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Hua JPY, Abram SV, Loewy RL, Stuart B, Fryer SL, Vinogradov S, Mathalon DH. Brain Age Gap in Early Illness Schizophrenia and the Clinical High-Risk Syndrome: Associations With Experiential Negative Symptoms and Conversion to Psychosis. Schizophr Bull 2024:sbae074. [PMID: 38815987 DOI: 10.1093/schbul/sbae074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND AND HYPOTHESIS Brain development/aging is not uniform across individuals,spawning efforts to characterize brain age from a biological perspective to model the effects of disease and maladaptive life processes on the brain. The brain age gap represents the discrepancy between estimated brain biological age and chronological age (in this case, based on structural magnetic resonance imaging, MRI). Structural MRI studies report an increased brain age gap (biological age > chronological age) in schizophrenia, with a greater brain age gap related to greater negative symptom severity. Less is known regarding the nature of this gap early in schizophrenia (ESZ), if this gap represents a psychosis conversion biomarker in clinical high-risk (CHR-P) individuals, and how altered brain development and/or agingmap onto specific symptom facets. STUDY DESIGN Using structural MRI, we compared the brain age gap among CHR-P (n = 51), ESZ (n = 78), and unaffected comparison participants (UCP; n = 90), and examined associations with CHR-P psychosis conversion (CHR-P converters n = 10; CHR-P non-converters; n = 23) and positive and negative symptoms. STUDY RESULTS ESZ showed a greater brain age gap relative to UCP and CHR-P (Ps < .010). CHR-P individuals who converted to psychosis showed a greater brain age gap (P = .043) relative to CHR-P non-converters. A larger brain age gap in ESZ was associated with increased experiential (P = .008), but not expressive negative symptom severity. CONCLUSIONS Consistent with schizophrenia pathophysiological models positing abnormal brain maturation, results suggest abnormal brain development is present early in psychosis. An increased brain age gap may be especially relevant to motivational and functional deficits in schizophrenia.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center, University of California, San Francisco, CA, USA
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Samantha V Abram
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Barbara Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Susanna L Fryer
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Daniel H Mathalon
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
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Rios RL, Green M, Smith SK, Kafashan M, Ching S, Farber NB, Lin N, Lucey BP, Reynolds CF, Lenze EJ, Palanca BJA. Propofol enhancement of slow wave sleep to target the nexus of geriatric depression and cognitive dysfunction: protocol for a phase I open label trial. BMJ Open 2024; 14:e087516. [PMID: 38816055 PMCID: PMC11138309 DOI: 10.1136/bmjopen-2024-087516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Late-life treatment-resistant depression (LL-TRD) is common and increases risk for accelerated ageing and cognitive decline. Impaired sleep is common in LL-TRD and is a risk factor for cognitive decline. Slow wave sleep (SWS) has been implicated in key processes including synaptic plasticity and memory. A deficiency in SWS may be a core component of depression pathophysiology. The anaesthetic propofol can induce electroencephalographic (EEG) slow waves that resemble SWS. Propofol may enhance SWS and oral antidepressant therapy, but relationships are unclear. We hypothesise that propofol infusions will enhance SWS and improve depression in older adults with LL-TRD. This hypothesis has been supported by a recent small case series. METHODS AND ANALYSIS SWIPED (Slow Wave Induction by Propofol to Eliminate Depression) phase I is an ongoing open-label, single-arm trial that assesses the safety and feasibility of using propofol to enhance SWS in older adults with LL-TRD. The study is enrolling 15 English-speaking adults over age 60 with LL-TRD. Participants will receive two propofol infusions 2-6 days apart. Propofol infusions are individually titrated to maximise the expression of EEG slow waves. Preinfusion and postinfusion sleep architecture are evaluated through at-home overnight EEG recordings acquired using a wireless headband equipped with dry electrodes. Sleep EEG recordings are scored manually. Key EEG measures include sleep slow wave activity, SWS duration and delta sleep ratio. Longitudinal changes in depression, suicidality and anhedonia are assessed. Assessments are performed prior to the first infusion and up to 10 weeks after the second infusion. Cognitive ability is assessed at enrolment and approximately 3 weeks after the second infusion. ETHICS AND DISSEMINATION The study was approved by the Washington University Human Research Protection Office. Recruitment began in November 2022. Dissemination plans include presentations at scientific conferences, peer-reviewed publications and mass media. Positive results will lead to a larger phase II randomised placebo-controlled trial. TRIAL REGISTRATION NUMBER NCT04680910.
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Affiliation(s)
- Rachel Lynn Rios
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Michael Green
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - S Kendall Smith
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - MohammadMehdi Kafashan
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - ShiNung Ching
- Department of Electrical & Systems Engineering, Washington University in St. Louis, St Louis, Missouri, USA
| | - Nuri B Farber
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Nan Lin
- Department of Biostatistics and Data Science, Washington University in St Louis, St Louis, Missouri, USA
| | - Brendan P Lucey
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Eric J Lenze
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
| | - Ben Julian Agustin Palanca
- Department of Anesthesiology, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, Missouri, USA
- Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
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Głowacka M, Przybyła N, Humańska M, Kornatowski M. Depression and anxiety as predictors of performance status and life satisfaction in older adult neurological patients: a cross-sectional cohort study. Front Psychiatry 2024; 15:1412747. [PMID: 38832331 PMCID: PMC11145277 DOI: 10.3389/fpsyt.2024.1412747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Neurological disorders are one of the leading causes of disability globally. Studies emphasise that the course and effectiveness of rehabilitation interventions may be influenced by emotional factors. The aim of the present study was to assess the prevalence of depressive and anxiety symptoms in patients with neurological disorders and examine whether depression and tendency to respond with anxiety are predictors of disability in these patients. The study included 229 individuals with neurological disorders aged over 55. Our findings show that stroke patients are more likely to experience depressive symptoms and are more likely to display trait anxiety as compared with patients with other neurological disorders. Advanced age, female sex, low level of education and the presence of trait anxiety are associated with a higher severity of depressive symptoms. Stroke survivors have significantly poorer ECOG performance scores and are more likely to be incapable for work. Both depression and trait anxiety are significant predictors of neurological patients' performance status, and the presence of depressive symptoms is a determinant of these patients' level of satisfaction with life. An understanding of psychological risk factors for poorer performance status in individuals with neurological disorders will make it possible to plan prophylactic interventions in order to minimise negative health impacts and facilitate access to mental health facilities.
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Affiliation(s)
- Mariola Głowacka
- Institute of Nursing, Department of Integrated Medical Care, Faculty of Health Sciences, Collegium Medicum, The Mazovian University in Płock, Płock, Poland
| | - Natalia Przybyła
- Department of Applied Neurocognitivistics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marzena Humańska
- Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Maciej Kornatowski
- Medical Department, Collegium Medicum, The Mazovian University in Płock, Płock, Poland
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Grant I, Krupitsky E, Vetrova M, Umlauf A, Heaton RK, Hauger RL, Toussova O, Franklin DR, Letendre SL, Woody G, Blokhina E, Lioznov D, Zvartau E. Effects of Opioid Withdrawal on Psychobiology in People Living with HIV. Viruses 2024; 16:92. [PMID: 38257791 PMCID: PMC10818595 DOI: 10.3390/v16010092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE Many persons with opioid use disorders (OUDs) have HIV disease and experience clinically significant stress after they enroll in abstinence-based treatment and undergo medically assisted withdrawal. We examined whether opioid withdrawal affects virologic control, inflammatory markers, cognition, and mood in persons with an OUD and HIV, and explored whether measures of withdrawal stress, such as activation of the HPA axis, contribute to alterations in immune function, cognition, and mood. METHOD AND PARTICIPANTS Study participants were 53 persons with HIV who were admitted for OUD treatment at the City Addiction Hospital in Saint Petersburg, Russian Federation. Participants were examined at admission, at the anticipated peak of withdrawal 3 to 7 days after the last day of a clonidine-based withdrawal process lasting 7 to 14 days, and 3 to 4 weeks after completing withdrawal. At these times, participants received medical exams and were evaluated for symptoms of withdrawal, as well as cognition and mood. Viral load, plasma cortisol, DHEA sulfate ester (DHEA-S), interleukin-6 (IL-6), and soluble CD14 (sCD14) were determined. Multivariable models examined the relationships between markers of HPA activation and the other parameters over time. RESULTS HPA activation as indexed by cortisol/DHEA-S ratio increased during withdrawal, as did markers of immune activation, IL-6 and sCD14. There were no significant associations between viral load and indicators of HPA activation. In longitudinal analyses, higher cortisol/DHEA sulfate was related to worse cognition overall, and more mood disturbance. Increase in IL-6 was associated with worse cognitive performance on a learning task. There were no significant associations with sCD14. CONCLUSIONS Worsening of cognition and measures of mood disturbance during withdrawal were associated with activation of the HPA axis and some measures of inflammation. Whether repeated episodes of opioid withdrawal have a cumulative impact on long-term HIV outcomes and neurocognition is a topic for further investigation.
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Affiliation(s)
- Igor Grant
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
| | - Evgeny Krupitsky
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
- Department of Addictions, Bekhterev National Medical Research Center for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
| | - Marina Vetrova
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
| | - Anya Umlauf
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
| | - Robert K. Heaton
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
| | - Richard L. Hauger
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Olga Toussova
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
| | - Donald R. Franklin
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
| | - Scott L. Letendre
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA; (A.U.); (R.K.H.); (R.L.H.); (D.R.F.); (S.L.L.)
- Department of Medicine, University of California, San Diego, CA 92093, USA
| | - George Woody
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Elena Blokhina
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
| | - Dmitry Lioznov
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
| | - Edwin Zvartau
- Department of Pharmacology, Pavlov State Medical University, 197022 Saint Petersburg, Russia; (E.K.); (M.V.); (O.T.); (E.B.); (D.L.); (E.Z.)
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Gebara MA, Brown PJ, Roose SP. Finally, New Hope for the Treatment of LLTRD. Am J Geriatr Psychiatry 2023; 31:1042-1044. [PMID: 37562991 DOI: 10.1016/j.jagp.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023]
Affiliation(s)
- Marie Anne Gebara
- Department of Psychiatry (MAG), University of Pittsburgh, School of Medicine, Pittsburgh, PA.
| | - Patrick J Brown
- Department of Psychiatry (PJB, SPR), Columbia University College of Physicians and Surgeons, The New York State Psychiatric Institute, New York, NY
| | - Steven P Roose
- Department of Psychiatry (PJB, SPR), Columbia University College of Physicians and Surgeons, The New York State Psychiatric Institute, New York, NY
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Luo X, Ruan Z, Liu L. Causal relationship between depression and aging: a bidirectional two-sample Mendelian randomization study. Aging Clin Exp Res 2023; 35:3179-3187. [PMID: 37999829 DOI: 10.1007/s40520-023-02596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/16/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND The causal relationship and the direction of the effect between depression and aging remain controversial. METHODS We used a bidirectional two-sample Mendelian randomization analysis to examine the relationship between depression and age proxy indicators. We obtained pooled statistics from genome-wide association studies (GWAS) on depression and the age proxy indicators. We employed five MR analysis methods to address potential biases and ensure robustness of our results, with the inverse variance weighted (IVW) method being the primary outcome. We also conducted outlier exclusion using Radial MR, MRPRESSO, and MR Steiger filters. Additionally, sensitivity analyses were performed to assess heterogeneity and pleiotropy. RESULTS Our MR analysis revealed that depression causally leads to shortened telomere length (β = - 0.014; P = 0.038), increased frailty index (β = 0.076; P = 0.000), and accelerated GrimAge (β = 0.249; P = 0.024). Furthermore, our findings showed that the frailty index (OR = 1.679; P = 0.001) was causally associated with an increased risk of depression. Additionally, we found that appendicular lean mass (OR = 0.929; P = 0.000) and left-hand grip strength (OR = 0.836; P = 0.014) were causally associated with a reduced risk of depression. Sensitivity analyses demonstrated the robustness of our findings. CONCLUSIONS Our study provides evidence that depression contributes to the accelerated aging process, resulting in decreased telomere length, increased frailty index, and accelerated GrimAge. Additionally, we found that the frailty index increases the risk of depression, while appendicular lean mass and left-handed grip strength reduce the risk of depression.
