p=0.099). Sex, age, educational duration, and nature of work were included in the LGCM. The comparison among the subgroups in the LGCM indicated that these four dimensions showed consistency in dynamic tendency, demonstrating that cognitive function changes with sleep status.

Conclusion

The more severe the sleep disorder in patients with first-episode MDD, the more obvious was the damage to cognition. The dynamic impact of sleep quality on cognitive function is positively correlated, and over time, there is an association between the remission speed of depressive or anxiety symptoms and improving the speed of cognitive function in patients with MDD.

A visual cortical-lateral posterior thalamic nucleus circuit regulates depressive-like behaviors in male mice

Depression, a prevalent psychiatric disorder of ambiguous etiology and high heterogeneity, has been recently linked to the primary visual cortex (V1). However, the precise circuits mediating the impact of V1 on depressive-like behaviors are poorly understood. Here, we demonstrate that the V1, specifically the lateral posterior nucleus of the thalamus (LP)-projecting V1 glutamatergic subpopulation (GluV1→LP neurons), shows reduced activity after chronic restraint stress (CRS) in male mice, leading to depressive-like behaviors. Optogenetic or chemogenetic activation of these neurons ameliorated depressive-like behaviors in CRS-depressed mice, whereas reducing activity exacerbated these behaviors. This reduction in GluV1→LP neurons activity was predominantly due to a decrease in the guanine nucleotide-binding protein subunit gamma-4 (Gγ4). Overexpression of Gγ4 in the GluV1→LP neurons produced antidepressant-like effects, suggesting that Gγ4 is a crucial regulator of mood. Collectively, these results reveal a V1→LP circuit that modulates depressive-like behaviors, suggesting potential targets for therapeutic interventions.