Are Mood and Anxiety Disorders Inflammatory Diseases?

Boorman, Emily; Romano, Graziella; Russell, Ailsa; Mondelli, Valeria; Pariante, Carmine M.

doi:10.3928/00485713-20150501-06

Cited by 9 publications

(14 citation statements)

References 73 publications

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“…It has been demonstrated that efferent vagal fibers originating in the dorsal motor nucleus can modify the release of inflammatory cytokines, such as TNFα, from macrophages, thereby preventing over-activation of the inflammatory process without inducing immunosuppression ( 58 ). Loss of vagal tone, therefore, may be crucial to understanding the pro-inflammatory status associated with MDD and BD that has been described in the literature ( 59 , 60 ). If parasympathetic tone can be maintained at HC levels, reflecting a physiological degree of inflammatory response, antidepressant drug action may proceed unhindered ultimately leading to remission.…”

Section: Discussionmentioning

confidence: 99%

Diminution of Heart Rate Variability in Bipolar Depression

Hage

Britton

Daniels

et al. 2017

Front. Public Health

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Autonomic nervous system (ANS) dysregulation in depression is associated with symptoms associated with the ANS. The beat-to-beat pattern of heart rate defined as heart rate variability (HRV) provides a noninvasive portal to ANS function and has been proposed to represent a means of quantifying resting vagal tone. We quantified HRV in bipolar depressed (BDD) patients as a measure of ANS dysregulation seeking to establish HRV as a potential diagnostic and prognostic biomarker for treatment outcome. Forty-seven BDD patients were enrolled. They were randomized to receive either escitalopram–celecoxib or escitalopram-placebo over 8 weeks in a double-blind study design. Thirty-five patients completed the HRV studies. Thirty-six healthy subjects served as controls. HRV was assessed at pretreatment and end of study and compared with that of controls. HRV was quantified and corrected for artifacts using an algorithm that incorporates time and frequency domains to address non-stationarity of the beat-to-beat heart rate pattern. Baseline high frequency-HRV (i.e., respiratory sinus arrhythmia) was lower in BDD patients than controls, although the difference did not reach significance. Baseline low-frequency HRV was significantly lower in BDD patients (ln4.20) than controls (ln = 5.50) (p < 0.01). Baseline heart period was significantly shorter (i.e., faster heart rate) in BDD patients than controls. No significant change in HRV parameters were detected over the course of the study with either treatment. These findings suggest that components of HRV may be diminished in BDD patients.

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Section: Discussionmentioning

confidence: 99%

Diminution of Heart Rate Variability in Bipolar Depression

Hage

Britton

Daniels

et al. 2017

Front. Public Health

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“…According to the neuronal hyperexcitability hypothesis, that is because they reduce the inflammation that is merely exacerbating the underlying neuronal hyperexcitability. As predicted by the hypothesis, anti-inflammatory drugs have been of most benefit in those patients who have the most pretreatment inflammation [16,82].…”

Section: Neuropsychiatric Evidencementioning

confidence: 94%

The Multi-Circuit Neuronal Hyperexcitability Hypothesis of Psychiatric Disorders

Binder¹

2019

AJCEM

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After nearly a century of intensive research and clinical investigation, the pathophysiology of psychiatric disorders remains an enigma. Short of a clear understanding of how psychiatric symptoms are produced, the various cognitive, emotional, and behavior patterns that characterize psychiatric disorders continue to be grouped into syndromes and treated accordingly. The weakness of this approach is that the treatment is administered without a clear understanding of what pathological process is being treated. Moreover, the symptoms of most psychiatric disorders are frequently changing and melding into one another. This leads to diagnostic confusion, medication stacking, and poor treatment outcomes, all of which erode patient trust and perpetuate the stigma of mental illness. In this seminal report, a new hypothesis on the pathophysiology of psychiatric disorders will be presented based on multidisciplinary evidence that nearly all psychiatric disorders and their functional comorbidities are rooted in a single, shared, neurophysiological abnormality. The report will then trace that abnormality to its molecular roots and introduce a new paradigm through which the many faces of mental illness can be understood and uniformly treated. The Multi-Circuit Neuronal Hyperexcitability hypothesis of psychiatric disorders posits that an inherent hyperexcitability of the neurological system is at the root of mental illness and provides a precise, functionallyspecific framework that eliminates diagnostic confusion, informs a unified treatment approach, and helps remove the long-held stigma of mental illness. + Itemized comparison showing that the same conditions and chemicals that increase the potential for seizures (upper section) also increase the potential for psychiatric symptoms, and the same conditions and chemicals that decrease the potential for seizures (lower section) also decrease the potential for psychiatric symptoms.

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“…This theory ties each of the above mechanisms together in a prospective ‘unifying hypothesis’. When the body is exposed to stress it triggers an inflammatory response as a form of protection (Boorman et al 2015 ; Franklin et al 2015 ). Acute or prolonged stress can lead to increased inflammation and can result in neurodegeneration (Boorman et al 2015 ; Franklin et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…When the body is exposed to stress it triggers an inflammatory response as a form of protection (Boorman et al 2015 ; Franklin et al 2015 ). Acute or prolonged stress can lead to increased inflammation and can result in neurodegeneration (Boorman et al 2015 ; Franklin et al 2015 ). The inflammatory response is controlled by the HPA axis and involves an increase in pro-inflammatory cytokines, which in turn activate microglia (Boorman et al 2015 ; Franklin et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Dementia, post-traumatic stress disorder and major depressive disorder: a review of the mental health risk factors for dementia in the military veteran population

et al. 2018

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BackgroundDementia is currently incurable, irreversible and a major cause of disability for the world's older population. The association between mental health difficulties, such as post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), and dementia has a long history within the civilian population. Despite the increased importance of this link within the military veteran population, who suffer a greater propensity of mental health difficulties and consist largely of over 65s, attention is only recently being paid to the salience of such an association for this group. This paper aims to explore the relationship between PTSD and MDD with dementia within the military veteran population.MethodA systematic review was conducted on articles from 1990 to July 2016 on MEDLINE, EMBASE, EBSCO and Web of Science electronic databases with an update conducted in February 2017.ResultsSix empirical studies were identified from the review, the majority of which originated from the USA. Five of the studies asserted that veterans with a diagnosis of either PTSD or MDD are at a significantly greater risk of developing dementia than ‘healthy’ controls. The final study, conducted in Australia, found only a small, but non-significant, correlation between earlier MDD and future dementia, but no concurrent correlation.ConclusionsWhile causality cannot be determined, it is likely that PTSD and depressive disorders are related to an increased risk of dementia in military veterans. Potential pathological explanations and risk factors are reviewed and the clinical and neuroscience implications of these findings are explored.

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Are Mood and Anxiety Disorders Inflammatory Diseases?

Cited by 9 publications

References 73 publications

Diminution of Heart Rate Variability in Bipolar Depression

Diminution of Heart Rate Variability in Bipolar Depression

The Multi-Circuit Neuronal Hyperexcitability Hypothesis of Psychiatric Disorders

Dementia, post-traumatic stress disorder and major depressive disorder: a review of the mental health risk factors for dementia in the military veteran population

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