The Role of Depressive Subtypes within the Neuroinflammation Hypothesis of Major Depressive Disorder. (1st April 2019)

• Record Type: Journal Article
• Authors: Woelfer, Marie; Kasties, Vanessa; Kahlfuss, Sascha; Walter, Martin
• Is Part Of: Neuroscience. Volume 403(2019)
• Page Start: 93
• Page End: 110
• Publication Date: 2019-04-01
• Subjects: (d/pg/sg)ACC (dorsal/perigenual/subgenual) anterior cingulate cortex -- ACTH adrenocorticotropic hormone -- aMCC anterior midcingulate cortex -- BDNF brain-derived neurotrophic factor -- BH4 tetrahydrobiopterin -- BMI body–mass index -- CNS central nervous system -- CRH corticotropin-releasing hormone -- CRP C-reactive protein -- CSF cerebrospinal fluid -- COX-2 cyclooxygenase-2 -- DSM-5 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition -- EAATs excitatory amino acid transporters -- fMRI functional magnetic resonance imaging -- GCR glucocorticoid receptor -- HCV hepatitis C virus -- HPA hypothalamic–pituitary–adrenal -- IDO indoleamine 2, 3-dioxygenase -- IFN interferon -- IL interleukin -- LPS lipopolysaccharide -- MDD major depressive disorder -- mPFC medial prefrontal cortex -- MRS magnetic resonance spectroscopy -- NMDA(R) N-methyl-d-aspartate (receptor) -- PET positron emission tomography -- QUIN quinolinic acid -- RDoC Research Domain Criteria -- ROS reactive oxygen species -- SERT 5-hydroxytryptamine transporter -- SPECT single-photon emission computed tomography -- SSRI selective serotonin reuptake inhibitor -- TDO tryptophan 2, 3-dioxygenase -- TSPO 18-kDa translocator protein -- Th T helper cells -- TNF tumor necrosis factor; (neuro)inflammation -- microglia -- (atypical and melancholic) depression -- major depressive disorder -- functional magnetic resonance imaging (fMRI) -- cortisol; Neurochemistry -- Periodicals; Neurophysiology -- Periodicals; Neurology -- Periodicals; Neurochimie -- Périodiques; Neurophysiologie -- Périodiques; Neurochemistry; Neurophysiology; Electronic journals; Periodicals; Electronic journals; 612.8
• DOI: 10.1016/j.neuroscience.2018.03.034
• Languages: English
• ISSNs: 0306-4522

Abstract

Highlights: MDD can be clinically divided into subtypes, such as atypical and melancholic MDD. Inflammation seems not to have the same impact on every MDD subtype. Neuroinflammation shows a regional specificity in ACC. This specificity overlaps with neuronal patterns potentially distinguishing subtypes. Subtype-specific clinical features coincide with functional associations of ACC. Abstract: Major depressive disorder (MDD) is a very common disease that affects more than 350 million people worldwide, representing an enormous socioeconomic burden. From a clinical perspective, MDD can be divided into different subtypes, such as melancholic or atypical MDD. Interestingly, increasing evidence points toward an involvement of the immune system in MDD pathogenesis. However, inflammation does not seem to have the same impact on every MDD type. Here, we describe how inflammation can affect monoaminergic and glutamatergic neurotransmission, which provides a possible mechanism for MDD onset. Next, we examine the regional specificity of neuroinflammation, which shows striking overlaps with neural patterns activated in atypical MDD. Furthermore, we outline how inflammation may translate to subtype-specific clinical features and we suggest how this could be used for diagnostic and treatment purposes. By providing a link back to a dysregulated immune system as a contributing factor to MDD subtypes, we explain how brain regions particularly affected by certain subtypes may regulate the cortisol circuitry.