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White matter integrity and pro-inflammatory cytokines as predictors of antidepressant response in MDD

Published online by Cambridge University Press:  01 September 2022

S. Breit ,
E. Mazza ,
S. Poletti  and
F. Benedetti
S. Breit*
Affiliation:
University Hospital of Psychiatry and Psychotherapy of Bern, University Hospital Of Psychiatry And Psychotherapy, Bern, Switzerland
E. Mazza
Affiliation:
IRCCS Ospedale San Raffaele, Milano, Psychiatry And Clinical Psychobiology/neuroscience, Milan, Italy
S. Poletti
Affiliation:
IRCCS Ospedale San Raffaele, Milano, Psychiatry And Clinical Psychobiology/neuroscience, Milan, Italy
F. Benedetti
Affiliation:
IRCCS Ospedale San Raffaele, Milano, Psychiatry And Clinical Psychobiology/neuroscience, Milan, Italy
*
*Corresponding author.

Abstract

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Introduction

Major depressive disorder (MDD) often involves immune dysregulation with high peripheral levels of pro-inflammatory cytokines that might have an impact on the clinical course and treatment response. Moreover, MDD patients show brain volume changes and white matter (WM) alterations that are already existing in the early stage of illness.

Objectives

The aim of the present review is to elucidate the association between inflammation and WM integrity and its impact on the pathophysiology and progression of MDD as well as the role of possible novel biomarkers of treatment response to improve MDD prevention and treatment strategies.

Methods

We conducted an electronic literature search of PubMed on studies that examined the role of inflammation in depression and that focused on WM integrity and pro-inflammatory cytokines as predictors of antidepressant response.

Results

There is evidence for central effects of peripheral inflammation which could activate microglia which, in turn, might trigger a cascade of inflammatory processes leading to neurotransmitter imbalances. Numerous studies indicated that both altered levels of peripheral inflammatory markers, particularly TNF-α, IL-6, and CRP as well as WM integrity might predict antidepressant treatment outcome.

Conclusions

Despite mounting evidence on the impact of the immune system on WM microstructure, no study has yet addressed the interaction between the two factors in influencing antidepressant response. There is a lack of reproducible biomarkers predicting treatment response on an individual basis. The availability of such biomarkers would enable more efficient and personalized treatments with a faster treatment response and better prevention of treatment resistance.

Disclosure

No significant relationships.

Keywords

white matter integritybiomarkersMDDpro-inflammatory cytokines
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S553
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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