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Affiliation(s)
- Xinxin Luo
- Jiangxi Provincial People's Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Zhichao Ruan
- Beijing University of Chinese Medicine, Beijing, China
| | - Ling Liu
- Jiangxi Provincial People's Hospital and The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
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Alberry B, Silveira PP. Brain insulin signaling as a potential mediator of early life adversity effects on physical and mental health. Neurosci Biobehav Rev 2023; 153:105350. [PMID: 37544390 DOI: 10.1016/j.neubiorev.2023.105350] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
In numerous brain structures, insulin signaling modulates the homeostatic processes, sensitivity to reward pathways, executive function, memory, and cognition. Through human studies and animal models, mounting evidence implicates central insulin signaling in the metabolic, physiological, and psychological consequences of early life adversity. In this review, we describe the consequences of early life adversity in the brain where insulin signaling is a key factor and how insulin may moderate the effects of adversity on psychiatric and cardio-metabolic health outcomes. Further understanding of how early life adversity and insulin signaling impact specific brain regions and mental and physical health outcomes will assist in prevention, diagnosis, and potential intervention following early life adversity.
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Affiliation(s)
- Bonnie Alberry
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Patricia Pelufo Silveira
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
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MohanKumar SMJ, Murugan A, Palaniyappan A, MohanKumar PS. Role of cytokines and reactive oxygen species in brain aging. Mech Ageing Dev 2023; 214:111855. [PMID: 37541628 PMCID: PMC10528856 DOI: 10.1016/j.mad.2023.111855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
Aging is a complex process that produces profound effects on the brain. Although a number of external factors can promote the initiation and progression of brain aging, peripheral and central changes in the immune cells with time, also play an important role. Immunosenescence, which is an age-associated decline in immune function and Inflammaging, a low-grade inflammatory state in the aging brain contribute to an elevation in cytokine and reactive oxygen species production. In this review, we focus on the pro-inflammatory state that is established in the brain as a consequence of these two phenomena and the resulting detrimental changes in brain structure, function and repair that lead to a decline in central and neuroendocrine function.
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Affiliation(s)
- Sheba M J MohanKumar
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
| | - Abarna Murugan
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Arunkumar Palaniyappan
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Puliyur S MohanKumar
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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Rios RL, Kafashan M, Hyche O, Lenard E, Lucey BP, Lenze EJ, Palanca BJA. Targeting Slow Wave Sleep Deficiency in Late-Life Depression: A Case Series With Propofol. Am J Geriatr Psychiatry 2023; 31:643-652. [PMID: 37105885 PMCID: PMC10544727 DOI: 10.1016/j.jagp.2023.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023]
Abstract
Slow wave sleep (SWS), characterized by large electroencephalographic oscillations, facilitates crucial physiologic processes that maintain synaptic plasticity and overall brain health. Deficiency in older adults is associated with depression and cognitive dysfunction, such that enhancing sleep slow waves has emerged as a promising target for novel therapies. Enhancement of SWS has been noted after infusions of propofol, a commonly used anesthetic that induces electroencephalographic patterns resembling non-rapid eye movement sleep. This paper 1) reviews the scientific premise underlying the hypothesis that sleep slow waves are a novel therapeutic target for improving cognitive and psychiatric outcomes in older adults, and 2) presents a case series of two patients with late-life depression who each received two propofol infusions. One participant, a 71-year-old woman, had a mean of 2.8 minutes of evening SWS prior to infusions (0.7% of total sleep time). SWS increased on the night after each infusion, to 12.5 minutes (5.3% of total sleep time) and 24 minutes (10.6% of total sleep time), respectively. Her depression symptoms improved, reflected by a reduction in her Montgomery-Asberg Depression Rating Scale (MADRS) score from 26 to 7. In contrast, the other participant, a 77-year-old man, exhibited no SWS at baseline and only modest enhancement after the second infusion (3 minutes, 1.3% of total sleep time). His MADRS score increased from 13 to 19, indicating a lack of improvement in his depression. These cases provide proof-of-concept that propofol can enhance SWS and improve depression for some individuals, motivating an ongoing clinical trial (ClinicalTrials.gov NCT04680910).
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Affiliation(s)
- Rachel L Rios
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - MohammadMehdi Kafashan
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Orlandrea Hyche
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Emily Lenard
- Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Brendan P Lucey
- Center on Biological Rhythms and Sleep (BPL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Neurology (BPL), Washington University in St. Louis, MO
| | - Eric J Lenze
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Ben Julian A Palanca
- Department of Anesthesiology (RLR, MK, OH, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Psychiatry (EL, EJL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Center on Biological Rhythms and Sleep (BPL, BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Biomedical Engineering (BJAP), Washington University in St. Louis, St. Louis, MO; Division of Biology and Biomedical Sciences (BJAP), Washington University School of Medicine in St. Louis, St. Louis, MO.
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Rampersaud R, Wu GWY, Reus VI, Lin J, Blackburn EH, Epel ES, Hough CM, Mellon SH, Wolkowitz OM. Shorter telomere length predicts poor antidepressant response and poorer cardiometabolic indices in major depression. Sci Rep 2023; 13:10238. [PMID: 37353495 PMCID: PMC10290110 DOI: 10.1038/s41598-023-35912-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/25/2023] [Indexed: 06/25/2023] Open
Abstract
Telomere length (TL) is a marker of biological aging, and shorter telomeres have been associated with several medical and psychiatric disorders, including cardiometabolic dysregulation and Major Depressive Disorder (MDD). In addition, studies have shown shorter TL to be associated with poorer response to certain psychotropic medications, and our previous work suggested shorter TL and higher telomerase activity (TA) predicts poorer response to Selective Serotonin Reuptake Inhibitor (SSRI) treatment. Using a new group of unmedicated medically healthy individuals with MDD (n = 48), we sought to replicate our prior findings demonstrating that peripheral blood mononuclear cell (PBMC) TL and TA predict response to SSRI treatment and to identify associations between TL and TA with biological stress mediators and cardiometabolic risk indices. Our results demonstrate that longer pre-treatment TL was associated with better response to SSRI treatment (β = .407 p = .007). Additionally, we observed that TL had a negative relationship with allostatic load (β = - .320 p = .017) and a cardiometabolic risk score (β = - .300 p = .025). Our results suggest that PBMC TL reflects, in part, the cumulative effects of physiological stress and cardiovascular risk in MDD and may be a biomarker for predicting SSRI response.
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Affiliation(s)
- Ryan Rampersaud
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA.
| | - Gwyneth W Y Wu
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Victor I Reus
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elissa S Epel
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Christina M Hough
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Synthia H Mellon
- Department of OB-GYN and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Owen M Wolkowitz
- Weill Institute for Neurosciences and Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
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11
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Hatch KS, Gao S, Ma Y, Russo A, Jahanshad N, Thompson PM, Adhikari BM, Bruce H, Van der Vaart A, Sotiras A, Kvarta MD, Nichols TE, Schmaal L, Hong LE, Kochunov P. Brain deficit patterns of metabolic illnesses overlap with those for major depressive disorder: A new metric of brain metabolic disease. Hum Brain Mapp 2023; 44:2636-2653. [PMID: 36799565 PMCID: PMC10028678 DOI: 10.1002/hbm.26235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Metabolic illnesses (MET) are detrimental to brain integrity and are common comorbidities in patients with mental illnesses, including major depressive disorder (MDD). We quantified effects of MET on standard regional brain morphometric measures from 3D brain MRI as well as diffusion MRI in a large sample of UK BioBank participants. The pattern of regional effect sizes of MET in non-psychiatric UKBB subjects was significantly correlated with the spatial profile of regional effects reported by the largest meta-analyses in MDD but not in bipolar disorder, schizophrenia or Alzheimer's disease. We used a regional vulnerability index (RVI) for MET (RVI-MET) to measure individual's brain similarity to the expected patterns in MET in the UK Biobank sample. Subjects with MET showed a higher effect size for RVI-MET than for any of the individual brain measures. We replicated elevation of RVI-MET in a sample of MDD participants with MET versus non-MET. RVI-MET scores were significantly correlated with the volume of white matter hyperintensities, a neurological consequence of MET and age, in both groups. Higher RVI-MET in both samples was associated with obesity, tobacco smoking and frequent alcohol use but was unrelated to antidepressant use. In summary, MET effects on the brain were regionally specific and individual similarity to the pattern was more strongly associated with MET than any regional brain structural metric. Effects of MET overlapped with the reported brain differences in MDD, likely due to higher incidence of MET, smoking and alcohol use in subjects with MDD.
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Affiliation(s)
- Kathryn S Hatch
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Yizhou Ma
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Alessandro Russo
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California, USA
| | - Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Andrew Van der Vaart
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Aristeidis Sotiras
- Institute of Informatics, University of Washington, School of Medicine, St. Louis, Missouri, USA
- Department of Radiology, University of Washington, School of Medicine, St. Louis, Missouri, USA
| | - Mark D Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Thomas E Nichols
- Nuffield Department of Population Health of the University of Oxford, Oxford, UK
| | - Lianne Schmaal
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Australia
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
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12
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Oughli HA, Gebara MA, Ciarleglio A, Lavretsky H, Brown PJ, Flint AJ, Farber NB, Karp JF, Mulsant BH, Reynolds CF, Roose SP, Yang L, Butters MA, Lenze EJ. Intravenous Ketamine for Late-Life Treatment-Resistant Depression: A Pilot Study of Tolerability, Safety, Clinical Benefits, and Effect on Cognition. Am J Geriatr Psychiatry 2023; 31:210-221. [PMID: 36529623 PMCID: PMC10839705 DOI: 10.1016/j.jagp.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Evidence-based treatment options for late-life treatment-resistant depression (TRD) are limited. Ketamine is a promising treatment for TRD; however, there is a paucity of data on its safety and efficacy in older adults. METHODS In this pilot clinical trial, 25 adults aged ≥60 years with TRD received IV ketamine openly twice a week for 4 weeks; partial responders at the end of this acute phase were eligible to receive weekly infusions for 4 more weeks in a continuation phase. Acceptability, tolerability, and safety, including adverse and serious adverse events (AEs and SAEs), blood pressure changes, dissociation, craving, in addition to rates of depression response and remission were evaluated. The NIH Toolbox Cognitive Battery was used to assess specific measures of executive function (EF) and overall fluid cognition. RESULTS Completion rates were 88% for the acute phase and 100% for the continuation phase. No AEs resulted in participant discontinuation, and there were no SAEs. Treatment-emergent elevation of blood pressure, dissociation, and craving were transient and did not result in any participant discontinuation. Depressive symptoms improved significantly and 48% of participants responded. During the acute phase, the EF measures and the fluid cognition composite score improved (Cohen's d = 0.61), and these improvements were sustained in the continuation phase. CONCLUSION This pilot study suggests that repeated IV ketamine infusions are well-tolerated and are associated with improvement in depression and EF in older adults with TRD. These promising findings need to be confirmed and extended in a larger randomized controlled trial.
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Affiliation(s)
- Hanadi Ajam Oughli
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Marie Anne Gebara
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
| | - Adam Ciarleglio
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, the George Washington University, Washington, DC
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Patrick J Brown
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY
| | - Alastair J Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Mental Health, University Health Network, Toronto, Canada
| | - Nuri B Farber
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Jordan F Karp
- Department of Psychiatry, College of Medicine-Tucson, University of Arizona, Tucson, AZ
| | - Benoit H Mulsant
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada
| | - Charles F Reynolds
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven P Roose
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY
| | - Lei Yang
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Meryl A Butters
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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13
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Han MH, Lee EH, Park HH, Choi SH, Koh SH. Relationship between telomere shortening and early subjective depressive symptoms and cognitive complaints in older adults. Aging (Albany NY) 2023; 15:914-931. [PMID: 36805537 PMCID: PMC10008503 DOI: 10.18632/aging.204533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
Telomere length (TL) has been reported to be associated with depression and cognitive impairment in elderly. Early detection of depression and cognitive impairment is important to delay disease progression. Therefore, we aimed to identify whether TL is associated with early subjective depressive symptoms and cognitive complaints among healthy elderly subjects. This study was a multicenter, outcome assessor-blinded, 24-week, randomized controlled trial (RCT). Measurement of questionnaire and physical activity scores and blood sample analyses were performed at baseline and after six months of follow-up in all study participants. Linear regression analyses were performed to identify whether early subjective depressive symptoms, cognitive complaints, and several blood biomarkers are associated with TL. Altogether, 137 relatively healthy elderly individuals (60-79 years old) were enrolled in this prospective RCT. We observed an approximate decrease of 0.06 and 0.11-0.14 kbps of TL per one point increase in the geriatric depression scale and cognitive complaint interview scores, respectively, at baseline and after six months of follow-up. We also found an approximate decrease of 0.08-0.09 kbps of TL per one point increase in interleukin (IL)-6 levels at baseline and after six months of follow-up. Our study showed that both early subjective depressive symptoms and cognitive complaints were associated with a relatively shorter TL in relatively healthy elderly individuals. In addition, based on our findings, we believe that IL-6 plays an important role in the relationship between shortening TL and early subjective depressive symptoms and cognitive complaints.
