Neuroinflammatory and morphological changes in late-life depression: the NIMROD study

Yamagata

Int J Geriat Psychiatry

et al. 2018

Objectives The present study investigated the usefulness of evaluating the existence of volume reduction in brain regions using voxel‐based morphometry (VBM) to dissociate major depressive disorder (MDD) from bipolar disorder (BD). Methods/Design This study enrolled 92 individuals with MDD, 32 individuals with BD, and 43 healthy controls (HCs). We focused on gray matter volume (GMV) of the subgenual anterior cingulate cortex (sgACC), subcallosal area (SCA), and hippocampus. The degree of volume reduction in these brain regions was calculated as the z score, and the differences of z scores in these regions were investigated among the MDD, BD, and HC groups. We then performed a receiver operating characteristic curve analysis to dissociate the individuals with MDD and BD from the HCs based on the z scores in the GMV of these brain regions. Results While there were no significant differences in the z scores of the hippocampus among the three groups, the z score of the sgACC was significantly higher in the MDD group than in the BD and HC groups, and the SCA z score was significantly higher in the MDD and BD groups than in the HC group. Conclusions Our findings suggest that VBM evaluation of GMV reduction in the sgACC may be useful as an objective adjunctive tool to distinguish between MDD and BD.

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Regional brain volume reductions in major depressive disorder and bipolar disorder: An analysis by voxel‐based morphometry

Yamagata

Int J Geriat Psychiatry

et al. 2018

“…Despite some negative results 6 , the majority of TSPO-PET studies in patients with depression have reported increased TSPO binding compared with healthy controls [7][8][9][10][11] , suggesting increased microglial activation in these patients. These studies thus propose that the inflammatory response in depression involves not only the periphery 12,13 but also the brain.…”

Section: Introductionmentioning

confidence: 98%

PET imaging shows no changes in TSPO brain density after IFN-α immune challenge in healthy human volunteers

et al. 2020

Depression is associated with peripheral inflammation, but its link with brain microglial activity remains unclear. In seven healthy males, we used repeated translocator protein-Positron Emission Tomography (TSPO-PET) dynamic scans with [ 11 C]PBR28 to image brain microglial activation before and 24 h after the immune challenge interferon (IFN)-α. We also investigated the association between changes in peripheral inflammation, changes in microglial activity, and changes in mood. IFN-α administration decreased [ 11 C]PBR28 PET tissue volume of distribution (Vt) across the brain (−20 ± 4%; t 6 = 4.1, p = 0.01), but after correction for radioligand free-plasma fraction there were no longer any changes (+23 ± 31%; t = 0.1, p = 0.91). IFN-α increased serum IL-6 (1826 ± 513%, t 6 = −7.5, p < 0.001), IL-7 (39 ± 12%, t 6 = −3.6, p = 0.01), IL-10 (328 ± 48%, t 6 = −12.8, p < 0.001), and IFN-γ (272 ± 64%, t 6 = −7.0, p < 0.001) at 4-6 h, and increased serum TNF-α (49 ± 7.6%, t 6 = −7.5, p < 0.001), IL-8 (39 ± 12%, t 6 = −3.5, p = 0.013), and C-reactive protein (1320 ± 459%, t 6 = −7.2, p < 0.001) at 24 h. IFN-α induced temporary mood changes and sickness symptoms after 4-6 h, measured as an increase in POMS-2 total mood score, confusion and fatigue, and a decrease in vigor and friendliness (all p ≤ 0.04). No association was found between changes in peripheral inflammation and changes in PET or mood measures. Our work suggests that brain TSPO-PET signal is highly dependent of inflammation-induced changes in ligand binding to plasma proteins. This limits its usefulness as a sensitive marker of neuroinflammation and consequently, data interpretation. Thus, our results can be interpreted as showing either that [ 11 C]PBR28 is not sensitive enough under these conditions, or that there is simply no microglial activation in this model.

“…In general, females have higher rates of depression than males, especially older people with disabilities (Pagan-Rodriguez & Perez, 2012). Compared to older people without depression, older people with the diagnosis showed both central and peripheral signs of inflammation, and enhanced level of a specific translocator protein, which is associated with cardiovascular diseases (Su et al, 2016). Moreover, these patients showed significant gray matter reduction in the whole brain, which is associated with disruption of the neural network that regulates mood and behavior (Stratmann et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Older Thai Peoples’ Perceptions and Experiences of Major Depression

Kleebthong¹,

Chareonsuk²,

Kristiansen³

2017

GJHS

Background: Depressive disorders are common mental health problems and may be disabling among the general older population. Although older people have significant symptoms of depression, the symptoms are likely to be underreported. The condition often co-exist along with somatic ill and has often been unrecognized. The aim of the study was to explore and understand the perceptions and experiences of older Thai people diagnosed with major depressive disorder. Methods:A qualitative inductive research design was used and latent content analysis was utilized. The data were collected through face-to-face, in-depth interviews. Fourteen older people diagnosed with major depressive disorder were selected for participant using purposive sampling. Findings:Older Thai peoples' perceptions and experiences of depression were abstracted into two themes. First theme was leading a life in detachment, which included three subthemes: living with meaninglessness, holding distress with one's self, and feeling judged by surrounded people. The second theme was inconvenience of approaching mental health treatment, which included two subthemes: sensing an unapproachable health care service, and lacking knowledge about clinical depression. Conclusion:Older Thai peoples' perceptions and experiences of major depression were affected with high level suspected existential loneliness that might even be worse in a collect oriented society as in the Thai context. Further, it seem hard to approach the mental health care. The central reason for this is interpreted as lack of mental health literacy, and in this case, specifically, knowledge on depression. Future studies should focus on relatives' experiences of living with an older family member that suffered from major depression, and on the state of mental health literacy in the rural Thai population.