“…Approximately 10–30% of those suffering from depression exhibit treatment resistance (Al-Harbi, 2012), which has been linked to an increase in circulating cytokines (Maes et al., 1997, Musselman et al., 2001b, Miller et al., 2002, Alesci et al., 2005, Motivala et al., 2005, Raison et al., 2013). Although much of what is known about inflammation and depression has been determined by studying cytokine levels in the plasma, elevated pro-inflammatory cytokines are also reported in the cerebrospinal fluid (CSF) of subpopulations of depressed patients (Sasayama et al., 2013, Kern et al., 2014, Devorak et al., 2015). It has only recently been shown for the first time using positron emission tomography that microglial activation is increased in the brains of depressed patients compared to healthy controls, and was positively correlated with severity of depressive symptoms (Setiawan et al., 2015).…”