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Affiliation(s)
- Myung-Hoon Han
- Department of Neurosurgery, Hanyang University Guri Hospital, Guri 11923, South Korea
| | - Eun-Hye Lee
- Department of Neurology, Hanyang University Guri Hospital, Guri 11923, South Korea
| | - Hyun-Hee Park
- Department of Neurology, Hanyang University Guri Hospital, Guri 11923, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University College of Medicine, Incheon 22332, South Korea
| | - Seong-Ho Koh
- Department of Neurology, Hanyang University Guri Hospital, Guri 11923, South Korea
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul 04763, South Korea
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14
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Triolo F, Sjöberg L, Calderón-Larrañaga A, Belvederi Murri M, Vetrano DL, Fratiglioni L, Dekhtyar S. Late-life depression and multimorbidity trajectories: the role of symptom complexity and severity. Age Ageing 2023; 52:6974845. [PMID: 36735844 PMCID: PMC9897302 DOI: 10.1093/ageing/afac315] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/31/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION as late-life depression is associated with poor somatic health, we aimed to investigate the role of depression severity and symptom phenotypes in the progression of somatic multimorbidity. METHODS we analysed data from 3,042 dementia-free individuals (60+) participating in the population-based Swedish National Study on Aging and Care in Kungsholmen. Using the baseline clinical assessment of 21 depressive symptoms from the Comprehensive Psychopathological Rating Scale, we: (i) diagnosed major, minor (in accordance with DSM-IV-TR) and subsyndromal depression; (ii) extracted symptom phenotypes by applying exploratory network graph analysis. Somatic multimorbidity was measured as the number of co-occurring chronic diseases over a 15-year follow-up. Linear mixed models were used to explore somatic multimorbidity trajectories in relation to baseline depression diagnoses and symptom phenotypes, while accounting for sociodemographic and behavioural factors. RESULTS in multi-adjusted models, relative to individuals without depression, those with major (β per year: 0.33, 95% confidence interval [CI]: 0.06-0.61) and subsyndromal depression (β per year: 0.21, 95%CI: 0.12-0.30) experienced an accelerated rate of somatic multimorbidity accumulation, whereas those with minor depression did not. We identified affective, anxiety, cognitive, and psychomotor symptom phenotypes from the network analysis. When modelled separately, an increase in symptom score for each phenotype was associated with faster multimorbidity accumulation, although only the cognitive phenotype retained its association in a mutually adjusted model (β per year: 0.07, 95%CI: 0.03-0.10). CONCLUSIONS late-life major and subsyndromal depression are associated with accelerated somatic multimorbidity. Depressive symptoms characterised by a cognitive phenotype are linked to somatic health change in old age.
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Affiliation(s)
- Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Linnea Sjöberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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15
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Dickens SP, Backus ASN. Behavioral Health and Stress in Agriculture. J Agromedicine 2023; 28:73-76. [PMID: 36300340 DOI: 10.1080/1059924x.2022.2140736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Behavioral health and stress are often antecedents to chronic health problems and injury; however, until recently addressing health and safety issues from a behavioral perspective has received little treatment. In this article, we review the current state of behavioral health and stress in agriculture, examine current trends to address this stress, identify gaps still to be filled and make recommendations for future efforts.
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Affiliation(s)
- Steven P Dickens
- Invest EAP Centers for Wellbeing, State of VT, Burlington, Vermont, USA
| | - Ann S N Backus
- Harvard Chan-NIOSH Education and Research Center, Boston, Massachusetts, USA
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16
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Yu C, Zhang F, Zhang L, Li J, Tang S, Li X, Peng M, Zhao Q, Zhu X. A bioinformatics approach to identifying the biomarkers and pathogenesis of major depressive disorder combined with acute myocardial infarction. Am J Transl Res 2023; 15:932-948. [PMID: 36915729 PMCID: PMC10006793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/17/2023] [Indexed: 03/16/2023]
Abstract
This study investigated the pathogenesis of major depressive disorder (MDD) and acute myocardial infarction (AMI) using bioinformatics. We analyzed MDD and AMI (MDD-AMI) datasets provided by the Gene Expression Omnibus (GEO) database for genes common to MDD and AMI using GEO2R and weighted gene co-expression network analysis (WGCNA). We also performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and we used Disease Ontology (DO) analysis to identify a) the pathways through which genes function and b) comorbidities. We also created a protein-protein interaction (PPI) network using the STRING database to identify the hub genes and biomarkers. NetworkAnalyst 3.0 was used to construct a transcription factor (TF) gene regulatory network. We also identified relevant complications and potential drug candidates. The 27 genes common to MDD and AMI were enriched in the pathways regulating TFs and mediating immunity and inflammation. The hub genes in the PPI network included TLR2, HP, ICAM1, LCN2, LTF, VCAN, S100A9 and NFKBIA. Key TFs were KLF9, KLF11, ZNF24, and ZNF580. Cardiovascular, pancreatic, and skeletal diseases were common complications. Hydrocortisone, simvastatin, and estradiol were candidate treatment drugs. Identification of these genes and their pathways may provide new targets for further research on the pathogenesis, biomarkers, and treatment of MDD-AMI. Together our results suggested that TLR2 and VCAN might be the key genes associated with MDD complicated by AMI.
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Affiliation(s)
- Cheng Yu
- Department of Traditional Chinese Medicine Classics, Shandong University of Traditional Chinese Medicine Affiliated Hospital Jinan, Shandong, China
| | - Fengjun Zhang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine Jinan, Shandong, China
| | - Lili Zhang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine Jinan, Shandong, China
| | - Jiajing Li
- Department of Traditional Chinese Medicine Classics, Shandong University of Traditional Chinese Medicine Affiliated Hospital Jinan, Shandong, China
| | - Saixue Tang
- First Clinical School of Medicine, Shandong University of Traditional Chinese Medicine Jinan, Shandong, China
| | - Xuejun Li
- Department of Traditional Chinese Medicine Classics, Shandong University of Traditional Chinese Medicine Affiliated Hospital Jinan, Shandong, China
| | - Min Peng
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Qiong Zhao
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Xiuli Zhu
- Department of Radiation Oncology and Shandong Province Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences Jinan, Shandong, China
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17
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Saxena K, Simonetti A, Verrico CD, Janiri D, Di Nicola M, Catinari A, Kurian S, Saxena J, Mwangi B, Soares JC. Neurocognitive Correlates of Cerebellar Volumetric Alterations in Youth with Pediatric Bipolar Spectrum Disorders and Bipolar Offspring. Curr Neuropharmacol 2023; 21:1367-1378. [PMID: 36239717 PMCID: PMC10324334 DOI: 10.2174/1570159x21666221014120332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Emerging evidence points towards the involvement of the cerebellum in the processing of emotions and pathophysiology of mood disorders. However, cerebellar and related cognitive alterations in youth with pediatric bipolar disorder (PBD) and those at high risk to develop the disorder, such as bipolar offspring (BD-OFF) are not clearly defined. OBJECTIVE To investigate cerebellar gray and white matter volumes, cognition, and their relationship in youth with PBD and BD-OFF. METHODS Thirty youth (7 to 17 years, inclusive) with PBD, 30 BD-OFF and 40 healthy controls (HC) were recruited. Study participants underwent a computer-based cognitive battery assessing affective processing, executive function, attention, psychomotor speed, and learning. Three-tesla MRI scan was performed to assess cerebellar white and gray matter volumes. Cerebellar segmentation was performed with FreeSurfer. Statistical analyses include between-group differences in cognitive domains, cerebellar gray, and white matter volumes. Relationships between cerebellar volumes and cognitive domains were examined. RESULTS Youth with PBD showed greater cerebellar gray matter volumes than both BD-OFF and HC, whereas no differences were present between BD-OFF and HC. Both youth with PBD and BD-OFF showed altered processing of negative emotions and a bias towards positive emotions. In youth with PBD and BD-OFF, greater impairment in the processing of emotions correlated with greater cerebellar gray matter volumes. CONCLUSION The present findings corroborate hypotheses on cerebellar involvement in the processing of emotions and the pathophysiology of PBD. The presence of cerebellar dysfunction in BD-OFF is unclear.
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Affiliation(s)
- Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Christopher D. Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
| | - Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonello Catinari
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, TX, USA
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, TX, USA
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18
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Abram SV, Roach BJ, Hua JPY, Han LKM, Mathalon DH, Ford JM, Fryer SL. Advanced brain age correlates with greater rumination and less mindfulness in schizophrenia. Neuroimage Clin 2023; 37:103301. [PMID: 36586360 PMCID: PMC9830317 DOI: 10.1016/j.nicl.2022.103301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/05/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Individual variation in brain aging trajectories is linked with several physical and mental health outcomes. Greater stress levels, worry, and rumination correspond with advanced brain age, while other individual characteristics, like mindfulness, may be protective of brain health. Multiple lines of evidence point to advanced brain aging in schizophrenia (i.e., neural age estimate > chronological age). Whether psychological dimensions such as mindfulness, rumination, and perceived stress contribute to brain aging in schizophrenia is unknown. METHODS We estimated brain age from high-resolution anatomical scans in 54 healthy controls (HC) and 52 individuals with schizophrenia (SZ) and computed the brain predicted age difference (BrainAGE-diff), i.e., the delta between estimated brain age and chronological age. Emotional well-being summary scores were empirically derived to reflect individual differences in trait mindfulness, rumination, and perceived stress. Core analyses evaluated relationships between BrainAGE-diff and emotional well-being, testing for slopes differences across groups. RESULTS HC showed higher emotional well-being (greater mindfulness and less rumination/stress), relative to SZ. We observed a significant group difference in the relationship between BrainAge-diff and emotional well-being, explained by BrainAGE-diff negatively correlating with emotional well-being scores in SZ, and not in HC. That is, SZ with younger appearing brains (predicted age < chronological age) had emotional summary scores that were more like HC, a relationship that endured after accounting for several demographic and clinical variables. CONCLUSIONS These data reveal clinically relevant aspects of brain age heterogeneity among SZ and point to case-control differences in the relationship between advanced brain aging and emotional well-being.
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Affiliation(s)
- Samantha V Abram
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, United States; Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Brian J Roach
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
| | - Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco Veterans Affairs Medical Center, and the University of California, San Francisco, CA, United States; Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Laura K M Han
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Susanna L Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.
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19
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Seeman MV. Subjective Overview of Accelerated Aging in Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:737. [PMID: 36613059 PMCID: PMC9819113 DOI: 10.3390/ijerph20010737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Schizophrenia, like many other human diseases, particularly neuropsychiatric diseases, shows evidence of accelerated brain aging. The molecular nature of the process of aging is unknown but several potential indicators have been used in research. The concept of accelerated aging in schizophrenia took hold in 2008 and its timing, pace, determinants and deterrents have been increasingly examined since. The present overview of the field is brief and selective, based on diverse studies, expert opinions and successive reviews. Current thinking is that the timing of age acceleration in schizophrenia can occur at different time periods of the lifespan in different individuals, and that antipsychotics may be preventive. The majority opinion is that the cognitive decline and premature death often seen in schizophrenia are, in principle, preventable.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, 260 Heath St. West, Suite #605, Toronto, ON M5P 3L6, Canada
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20
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Is depression the missing link between inflammatory mediators and cancer? Pharmacol Ther 2022; 240:108293. [PMID: 36216210 DOI: 10.1016/j.pharmthera.2022.108293] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
Patients with cancer are at greater risk of developing depression in comparison to the general population and this is associated with serious adverse effects, such as poorer quality of life, worse prognosis and higher mortality. Although the relationship between depression and cancer is now well established, a common underlying pathophysiological mechanism between the two conditions is yet to be elucidated. Existing theories of depression, based on monoamine neurotransmitter system dysfunction, are insufficient as explanations of the disorder. Recent advances have implicated neuroinflammatory mechanisms in the etiology of depression and it has been demonstrated that inflammation at a peripheral level may be mirrored centrally in astrocytes and microglia serving to promote chronic levels of inflammation in the brain. Three major routes to depression in cancer in which proinflammatory mediators are implicated, seem likely. Activation of the kynurenine pathway involving cytokines, increases tryptophan catabolism, resulting in diminished levels of serotonin which is widely acknowledged as being the hallmark of depression. It also results in neurotoxic effects on brain regions thought to be involved in the evolution of major depression. Proinflammatory mediators also play a crucial role in impairing regulatory glucocorticoid mediated feedback of the hypothalamic-pituitary-adrenal axis, which is activated by stress and considered to be involved in both depression and cancer. The third route is via the glutamatergic pathway, whereby glutamate excitotoxicity may lead to depression associated with cancer. A better understanding of the mechanisms underlying these dysregulated and other newly emerging pathways may provide a rationale for therapeutic targeting, serving to improve the care of cancer patients.
