Background
Adult neurogenesis is coupled to angiogenesis in neurogenic niches in the dentate gyrus (DG) and increased by antidepressants in rodents. We hypothesized that, in major depressive disorder (MDD), antidepressants increase neural progenitor cells (NPCs) and capillaries in the human DG.
Methods
NPCs and capillaries, detected on hippocampal sections by immunohistochemistry for nestin, were quantified by stereology in matched MDDs (untreated, n=12), MDD treated with selective serotonin reuptake inhibitors (MDD*SSRI, n=6) or tricyclic antidepressants (MDD*TCA, n=6) and nonpsychiatric controls (n=12), all confirmed by psychological autopsy.
Results
MDD*SSRI had a larger capillary area and more NPCs versus MDDs (p=.034 and p=.008, respectively) and controls (p=.010 and p=.002, respectively) in the whole DG, more NPCs in the anterior (pes, p=.042) and central (mid-body, p=.004) DG, and greater capillary area in the pes (p=.002) and mid-body (p=.021). NPC number and capillary area correlated positively in the whole sample (R2=.454, p<.001) and in treated subjects (R2=.749, p=.001). We found no NPCs or antidepressant-related angiogenesis in CA1 and parahippocampal gyrus. DG volume correlated positively with NPC number (p=.004) and capillary area (p<.001), and differed between groups in whole hippocampus (p=.013) and mid-body (p=.036). Age negatively correlated with NPC number (p=.042), capillary area (p=.037) and bifurcations (p=.030). No sex effect was detected.
Conclusions
Antidepressants increase human hippocampal NPCs and angiogenesis selectively in the anterior and mid DG. These results raise the possibility of a causal relationship between angiogenesis and neurogenesis, as seen in other proliferating tissues, and support their possible role in the mechanism of action of antidepressants.