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21
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Hoy-Ellis CP, Fredriksen-Goldsen KI, Kim HJ. Utilization of Recommended Preventive Health Screenings Between Transgender and Cisgender Older Adults in Sexual and Gender Minority Communities. J Aging Health 2022; 34:844-857. [PMID: 35112914 PMCID: PMC9706779 DOI: 10.1177/08982643211068557] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ObjectivesTransgender older adults are among the most health disparate populations in the United States; they also face some of the most significant barriers in accessing high quality, affordable, preventive healthcare services. We compare utilization rates of eight recommended preventive health screenings for adults aged 50 and older, by gender identity. Methods: We analyzed data from 2514 lesbian, gay, bisexual, and transgender adults aged 50 and older, testing associations between gender identities and screening service utilizations by applying a series of multivariate logistic regression analyses, controlling for sociodemographics. Results: Compared to cisgender LGB participants, transgender participants had significantly lower odds to have met four of the recommended screenings. Transgender men had significantly lower odds than transgender women to have met two of the recommended screenings. Discussion: Increasing transgender older adults' access to preventative health screening tests is critical to reduce the health burden in this aging population.
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22
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Tollenaar MSM, Pittner KK, Buisman RSMR, Knipping KK, Garssen JJ, Nimphy CAC, van den Berg LJML, Bolijn JEA, Alink LRAL, Elzinga BMB, Bakermans-Kranenburg MJM, IJzendoorn MHM. Salivary immune markers are not associated with self-reported childhood maltreatment or psychopathology in adults. Psychoneuroendocrinology 2022; 144:105867. [PMID: 35863154 DOI: 10.1016/j.psyneuen.2022.105867] [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: 04/27/2022] [Revised: 07/05/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psychological stress has repeatedly been found to be associated with pro-inflammatory markers in blood, and neuro-inflammation may play a role in the development of psychopathology after early life stress. Salivary immune testing is a novel method to non-invasively assess immune functioning. We examined a large range of salivary immune markers in relation to self-reported childhood maltreatment and psychopathology in an adult sample. METHODS Participants (N = 118, 51% female, mean age = 46.6 yrs, range 22-64) were drawn from a cross-sectional three-generation study, and supplied 2 ml of saliva via passive drool. They reported on childhood maltreatment experiences and on psychopathological symptoms in the last 6 months. Hair cortisol was additionally assessed in a subsample (n = 68). Levels of IL1ß, IL6, IL8, IFNγ, TNFα, tIgE, sIgA, FLCƛ, and FLCƙ were assessed. RESULTS Linear mixed model analyses showed that several salivary immune markers were associated with age (sIgA and IgE), BMI (sIgA, IL1ß, and IL6), sex (FLCs and IgE), and bad health (IL6, IL8, TNFα). No associations with (anti-inflammatory) medication use or oral health problems were found. Notably, no associations between the immune markers and self-reported childhood maltreatment, psychopathology, or hair cortisol were found. CONCLUSIONS Salivary immune measures were found to be sensitive to individual differences in age, sex, health and BMI. However. in the current sample there was no indication of inflammation in relation to chronic psychological stress. Larger studies, including participants with higher stress levels, are needed to further examine associations between salivary immune markers and psychological stress.
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Affiliation(s)
- M S Marieke Tollenaar
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.
| | - K Katharina Pittner
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - R S M Renate Buisman
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - K Karen Knipping
- Danone Nutricia Research, Utrecht, the Netherlands; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - J Johan Garssen
- Danone Nutricia Research, Utrecht, the Netherlands; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands
| | - C A Cosima Nimphy
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands
| | - L J M Lisa van den Berg
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands
| | - J E Annelies Bolijn
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands
| | - L R A Lenneke Alink
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands
| | - B M Bernet Elzinga
- Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands
| | - M J Marian Bakermans-Kranenburg
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands; Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Centre for Attachment Research, The New School, New York, United States
| | - M H Marinus IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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24
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Chandley MJ, Szebeni A, Szebeni K, Wang-Heaton H, Garst J, Stockmeier CA, Lewis NH, Ordway GA. Markers of elevated oxidative stress in oligodendrocytes captured from the brainstem and occipital cortex in major depressive disorder and suicide. Prog Neuropsychopharmacol Biol Psychiatry 2022; 117:110559. [PMID: 35452747 DOI: 10.1016/j.pnpbp.2022.110559] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
Major depressive disorder (MDD) and suicide have been associated with elevated indices of oxidative damage in the brain, as well as white matter pathology including reduced myelination by oligodendrocytes. Oligodendrocytes highly populate white matter and are inherently susceptible to oxidative damage. Pathology of white matter oligodendrocytes has been reported to occur in brain regions that process behaviors that are disrupted in MDD and that may contribute to suicidal behavior. The present study was designed to determine whether oligodendrocyte pathology related to oxidative damage extends to brain areas outside of those that are traditionally considered to contribute to the psychopathology of MDD and suicide. Relative telomere lengths and the gene expression of five antioxidant-related genes, SOD1, SOD2, GPX1, CAT, and AGPS were measured in oligodendrocytes laser captured from two non-limbic brain areas: occipital cortical white matter and the brainstem locus coeruleus. Postmortem brain tissues were obtained from brain donors that died by suicide and had an active MDD at the time of death, and from psychiatrically normal control donors. Relative telomere lengths were significantly reduced in oligodendrocytes of both brain regions in MDD donors as compared to control donors. Three antioxidant-related genes (SOD1, SOD2, GPX1) were significantly reduced and one was significantly elevated (AGPS) in oligodendrocytes from both brain regions in MDD as compared to control donors. These findings suggest that oligodendrocyte pathology in MDD and suicide is widespread in the brain and not restricted to brain areas commonly associated with depression psychopathology.
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Affiliation(s)
- Michelle J Chandley
- Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America.
| | - Attila Szebeni
- Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Katalin Szebeni
- Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Hui Wang-Heaton
- Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Jacob Garst
- Department of Chemistry, College of Arts and Sciences, East Tennessee State University, Johnson City, TN, United States of America
| | - Craig A Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Nicole H Lewis
- Department of Medical Education, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Gregory A Ordway
- Department of Biomedical Sciences, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
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25
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Perez NB, Vorderstrasse AA, Yu G, Melkus GD, Wright F, Ginsberg SD, Crusto CA, Sun YV, Taylor JY. Associations Between DNA Methylation Age Acceleration, Depressive Symptoms, and Cardiometabolic Traits in African American Mothers From the InterGEN Study. Epigenet Insights 2022; 15:25168657221109781. [PMID: 35784386 PMCID: PMC9247996 DOI: 10.1177/25168657221109781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
Background African American women (AAW) have a high risk of both cardiometabolic (CM) illness and depressive symptoms. Depressive symptoms co-occur in individuals with CM illness at higher rates than the general population, and accelerated aging may explain this. In this secondary analysis, we examined associations between age acceleration; depressive symptoms; and CM traits (hypertension, diabetes mellitus [DM], and obesity) in a cohort of AAW. Methods Genomic and clinical data from the InterGEN cohort (n = 227) were used. Age acceleration was based on the Horvath method of DNA methylation (DNAm) age estimation. Accordingly, DNAm age acceleration (DNAm AA) was defined as the residuals from a linear regression of DNAm age on chronological age. Spearman's correlations, linear and logistic regression examined associations between DNAm AA, depressive symptoms, and CM traits. Results DNAm AA did not associate with total depressive symptom scores. DNAm AA correlated with specific symptoms including self-disgust/self-hate (-0.13, 95% CI -0.26, -0.01); difficulty with making decisions (-0.15, 95% CI -0.28, -0.02); and worry over physical health (0.15, 95% CI 0.02, 0.28), but were not statistically significant after multiple comparison correction. DNAm AA associated with obesity (0.08, 95% CI 1.02, 1.16), hypertension (0.08, 95% CI 1.01, 1.17), and DM (0.20, 95% CI 1.09, 1.40), after adjustment for potential confounders. Conclusions Associations between age acceleration and depressive symptoms may be highly nuanced and dependent on study design contexts. Factors other than age acceleration may explain the connection between depressive symptoms and CM traits. AAW with CM traits may be at increased risk of accelerated aging.
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Affiliation(s)
| | | | - Gary Yu
- Rory Meyers College of Nursing, New
York University, New York, NY, USA
| | | | - Fay Wright
- Rory Meyers College of Nursing, New
York University, New York, NY, USA
| | - Stephen D Ginsberg
- Center for Dementia Research, Nathan
Kline Institute, Orangeburg, NY, USA
- NYU Grossman School of Medicine, New
York, NY, USA
| | - Cindy A Crusto
- Yale School of Medicine, Orange, CT,
USA
- Department of Psychology, University of
Pretoria, Pretoria, South Africa
| | - Yan V Sun
- Emory University School of Public
Health, Atlanta, GA, USA
- Atlanta VA Health Care System, Decatur,
GA, USA
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26
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Bobo WV, Grossardt BR, Virani S, St Sauver JL, Boyd CM, Rocca WA. Association of Depression and Anxiety With the Accumulation of Chronic Conditions. JAMA Netw Open 2022; 5:e229817. [PMID: 35499825 PMCID: PMC9062691 DOI: 10.1001/jamanetworkopen.2022.9817] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Longitudinal associations between comorbid depression and anxiety with the accumulation of chronic illnesses are unclear, and questions remain about the contributions associated with each condition in the increasing prevalence of multimorbidity. OBJECTIVE To compare the risk and rate of accumulating chronic conditions in people with depression, anxiety, and comorbid depression and anxiety vs individuals with neither depression nor anxiety. DESIGN, SETTING, AND PARTICIPANTS This cohort study used the Rochester Epidemiology Project medical records-linkage system to identify residents of Olmsted County, Minnesota, from January 1, 2005, to December 31, 2014, with follow-up ending December 31, 2017. The sample was divided into cohorts anchored at birthday ages of 20, 40, and 60 years. Individuals were classified at anchoring birthday age as having depression alone, anxiety alone, comorbid depression and anxiety, or neither depression nor anxiety (reference group), using electronically extracted diagnosis codes from the International Classification of Diseases, Ninth Revision (ICD-9) in the 5 years before each anchoring birthday. Data were analyzed from August 2020 through November 2021. EXPOSURES Depression alone, anxiety alone, comorbid depression and anxiety, or neither depression nor anxiety (reference group). MAIN OUTCOMES AND MEASURES The main outcome was sex-specific risk, calculated as hazard ratios (HRs) and rates of accumulation, calculated as mean annual incidence rates per 100 person-years, of 15 common chronic conditions within each birthday age cohort through the end of study. RESULTS Among the 40 360 individuals included across all 3 age cohorts, 21 516 (53.3%) were women. After balancing cohorts on race, Hispanic ethnicity, education level, body mass index, smoking status, and calendar year at index birthday, the risk of accumulating chronic conditions was significantly increased among women with depression alone (cohort aged 20 years: HR, 1.20 [95% CI, 1.02-1.42]; cohort aged 40 years: HR, 1.20 [95% CI, 1.10-1.31]; cohort aged 60 years: HR, 1.09 [95% CI, 1.02-1.16]) and women with comorbid depression and anxiety (cohort aged 20 years: HR, 1.60 [95% CI, 1.28-1.99]; cohort aged 40 years: HR, 1.41 [95% CI, 1.21-1.65]; cohort aged 60 years: HR, 1.29 [95% CI, 1.15-1.44]) compared with referent women in the same birthday cohorts and in men with comorbid depression and anxiety compared with referent men in the cohort aged 20 years (HR, 1.77 [95% CI, 1.08-2.91]). For women, the rates of accumulation of conditions were significantly higher across birthday cohorts in the comorbid depression and anxiety group compared with the depression alone group (eg, cohort aged 20 years: difference, 1.2 [95% CI, 0.2-2.1] per 100 person-years) and reference group (eg, cohort aged 20 years: difference, 1.7 [95% CI, 0.9-2.6] per 100 person-years). For men, compared with the reference group, the rates of accumulation of conditions were significantly higher in men with comorbid depression and anxiety in the cohort aged 20 years (difference, 1.4 [95% CI, 0.1-2.6] per 100 person-years) and in men with depression in the cohort aged 40 years (difference, 2.0 [95% CI, 0.8-3.2] per 100 person-years). CONCLUSIONS AND RELEVANCE In this cohort study, the risk of accumulating chronic conditions was increased with depression and comorbid depression and anxiety in women across the age span and in younger men with comorbid depression and anxiety. Compared with women without depression or anxiety, there was a more rapid rate of accumulation of chronic conditions in women with depression and anxiety individually and an even higher rate when depression and anxiety cooccurred.
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Affiliation(s)
- William V. Bobo
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville
| | - Brandon R. Grossardt
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Sanya Virani
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Jennifer L. St Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - Cynthia M. Boyd
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Walter A. Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
- Women’s Health Research Center, Mayo Clinic, Rochester, Minnesota
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27
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Ryan MC, Hong LE, Hatch KS, Gao S, Chen S, Haerian K, Wang J, Goldwaser EL, Du X, Adhikari BM, Bruce H, Hare S, Kvarta MD, Jahanshad N, Nichols TE, Thompson PM, Kochunov P. The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging. Hum Brain Mapp 2022; 43:1997-2010. [PMID: 35112422 PMCID: PMC8933252 DOI: 10.1002/hbm.25769] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/28/2021] [Accepted: 12/28/2021] [Indexed: 12/24/2022] Open
Abstract
Severe mental illnesses (SMI) including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia spectrum disorder (SSD) elevate accelerated brain aging risks. Cardio‐metabolic disorders (CMD) are common comorbidities in SMI and negatively impact brain health. We validated a linear quantile regression index (QRI) approach against the machine learning “BrainAge” index in an independent SSD cohort (N = 206). We tested the direct and additive effects of SMI and CMD effects on accelerated brain aging in the N = 1,618 (604 M/1,014 F, average age = 63.53 ± 7.38) subjects with SMI and N = 11,849 (5,719 M/6,130 F; 64.42 ± 7.38) controls from the UK Biobank. Subjects were subdivided based on diagnostic status: SMI+/CMD+ (N = 665), SMI+/CMD− (N = 964), SMI−/CMD+ (N = 3,765), SMI−/CMD− (N = 8,083). SMI (F = 40.47, p = 2.06 × 10−10) and CMD (F = 24.69, p = 6.82 × 10−7) significantly, independently impacted whole‐brain QRI in SMI+. SSD had the largest effect (Cohen’s d = 1.42) then BD (d = 0.55), and MDD (d = 0.15). Hypertension had a significant effect on SMI+ (d = 0.19) and SMI− (d = 0.14). SMI effects were direct, independent of MD, and remained significant after correcting for effects of antipsychotic medications. Whole‐brain QRI was significantly (p < 10−16) associated with the volume of white matter hyperintensities (WMH). However, WMH did not show significant association with SMI and was driven by CMD, chiefly hypertension (p < 10−16). We used a simple and robust index, QRI, the demonstrate additive effect of SMI and CMD on accelerated brain aging. We showed a greater effect of psychiatric illnesses on QRI compared to cardio‐metabolic illness. Our findings suggest that subjects with SMI should be among the targets for interventions to protect against age‐related cognitive decline.
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Affiliation(s)
- Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kathryn S Hatch
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Division of Biostatistics and Bioinformatics, Department of Public Health and Epidemiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Krystl Haerian
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA
| | - Jingtao Wang
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Eric L Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mark D Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Thomas E Nichols
- Nuffield Department of Population Health of the University of Oxford, Oxford, UK
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
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28
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Tang S, Wu Z, Cao H, Chen X, Wu G, Tan W, Liu D, Yang J, Long Y, Liu Z. Age-Related Decrease in Default-Mode Network Functional Connectivity Is Accelerated in Patients With Major Depressive Disorder. Front Aging Neurosci 2022; 13:809853. [PMID: 35082661 PMCID: PMC8785895 DOI: 10.3389/fnagi.2021.809853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Major depressive disorder (MDD) is a common psychiatric disorder which is associated with an accelerated biological aging. However, little is known whether such process would be reflected by a more rapid aging of the brain function. In this study, we tested the hypothesis that MDD would be characterized by accelerated aging of the brain's default-mode network (DMN) functions. Resting-state functional magnetic resonance imaging data of 971 MDD patients and 902 healthy controls (HCs) was analyzed, which was drawn from a publicly accessible, multicenter dataset in China. Strength of functional connectivity (FC) and temporal variability of dynamic functional connectivity (dFC) within the DMN were calculated. Age-related effects on FC/dFC were estimated by linear regression models with age, diagnosis, and diagnosis-by-age interaction as variables of interest, controlling for sex, education, site, and head motion effects. The regression models revealed (1) a significant main effect of age in the predictions of both FC strength and dFC variability; and (2) a significant main effect of diagnosis and a significant diagnosis-by-age interaction in the prediction of FC strength, which was driven by stronger negative correlation between age and FC strength in MDD patients. Our results suggest that (1) both healthy participants and MDD patients experience decrease in DMN FC strength and increase in DMN dFC variability along age; and (2) age-related decrease in DMN FC strength may occur at a faster rate in MDD patients than in HCs. However, further longitudinal studies are still needed to understand the causation between MDD and accelerated aging of brain.
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Affiliation(s)
- Shixiong Tang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Medical Imaging in Hunan Province, Changsha, China
| | - Zhipeng Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, United States
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, United States
| | - Xudong Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Guowei Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenjian Tan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Dayi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jie Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yicheng Long
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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29
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Bougea A, Anagnostouli M, Angelopoulou E, Spanou I, Chrousos G. Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies. J Geriatr Psychiatry Neurol 2022; 35:24-37. [PMID: 33205677 DOI: 10.1177/0891988720973759] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stress has deleterious effects on brain health and yet, the prognostic value of psychosocial stress regarding the most common types of dementias, including Alzheimer disease, is still unclear. The primary aim of this systematic review was to explore the association between psychosocial stress and late onset dementia. We classified 24articles from Medline, PsycINFO, CINAHL, and Web of Science, as pertaining toxic categories of psychosocial and trauma-related stress (low socio-economic status [SES] related inequalities, marital status, posttraumatic stress disorder, work stress, "vital exhaustion" [VE], and, combined stressors). Using the Quality of Prognosis Studies in Systematic Reviews tool, we judged the quality of evidence to be low. This systematic review provided some non-robust, yet suggestive evidence that the above psychosocial types of stress are associated with increased risk of dementia in later life. Future robust, longitudinal studies with repeated validated measures of psychosocial stress and dementiaare required to strengthen or refute these findings.
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Affiliation(s)
- Anastasia Bougea
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Demyelinating Diseases Clinic, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Efthalia Angelopoulou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Spanou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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30
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Lahav Y, Avidor S, Levy D, Ohry A, Zeilig G, Lahav M, Golander H, Chacham-Guber A, Uziel O, Defrin R. Shorter telomeres among individuals with physical disability: The moderating role of perceived stress. J Gerontol B Psychol Sci Soc Sci 2021; 77:1384-1393. [PMID: 34687310 DOI: 10.1093/geronb/gbab200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Evidence suggests that individuals with physical disability may suffer from psychological distress and accelerated cellular aging, manifested by shortened telomere length (TL), compared with healthy individuals. Studies indicate that high levels of perceived stress and depression may increase the physiological susceptibility and thus, may contribute to a short TL. However, the moderating role of perceived stress and depression within the relationship between physical disability and TL remains unknown. METHODS The participants consisted of 119 male subjects (mean age 54.36 years, range 35-70). Of them, 30 were able-bodied and 86 had a physical disability: 34 were due to Poliomyelitis (polio) and 55 were due to spinal cord injury (SCI). Blood samples for TL analysis were collected; the participants completed questionnaires and underwent disability evaluation. RESULTS Participants with disability had a shorter TL as well as elevated levels of perceived stress and depression compared with able-bodied controls. Both the perceived stress and depression were correlated with a shorter TL. Nonetheless, perceived stress, rather than depression, moderated the relationship between disability and TL; among participants with higher perceived stress levels, in particular, individuals with physical disability had a shorter TL than the able-bodied controls. DISCUSSION The present findings suggest that individuals with physical disability and who exhibit high levels of perceived stress may be particularly vulnerable for accelerated cellular aging, suggesting that perceived stress can be used as a valuable target for intervention.
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Affiliation(s)
- Yael Lahav
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | - Sharon Avidor
- Faculty of Social and Community Sciences, Ruppin Academic Center
| | - David Levy
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | - Avi Ohry
- Section of Rehabilitation Medicine, Reuth Medical and Rehabilitation Center, Tel Aviv.,Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer.,Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University
| | - Meir Lahav
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva
| | - Hava Golander
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | | | - Orit Uziel
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva
| | - Ruth Defrin
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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31
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Martínez-Magaña JJ, Genis-Mendoza AD, Santana D, Tóvilla-Zárate CA, Lanzagorta N, Nicolini H. [The presence of a psychiatric diagnosis could alter the epigenetic clock in monozygotic twins]. Rev Esp Geriatr Gerontol 2021; 56:361-363. [PMID: 34583863 DOI: 10.1016/j.regg.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The acceleration of the epigenetic clock has been associated with a reduction in life expectancy. Individuals diagnosed with a psychiatric disorder have a reduction in life expectancy, and some studies have correlated it with accelerated aging. OBJECTIVE The present study aims to explore whether the presence of any psychiatric disorder could accelerate the epigenetic clock in monozygotic twins. METHODS A total of 15 pairs of monozygotic twins were included. Epigenetic age in peripheral blood cells was estimated by previously published algorithms, using the 450K Beadchip microarray. RESULTS We found that in twins with a diagnosis of a psychiatric disorder, the epigenetic clock could increase compared to their twin without a psychiatric disorder. DISCUSSION AND CONCLUSION The presence of some psychiatric disorder could accelerate the epigenetic clock in homozygous twins, but studies with larger samples are required to clarify this relationship.
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Affiliation(s)
- José Jaime Martínez-Magaña
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México; Servicios de Atención Psiquiátrica, Hospital Psiquiátrico Infantil Juan N. Navarro, Ciudad de México, México
| | - Daniel Santana
- Clínica de Trastornos del Sueño, Universidad Nacional Autonóma de México, Ciudad de México, México
| | - Carlos Alfonso Tóvilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México
| | - Nuria Lanzagorta
- División de Investigación, Departamento de Psiquiatría, Grupo de Estudios Médicos y Familiares Carracci, Ciudad de México, México
| | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, México; División de Investigación, Departamento de Psiquiatría, Grupo de Estudios Médicos y Familiares Carracci, Ciudad de México, México.
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32
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Hough CM, Bersani FS, Mellon SH, Morford AE, Lindqvist D, Reus VI, Epel ES, Wolkowitz OM. Pre-treatment allostatic load and metabolic dysregulation predict SSRI response in major depressive disorder: a preliminary report. Psychol Med 2021; 51:2117-2125. [PMID: 32438932 DOI: 10.1017/s0033291720000896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with increased allostatic load (AL; a measure of physiological costs of repeated/chronic stress-responding) and metabolic dysregulation (MetD; a measure of metabolic health and precursor to many medical illnesses). Though AL and MetD are associated with poor somatic health outcomes, little is known regarding their relationship with antidepressant-treatment outcomes. METHODS We determined pre-treatment AL and MetD in 67 healthy controls and 34 unmedicated, medically healthy MDD subjects. Following this, MDD subjects completed 8-weeks of open-label selective serotonin reuptake inhibitor (SSRI) antidepressant treatment and were categorized as 'Responders' (⩾50% improvement in depression severity ratings) or 'Non-responders' (<50% improvement). Logistic and linear regressions were performed to determine if pre-treatment AL or MetD scores predicted SSRI-response. Secondary analyses examined cross-sectional differences between MDD and control groups. RESULTS Pre-treatment AL and MetD scores significantly predicted continuous antidepressant response (i.e. absolute decreases in depression severity ratings) (p = 0.012 and 0.014, respectively), as well as post-treatment status as a Responder or Non-responder (p = 0.022 and 0.040, respectively), such that higher pre-treatment AL and MetD were associated with poorer SSRI-treatment outcomes. Pre-treatment AL and MetD of Responders were similar to Controls, while those of Non-responders were significantly higher than both Responders (p = 0.025 and 0.033, respectively) and Controls (p = 0.039 and 0.001, respectively). CONCLUSIONS These preliminary findings suggest that indices of metabolic and hypothalamic-pituitary-adrenal-axis dysregulation are associated with poorer SSRI-treatment response. To our knowledge, this is the first study to demonstrate that these markers of medical disease risk also predict poorer antidepressant outcomes.
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Affiliation(s)
- Christina M Hough
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - F Saverio Bersani
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Sciences, UCSF School of Medicine, San Francisco, CA, USA
| | - Alexandra E Morford
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniel Lindqvist
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
- Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Victor I Reus
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
| | - Owen M Wolkowitz
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA, USA
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33
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Mendes-Silva AP, Vieira ELM, Xavier G, Barroso LSS, Bertola L, Martins EAR, Brietzke EM, Belangero SIN, Diniz BS. Telomere shortening in late-life depression: A potential marker of depression severity. Brain Behav 2021; 11:e2255. [PMID: 34152095 PMCID: PMC8413729 DOI: 10.1002/brb3.2255] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/07/2021] [Accepted: 06/05/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Telomeres are structures at the extremity of chromosomes that prevents genomic instability, and its shortening seems to be a hallmark of cellular aging. Past studies have shown contradictory results of telomere length (TL) in major depression, and are a few studies in late-life depression (LLD). This explores the association between TL as a molecular marker of aging and diagnosis of LLD, the severity of depressive symptoms, and cognitive performance in older adults. METHODS/DESIGN We included 78 older adults (45 with LLD and 33 nondepressed controls, according to DSM-V criteria), aged 60-90 years. TL was measured in leukocytes by a quantitative polymerase chain reaction, determining the relative ratio (T/S) between the telomere region copy number (T) and a single copy gene (S), using a relative standard curve. RESULTS TL was significantly shorter in the LLD compared with control participants (p = .039). Comparing groups through the severity of depressive symptoms, we found a negative correlation with the severity of depressive symptoms (Hamilton Depression Rating Scale-21, r = -0.325, p = .004) and medical burden (r = -0.271, p = .038). There was no significant correlation between TL and cognitive performance (Mattis Dementia Rating Scale, r = 0.152, p = .21). CONCLUSIONS We found that older adults with LLD have shorter telomere than healthy controls, especially those with a more severe depressive episode. Our findings suggest that shorter TL can be a marker of the severity of depressive episodes in older adults and indicate that these individuals may be at higher risk of age-associated adverse outcomes linked to depression.
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Affiliation(s)
| | | | - Gabriela Xavier
- Department of Morphology and Genetics, Federal University of São Paulo, São Paulo, São Paulo, Brazil.,LINC-Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Lucelia Scarabeli Silva Barroso
- Graduate Program in Molecular Medicine, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Minas Gerais, Brazil
| | - Laiss Bertola
- Graduate Program in Molecular Medicine, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Minas Gerais, Brazil
| | - Efrem Augusto Ribeiro Martins
- Graduate Program in Molecular Medicine, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Minas Gerais, Brazil
| | - Elisa Macedo Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Ontario, Canada.,Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Ontario, Canada
| | - Sintia Iole Nogueira Belangero
- Department of Morphology and Genetics, Federal University of São Paulo, São Paulo, São Paulo, Brazil.,LINC-Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Breno Satler Diniz
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut, USA.,Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
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34
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Pousa PA, Souza RM, Melo PHM, Correa BHM, Mendonça TSC, Simões-e-Silva AC, Miranda DM. Telomere Shortening and Psychiatric Disorders: A Systematic Review. Cells 2021; 10:1423. [PMID: 34200513 PMCID: PMC8227190 DOI: 10.3390/cells10061423] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/23/2022] Open
Abstract
Telomeres are aging biomarkers, as they shorten while cells undergo mitosis. The aim of this study was to evaluate whether psychiatric disorders marked by psychological distress lead to alterations to telomere length (TL), corroborating the hypothesis that mental disorders might have a deeper impact on our physiology and aging than it was previously thought. A systematic search of the literature using MeSH descriptors of psychological distress ("Traumatic Stress Disorder" or "Anxiety Disorder" or "depression") and telomere length ("cellular senescence", "oxidative stress" and "telomere") was conducted on PubMed, Cochrane Library and ScienceDirect databases. A total of 56 studies (113,699 patients) measured the TL from individuals diagnosed with anxiety, depression and posttraumatic disorders and compared them with those from healthy subjects. Overall, TL negatively associates with distress-related mental disorders. The possible underlying molecular mechanisms that underly psychiatric diseases to telomere shortening include oxidative stress, inflammation and mitochondrial dysfunction linking. It is still unclear whether psychological distress is either a cause or a consequence of telomere shortening.
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Affiliation(s)
- Pedro A. Pousa
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Raquel M. Souza
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Paulo Henrique M. Melo
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Bernardo H. M. Correa
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Tamires S. C. Mendonça
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Ana Cristina Simões-e-Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 30130-100, Brazil; (P.A.P.); (R.M.S.); (P.H.M.M.); (B.H.M.C.); (T.S.C.M.); (A.C.S.-e.-S.)
| | - Débora M. Miranda
- Department of Pediatrics, Laboratory of Molecular Medicine, UFMG, Belo Horizonte, Minas Gerais 30130-100, Brazil
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Rackova L, Mach M, Brnoliakova Z. An update in toxicology of ageing. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 84:103611. [PMID: 33581363 DOI: 10.1016/j.etap.2021.103611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
The field of ageing research has been rapidly advancing in recent decades and it had provided insight into the complexity of ageing phenomenon. However, as the organism-environment interaction appears to significantly affect the organismal pace of ageing, the systematic approach for gerontogenic risk assessment of environmental factors has yet to be established. This puts demand on development of effective biomarker of ageing, as a relevant tool to quantify effects of gerontogenic exposures, contingent on multidisciplinary research approach. Here we review the current knowledge regarding the main endogenous gerontogenic pathways involved in acceleration of ageing through environmental exposures. These include inflammatory and oxidative stress-triggered processes, dysregulation of maintenance of cellular anabolism and catabolism and loss of protein homeostasis. The most effective biomarkers showing specificity and relevancy to ageing phenotypes are summarized, as well. The crucial part of this review was dedicated to the comprehensive overview of environmental gerontogens including various types of radiation, certain types of pesticides, heavy metals, drugs and addictive substances, unhealthy dietary patterns, and sedentary life as well as psychosocial stress. The reported effects in vitro and in vivo of both recognized and potential gerontogens are described with respect to the up-to-date knowledge in geroscience. Finally, hormetic and ageing decelerating effects of environmental factors are briefly discussed, as well.
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Affiliation(s)
- Lucia Rackova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia.
| | - Mojmir Mach
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
| | - Zuzana Brnoliakova
- Institute of Experimental Pharmacology and Toxicology, Centre of Experimental Medicine, Slovak Academy of Sciences, Dubravska cesta 9, 841 04 Bratislava, Slovakia
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36
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Merz MP, Turner JD. Is early life adversity a trigger towards inflammageing? Exp Gerontol 2021; 150:111377. [PMID: 33905877 DOI: 10.1016/j.exger.2021.111377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Abstract
There are many 'faces' of early life adversity (ELA), such as childhood trauma, institutionalisation, abuse or exposure to environmental toxins. These have been implicated in the onset and severity of a wide range of chronic non-communicable diseases later in life. The later-life disease risk has a well-established immunological component. This raises the question as to whether accelerated immune-ageing mechanistically links early-life adversity to the lifelong health trajectory resulting in either 'poor' or 'healthy' ageing. Here we examine observational and mechanistic studies of ELA and inflammageing, highlighting common and distinct features in these two life stages. Many biological processes appear in common including reduction in telomere length, increased immunosenescence, metabolic distortions and chronic (viral) infections. We propose that ELA shapes the developing immune, endocrine and nervous system in a non-reversible way, creating a distinct phenotype with accelerated immunosenescence and systemic inflammation. We conclude that ELA might act as an accelerator for inflammageing and age-related diseases. Furthermore, we now have the tools and cohorts to be able to dissect the interaction between ELA and later life phenotype. This should, in the near future, allow us to identify the ecological and mechanistic processes that are involved in 'healthy' or accelerated immune-ageing.
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Affiliation(s)
- Myriam P Merz
- Immune Endocrine and Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg; Faculty of Science, Technology and Medicine, University of Luxembourg, 2 avenue de Université, L-4365 Esch-sur-Alzette, Luxembourg
| | - Jonathan D Turner
- Immune Endocrine and Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg.
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37
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"GrimAge," an epigenetic predictor of mortality, is accelerated in major depressive disorder. Transl Psychiatry 2021; 11:193. [PMID: 33820909 PMCID: PMC8021561 DOI: 10.1038/s41398-021-01302-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/21/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022] Open
Abstract
Major depressive disorder (MDD) is associated with premature mortality and is an independent risk factor for a broad range of diseases, especially those associated with aging, such as cardiovascular disease, diabetes, and Alzheimer's disease. However, the pathophysiology underlying increased rates of somatic disease in MDD remains unknown. It has been proposed that MDD represents a state of accelerated cellular aging, and several measures of cellular aging have been developed in recent years. Among such metrics, estimators of biological age based on predictable age-related patterns of DNA methylation (DNAm), so-called 'epigenetic clocks', have shown particular promise for their ability to capture accelerated aging in psychiatric disease. The recently developed DNAm metric known as 'GrimAge' is unique in that it was trained on time-to-death data and has outperformed its predecessors in predicting both morbidity and mortality. Yet, GrimAge has not been investigated in MDD. Here we measured GrimAge in 49 somatically healthy unmedicated individuals with MDD and 60 age-matched healthy controls. We found that individuals with MDD exhibited significantly greater GrimAge relative to their chronological age ('AgeAccelGrim') compared to healthy controls (p = 0.001), with a median of 2 years of excess cellular aging. This difference remained significant after controlling for sex, current smoking status, and body-mass index (p = 0.015). These findings are consistent with prior suggestions of accelerated cellular aging in MDD, but are the first to demonstrate this with an epigenetic metric predictive of premature mortality.
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Bobo WV, Ryu E, Petterson TM, Lackore K, Cheng Y, Liu H, Suarez L, Preisig M, Cooper LT, Roger VL, Pathak J, Chamberlain AM. Bi-directional association between depression and HF: An electronic health records-based cohort study. JOURNAL OF COMORBIDITY 2021; 10:2235042X20984059. [PMID: 33489926 PMCID: PMC7768856 DOI: 10.1177/2235042x20984059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/21/2020] [Accepted: 12/05/2020] [Indexed: 11/16/2022]
Abstract
Objective: To determine whether a bi-directional relationship exists between depression and HF within a single population of individuals receiving primary care services, using longitudinal electronic health records (EHRs). Methods: This retrospective cohort study utilized EHRs for adults who received primary care services within a large healthcare system in 2006. Validated EHR-based algorithms identified 10,649 people with depression (depression cohort) and 5,911 people with HF (HF cohort) between January 1, 2006 and December 31, 2018. Each person with depression or HF was matched 1:1 with an unaffected referent on age, sex, and outpatient service use. Each cohort (with their matched referents) was followed up electronically to identify newly diagnosed HF (in the depression cohort) and depression (in the HF cohort) that occurred after the index diagnosis of depression or HF, respectively. The risks of these outcomes were compared (vs. referents) using marginal Cox proportional hazard models adjusted for 16 comorbid chronic conditions. Results: 2,024 occurrences of newly diagnosed HF were observed in the depression cohort and 944 occurrences of newly diagnosed depression were observed in the HF cohort over approximately 4–6 years of follow-up. People with depression had significantly increased risk for developing newly diagnosed HF (HR 2.08, 95% CI 1.89–2.28) and people with HF had a significantly increased risk of newly diagnosed depression (HR 1.34, 95% CI 1.17–1.54) after adjusting for all 16 comorbid chronic conditions. Conclusion: These results provide evidence of a bi-directional relationship between depression and HF independently of age, sex, and multimorbidity from chronic illnesses.
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Affiliation(s)
- William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Tanya M Petterson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Kandace Lackore
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Yijing Cheng
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Division of Digital Health Science, Mayo Clinic, Rochester, MN, USA
| | - Laura Suarez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Leslie T Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Veronique L Roger
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jyotishman Pathak
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, NY, USA
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39
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Ekbäck E, Granåsen G, Svärling R, Blomqvist I, Henje E. Clinical Effectiveness of Training for Awareness Resilience and Action Online Compared to Standard Treatment for Adolescents and Young Adults With Depression: Study Protocol and Analysis Plan for a Pragmatic, Multi-Center Randomized Controlled Superiority Trial. Front Psychiatry 2021; 12:674583. [PMID: 34707516 PMCID: PMC8542661 DOI: 10.3389/fpsyt.2021.674583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/10/2021] [Indexed: 01/21/2023] Open
Abstract
Depression in adolescents and young adults is an increasing global health concern. Available treatments are not sufficiently effective and relapse rates remain high. The novel group-treatment program "Training for Awareness, Resilience and Action" (TARA) targets specific mechanisms based on neuroscientific findings in adolescent depression. TARA is framed within the National Institute of Mental Health's Research Domain Criteria and has documented feasibility and preliminary efficacy in the treatment of adolescent depression. Since neurodevelopment continues well into the mid-twenties, age-adapted treatments are warranted also for young adults. Patients 15-22 years old, with either major depressive disorder (MDD) or persistent depressive disorder (PDD) according to the DSM-IV/5 or a rating >40 on the clinician rating scale Children's Depression Rating Scale-Revised (CDRS-R), will be recruited from specialized Child and Adolescent Psychiatry and local Youth-Clinics and randomized to either TARA or standard treatment, including but not limited to antidepressant medication and/or psychotherapy. Outcome measures will be obtained before randomization (T0), after 3 months of treatment (T1) and at 6-months- (T2) and 24-months- (T3) follow-up. Additionally, dose-response measures will be obtained weekly in the TARA-arm and measures for mediation-analysis will be obtained halfway through treatment (T0.5). Primary outcome measure is Reynolds Adolescent Depression Scale (RADS-2) score at T1. Secondary outcome measures include RADS-2 score at T2, Multidimensional Anxiety Scale for Children at T1 and T2, and CDRS-R at T1. Additional outcome measures include self-report measures of depression-associated symptoms, systemic bio-indicators of depression from blood and hair, heartrate variability, brain magnetic resonance imaging, as well as three-axial accelerometry for sleep-objectivization. Qualitative data will be gathered to reach a more comprehensive understanding of the factors affecting adolescents and young adults with depression and the extent to which the different treatments address these factors. In summary, this article describes the design, methods and statistical analysis plan for pragmatically evaluating the clinical effectiveness of TARA. This will be the first RCT to examine the effects of TARA compared to standard treatment for adolescents and young adults with MDD or PDD. We argue that this study will extend the current knowledgebase regarding the treatment of depression. NCT Registration: identifier [NCT04747340].
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Affiliation(s)
- Erik Ekbäck
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Gabriel Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rachel Svärling
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Ida Blomqvist
- Department of Clinical Science, Umeå University, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Umeå University, Umeå, Sweden
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PBMC telomerase activity in depression and the response to electroconvulsive therapy. Eur Arch Psychiatry Clin Neurosci 2021; 271:1297-1307. [PMID: 34268617 PMCID: PMC8429154 DOI: 10.1007/s00406-021-01294-4] [Citation(s) in RCA: 1] [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: 02/23/2021] [Accepted: 07/04/2021] [Indexed: 12/02/2022]
Abstract
Telomerase, the DNA polymerase responsible for maintaining telomere length, has previously been implicated in depression and the response to antidepressant drugs. In this study, we aimed to compare telomerase activity in peripheral blood mononuclear cells between patients with severe depression recruited as part of the KEEP-WELL Trial (Ketamine for Depression Relapse Prevention Following ECT; NCT02414932) and age- and sex-matched healthy volunteers both at baseline/pre-ECT and at follow-up 1 month later for controls or in patients after a course of ECT. We found no differences in telomerase activity between patients with depression (n = 20) compared to healthy controls (n = 33) at baseline/pre-ECT, or between patients treated with ECT compared to controls at follow-up. In patients, telomerase activity was not associated with mood, as assessed by the 24-item Hamilton Rating Scale for Depression, or the duration of the current depressive episode. Additionally, we found no significant relationship between telomerase activity and exposure to recent or childhood adversity in either the patient or control groups. Overall, our results suggest that telomerase activity is not associated with depression, the therapeutic response to ECT, or exposure to adversity.
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de Nooij L, Harris MA, Hawkins EL, Clarke TK, Shen X, Chan SWY, Ziermans TB, McIntosh AM, Whalley HC. Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder from the Scottish Bipolar Family Study. Wellcome Open Res 2020; 4:206. [PMID: 32954013 PMCID: PMC7479500 DOI: 10.12688/wellcomeopenres.15617.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/14/2023] Open
Abstract
Background: Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain ageing. Currently, it remains unclear whether young individuals show differential brain structure aging trajectories associated with onset of mood disorder and/or presence of familial risk. Methods: Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well, n = 93), (ii) high familial risk who remained well (HR-well, n = 74) and (iii) high familial risk who developed a mood disorder (HR-MD, n = 35). Results: At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well ( β = -0.60, p corrected < 0.001) and HR-well ( β = -0.36, p corrected = 0.02), with a potential intermediate trajectory for HR-well ( β = -0.24 years, p corrected = 0.06). Conclusions: These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure aging trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
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Affiliation(s)
- Laura de Nooij
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Emma L. Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Stella W. Y. Chan
- Section of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Tim B. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Diagnosis-independent loss of T-cell costimulatory molecules in individuals with cytomegalovirus infection. Brain Behav Immun 2020; 87:795-803. [PMID: 32209361 PMCID: PMC7594105 DOI: 10.1016/j.bbi.2020.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/31/2020] [Accepted: 03/15/2020] [Indexed: 12/12/2022] Open
Abstract
Major depressive disorder (MDD) is associated with physiological changes commonly observed with increasing age, such as inflammation and impaired immune function. Age-related impaired adaptive immunity is characterized by the loss of naive T-cells and the reciprocal accumulation of memory T-cells together with the loss of T-cell co-stimulatory molecules. Additionally, the presence and activity of cytomegalovirus (CMV) alters the architecture of the T-cell compartment in a manner consistent with premature aging. Because CMV is also thought to reactivate with psychological stress, this study tested whether MDD influences age-related phenotypes of T-cell populations in the context of CMV infection in young and middle-aged adults. Morning blood samples from volunteers with a DSM-IV diagnosis of MDD (n = 98, mean age(SD) = 36(10) years, 74.5% female, 57.1% CMV+) and comparison controls (n = 98, mean age(SD) = 34(10) years, 68.4% female, 51.0% CMV+) were evaluated for CMV IgG antibody status and the distribution of late differentiated (CD27-CD28-) cells within CD4+ and CD8+ T-cell subsets, i.e. naive (CCR7+CD45RA+), effector memory (EM, CCR7-CD45RA-), central memory (CM, CCR7+CD45RA-) and effector memory cells re-expressing CD45RA (EMRA, CCR7-CD45RA+). Mixed linear regression models controlling for age, sex, ethnicity and flow cytometry batch showed that CMV seropositivity was associated with a reduction in naive T-cells, expansion of EMRA T-cells, and a greater percent distribution of CD27-CD28- cells within CD4+ and CD8+ memory T-cell subsets (p's < 0.004), but there was no significant effect of MDD, nor any significant interaction between CMV and diagnosis. Unexpectedly, depressed men were less likely to be CMV+ and depressed women were more likely to be CMV+ than sex-matched controls suggesting a possible interaction between sex and MDD on CMV susceptibility, but this three-way interaction did not significantly affect the T-cell subtypes. Our findings suggest that depression in young and middle-aged adults does not prematurely advance aging of the T-cell compartment independently of CMV, but there may be significant sex-specific effects on adaptive immunity that warrant further investigation.
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Bersani FS, Canevelli M, Cesari M, Maggioni E, Pasquini M, Wolkowitz OM, Ferracuti S, Biondi M, Bruno G. Frailty Index as a clinical measure of biological age in psychiatry. J Affect Disord 2020; 268:183-187. [PMID: 32174476 DOI: 10.1016/j.jad.2020.03.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/25/2020] [Accepted: 03/04/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serious mental illnesses may be characterized by accelerated biological aging, and over the last years the research on the topic has been stimulated by studies exploring the molecular underpinnings of senescence. METHODS In the present manuscript we propose that measuring frailty, a general product of organismal ageing, through the "Frailty Index" (FI), a recently-emerged macroscopic indicator of functional status and biological age, adds an important marker to the measurements currently implemented in the study of accelerated biological age in psychiatric illnesses. RESULTS The FI quantifies functional negative health attributes and measures their cumulative effect, thus providing a useful estimate of the individual's biological age and risk profile. Recent studies in older adults have observed significant associations between FI and molecular measures of aging. LIMITATIONS High FI values can be driven by causes different from aging per se, so FI may be a sensitive but not specific measure of biological aging. CONCLUSIONS FI, which is extensively used in geriatrics and gerontology but it has rarely been used in relation to mental health, may be of relevance in the evaluation of age-related phenomena associated with psychiatric diseases.
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Affiliation(s)
| | - Marco Canevelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Matteo Cesari
- Fondazione IRCCS Ca, Granda Ospedale Maggiore Policlinico, Milan, Italy; Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, USA
| | - Stefano Ferracuti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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de Nooij L, Harris MA, Hawkins EL, Clarke TK, Shen X, Chan SWY, Ziermans TB, McIntosh AM, Whalley HC. Longitudinal trajectories of brain age in young individuals at familial risk of mood disorder. Wellcome Open Res 2019; 4:206. [PMID: 32954013 PMCID: PMC7479500 DOI: 10.12688/wellcomeopenres.15617.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2019] [Indexed: 11/14/2023] Open
Abstract
Background: Within young individuals, mood disorder onset may be related to changes in trajectory of brain structure development. To date, however, longitudinal prospective studies remain scarce and show partly contradictory findings, with a lack of emphasis on changes at the level of global brain patterns. Cross-sectional adult studies have applied such methods and show that mood disorders are associated with accelerated brain ageing. Currently, it remains unclear whether young individuals show differential brain structure ageing trajectories associated with onset of mood disorder and/or presence of familial risk. Methods: Participants included young individuals (15-30 years, 53%F) from the prospective longitudinal Scottish Bipolar Family Study with and without close family history of mood disorder. All were well at time of recruitment. Implementing a structural MRI-based brain age prediction model, we globally assessed individual trajectories of age-related structural change using the difference between predicted brain age and chronological age (brain-predicted age difference (brain-PAD)) at baseline and at 2-year follow-up. Based on follow-up clinical assessment, individuals were categorised into three groups: (i) controls who remained well (C-well, n = 93), (ii) high familial risk who remained well (HR-well, n = 74) and (iii) high familial risk who developed a mood disorder (HR-MD, n = 35). Results: At baseline, brain-PAD was comparable between groups. Results showed statistically significant negative trajectories of brain-PAD between baseline and follow-up for HR-MD versus C-well ( β = -0.60, p corrected < 0.001) and HR-well ( β = -0.36, p corrected = 0.02), with a potential intermediate trajectory for HR-well ( β = -0.24 years, p corrected = 0.06). Conclusions: These preliminary findings suggest that within young individuals, onset of mood disorder and familial risk may be associated with a deceleration in brain structure ageing trajectories. Extended longitudinal research will need to corroborate findings of emerging maturational lags in relation to mood disorder risk and onset.
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Affiliation(s)
- Laura de Nooij
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Emma L. Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Stella W. Y. Chan
- Section of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Tim B. Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Muneer A, Minhas FA. Telomere Biology in Mood Disorders: An Updated, Comprehensive Review of the Literature. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:343-363. [PMID: 31352701 PMCID: PMC6705109 DOI: 10.9758/cpn.2019.17.3.343] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/28/2019] [Accepted: 04/15/2019] [Indexed: 12/19/2022]
Abstract
Major psychiatric disorders are linked to early mortality and patients afflicted with these ailments demonstrate an increased risk of developing physical diseases that are characteristically seen in the elderly. Psychiatric conditions like major depressive disorder, bipolar disorder and schizophrenia may be associated with accelerated cellular aging, indicated by shortened leukocyte telomere length (LTL), which could underlie this connection. Telomere shortening occurs with repeated cell division and is reflective of a cell’s mitotic history. It is also influenced by cumulative exposure to inflammation and oxidative stress as well as the availability of telomerase, the telomere-lengthening enzyme. Precariously short telomeres can cause cells to undergo senescence, apoptosis or genomic instability; shorter LTL correlates with compromised general health and foretells mortality. Important data specify that LTL may be reduced in principal psychiatric illnesses, possibly in proportion to exposure to the ailment. Telomerase, as measured in peripheral blood monocytes, has been less well characterized in psychiatric illnesses, but a role in mood disorder has been suggested by preclinical and clinical studies. In this manuscript, the most recent studies on LTL and telomerase activity in mood disorders are comprehensively reviewed, potential mediators are discussed, and future directions are suggested. An enhanced comprehension of cellular aging in psychiatric illnesses could lead to their re-conceptualizing as systemic ailments with manifestations both inside and outside the brain. At the same time this paradigm shift could identify new treatment targets, helpful in bringing about lasting cures to innumerable sufferers across the globe.
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Affiliation(s)
- Ather Muneer
- Department of Psychiatry, Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
| | - Fareed Aslam Minhas
- Department of Psychiatry, WHO Collaborating Center, Rawalpindi Medical University, Rawalpindi, Pakistan
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46
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Amen DG, Egan S, Meysami S, Raji CA, George N. Patterns of Regional Cerebral Blood Flow as a Function of Age Throughout the Lifespan. J Alzheimers Dis 2019; 65:1087-1092. [PMID: 30103336 DOI: 10.3233/jad-180598] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Understanding the influence of aging on the brain remains a challenge in determining its role as a risk factor for Alzheimer's disease. OBJECTIVE To identify patterns of aging in a large neuroimaging cohort. METHODS A large psychiatric cohort of 31,227 individuals received brain SPECT at rest and during a concentration task for a total of 62,454 scans. ANOVA was done to identify the mean age trends over the course of the age range in this group, 0-105 years. A regression model in which brain SPECT regions of interest was used to predict chronological age (CA) was then utilized to derive brain estimated age (BEA). The difference between CA and BEA was calculated to determine increased brain aging in common disorders in our sample such as depression, dementia, substance use, and anxiety. RESULTS Throughout the lifespan, variations in perfusion were observed in childhood, adolescence, and late life. Increased brain aging was seen in alcohol use, cannabis use, anxiety, bipolar, schizophrenia, attention-deficit/hyperactivity disorder, and in men. CONCLUSION Brain SPECT can predict chronological age and this feature varies as a function of common psychiatric disorders.
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47
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Kalungi A, Womersley JS, Kinyanda E, Joloba ML, Ssembajjwe W, Nsubuga RN, Levin J, Kaleebu P, Kidd M, Seedat S, Hemmings SMJ. Internalizing Mental Disorders and Accelerated Cellular Aging Among Perinatally HIV-Infected Youth in Uganda. Front Genet 2019; 10:705. [PMID: 31428136 PMCID: PMC6688656 DOI: 10.3389/fgene.2019.00705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 07/03/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction: Internalizing mental disorders (IMDs) in HIV+ children and adolescents are associated with impaired quality of life and non-adherence to anti-retroviral treatment. Telomere length is a biomarker of cellular aging, and shorter telomere length has been associated with IMDs. However, the nature of this association has yet to be elucidated. Objective: We determined the longitudinal association between IMDs and relative telomere length (rTL) and the influence of chronic stress among Ugandan perinatally HIV-infected youth (PHIY). Methods: IMDs (depressive disorders, anxiety disorders, and post-traumatic stress disorder) and IMDs were assessed using the locally adapted Child and Adolescent Symptom Inventory-5. In 368 PHIY with any IMD and 368 age- and sex-matched PHIY controls without any psychiatric disorder, rTL was assessed using quantitative polymerase chain reaction. Hierarchical cluster analysis was used to generate the three chronic stress classes (mild, moderate, and severe). t-tests were used to assess the difference between baseline and 12 month rTL and the mean difference in rTL between cases and controls both at baseline and at 12 months. Linear regression analysis was used to model the effects of chronic stress on the association between IMDs and rTL, controlling for age and sex. Results: We observed longer rTL among cases of IMDs compared with controls (p < 0.001). We also observed a statistically significant reduction in rTL between baseline and 12 months in the combined sample of cases and controls (p < 0.001). The same statistical difference was observed when cases and controls were individually analyzed (p < 0.001). We found no significant difference in rTL between cases and controls at 12 months (p = 0.117). We found no significant influence of chronic stress on the association between IMDs and rTL at both baseline and 12 months. Conclusion: rTL is longer among cases of IMDs compared with age- and sex-matched controls. We observed a significant attrition in rTL over 12 months, which seems to be driven by the presence of any IMDs. There is a need for future longitudinal and experimental studies to understand the mechanisms driving our findings.
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Affiliation(s)
- Allan Kalungi
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.,Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | | | - Eugene Kinyanda
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses L Joloba
- Department of Medical Microbiology, Makerere University, Kampala, Uganda.,School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Wilber Ssembajjwe
- Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rebecca N Nsubuga
- Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Jonathan Levin
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | | | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences University of Stellenbosch, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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de Almeida RN, Galvão ACDM, da Silva FS, Silva EADS, Palhano-Fontes F, Maia-de-Oliveira JP, de Araújo LSB, Lobão-Soares B, Galvão-Coelho NL. Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial. Front Psychol 2019; 10:1234. [PMID: 31231276 PMCID: PMC6558429 DOI: 10.3389/fpsyg.2019.01234] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/10/2019] [Indexed: 01/01/2023] Open
Abstract
Serotonergic psychedelics are emerging as potential antidepressant therapeutic tools, as suggested in a recent randomized controlled trial with ayahuasca for treatment-resistant depression. Preclinical and clinical studies have suggested that serum brain-derived neurotrophic factor (BDNF) levels increase after treatment with serotoninergic antidepressants, but the exact role of BDNF as a biomarker for diagnostic and treatment of major depression is still poorly understood. Here we investigated serum BDNF levels in healthy controls (N = 45) and patients with treatment-resistant depression (N = 28) before (baseline) and 48 h after (D2) a single dose of ayahuasca or placebo. In our sample, baseline serum BDNF levels did not predict major depression and the clinical characteristics of the patients did not predict their BDNF levels. However, at baseline, serum cortisol was a predictor of serum BDNF levels, where lower levels of serum BDNF were detected in a subgroup of subjects with hypocortisolemia. Moreover, at baseline we found a negative correlation between BDNF and serum cortisol in volunteers with eucortisolemia. After treatment (D2) we observed higher BDNF levels in both patients and controls that ingested ayahuasca (N = 35) when compared to placebo (N = 34). Furthermore, at D2 just patients treated with ayahuasca (N = 14), and not with placebo (N = 14), presented a significant negative correlation between serum BDNF levels and depressive symptoms. This is the first double-blind randomized placebo-controlled clinical trial that explored the modulation of BDNF in response to a psychedelic in patients with depression. The results suggest a potential link between the observed antidepressant effects of ayahuasca and changes in serum BDNF, which contributes to the emerging view of using psychedelics as an antidepressant. This trial is registered at http://clinicaltrials.gov (NCT02914769).
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Affiliation(s)
- Raíssa Nóbrega de Almeida
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana Cecília de Menezes Galvão
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Flávia Santos da Silva
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Erick Allan dos Santos Silva
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Fernanda Palhano-Fontes
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - João Paulo Maia-de-Oliveira
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lobão-Soares Barros de Araújo
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Bruno Lobão-Soares
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Nicole Leite Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
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Postolache TT, del Bosque-Plata L, Jabbour S, Vergare M, Wu R, Gragnoli C. Co-shared genetics and possible risk gene pathway partially explain the comorbidity of schizophrenia, major depressive disorder, type 2 diabetes, and metabolic syndrome. Am J Med Genet B Neuropsychiatr Genet 2019; 180:186-203. [PMID: 30729689 PMCID: PMC6492942 DOI: 10.1002/ajmg.b.32712] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 11/16/2018] [Accepted: 12/07/2018] [Indexed: 12/20/2022]
Abstract
Schizophrenia (SCZ) and major depressive disorder (MDD) in treatment-naive patients are associated with increased risk for type 2 diabetes (T2D) and metabolic syndrome (MetS). SCZ, MDD, T2D, and MetS are often comorbid and their comorbidity increases cardiovascular risk: Some risk genes are likely co-shared by them. For instance, transcription factor 7-like 2 (TCF7L2) and proteasome 26S subunit, non-ATPase 9 (PSMD9) are two genes independently reported as contributing to T2D and SCZ, and PSMD9 to MDD as well. However, there are scarce data on the shared genetic risk among SCZ, MDD, T2D, and/or MetS. Here, we briefly describe T2D, MetS, SCZ, and MDD and their genetic architecture. Next, we report separately about the comorbidity of SCZ and MDD with T2D and MetS, and their respective genetic overlap. We propose a novel hypothesis that genes of the prolactin (PRL)-pathway may be implicated in the comorbidity of these disorders. The inherited predisposition of patients with SCZ and MDD to psychoneuroendocrine dysfunction may confer increased risk of T2D and MetS. We illustrate a strategy to identify risk variants in each disorder and in their comorbid psychoneuroendocrine and mental-metabolic dysfunctions, advocating for studies of genetically homogeneous and phenotype-rich families. The results will guide future studies of the shared predisposition and molecular genetics of new homogeneous endophenotypes of SCZ, MDD, and metabolic impairment.
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Affiliation(s)
- Teodor T. Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, Colorado,Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, Maryland
| | - Laura del Bosque-Plata
- National Institute of Genomic Medicine, Nutrigenetics and Nutrigenomic Laboratory, Mexico City, Mexico
| | - Serge Jabbour
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Disease, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Michael Vergare
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rongling Wu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania,Department of Statistics, Penn State College of Medicine, Hershey, Pennsylvania
| | - Claudia Gragnoli
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolic Disease, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania,Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania,Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome, Italy
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50
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Lawrence KA, Matthieu MM, Robertson-Blackmore E. Civic Service as an Intervention to Promote Psychosocial Health and Implications for Mental Health in Post-9/11/01 Era Women Veterans. J Womens Health (Larchmt) 2019; 28:1133-1142. [PMID: 30920331 DOI: 10.1089/jwh.2018.7338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Women veterans experience significant morbidity with poorer health and mental health outcomes relative to nonveteran counterparts. Little is known about how to best promote health and well-being among reintegrating female veterans. Civic service has been shown to improve mental health in civilians, but its impact on female veterans is unknown. This study characterizes the physical and mental health and psychosocial functioning of female veterans and evaluates changes in these domains following completion of an intensive civic service program. Materials and Methods: Data were obtained from an observational, pre-post cohort study of post-9/11/01 era veterans who completed a 6-month, 20-hour per week civic service program. Of the 346 participants, 107 were women. Participants completed online pre- and post-program surveys. Nine measures of health, mental health, and psychosocial functioning were analyzed. Results: Before starting the program, 47% of women screened positive for a probable diagnosis of post-traumatic stress disorder (PTSD), 24% for depression, and 51% reported seeking assistance for mental health problems. Pre-post change scores indicated significant improvements on nine measures of health, mental health, and psychosocial functioning (p < 0.05). Perceived self-efficacy change scores predicted PTSD change scores, F(1, 93) = 8.00, p < 0.05. Seeking professional assistance for mental health problems and social isolation and loneliness change scores predicted depression change scores, F(2, 95) = 15.618, p < 0.05, explaining 23% of the variance. Conclusions: Civic service has the potential to promote and support the maintenance of psychosocial well-being for returning post-9/11/01 era women veterans with symptoms of PTSD or depression.
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Affiliation(s)
- Karen A Lawrence
- 1College of Social Work, University of Kentucky, Lexington, Kentucky
| | - Monica M Matthieu
- 2College for Public Health and Social Justice, School of Social Work, Saint Louis University, Saint Louis, Missouri
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