The molecular neurobiology of depression begins with an idea: depressive disorders represent a family of related but distinct conditions. Different points of vulnerability in the brain may predispose to depressive disorders. For example, it is likely that the core pathophysiology of depression associated with early life adversity is different from non-trauma related disorders. In particular, the pathophysiology of trauma-related depression involves the hypothalamic-pituitary-adrenal (HPA) axis, although, in turn, this reflects underlying molecular etiologies. In particular, dysregulation of signal transduction mechanisms may be one site of origin. This may be the result of yet other processes such as the effects of reactive oxygen species (ROS) or genomic imprinting. Unraveling these complex causes may lead to novel treatments that can be used in a targeted fashion.
Keywords/phrasesDepression; molecular; signal transduction; gene expression; genomics Unipolar depressive disorders encompass a range of features that strongly suggest a neurobiological substrate. These include symptoms such as include sleep and appetite disturbances (both up and down), loss of interest and pleasure, negative rumination, fatigue, and poor concentration, but also apparent abnormalities of the hypothalamic-pituitary-adrenal axis(1) or of neuroplasticity.(2) Moreover, depression appears to have genetic antecedents, which also point to a biological contribution to etiology.(3) However, the exact pathophysiology has been largely unknown until the last decade or so.To begin, depression clearly is not one entity, but subsumes a range of causes that involve genetic contributors, along with early and later stress.(2;4) Therefore, the depressive spectrum include conditions related to early traumatic events (typically with early onset of depression as well), through episodes in the absence of early trauma that may or may not be precipitated by an acute stressor. Therefore, the heterogeneous nature of the condition must be taken into account in any search for a biological substrate.Unfortunately, that is not usually the case. In fact, most studies simply take an unselected groups of "depressed" and "controls" for comparison. However, this is likely to contribute to type II error, since a particular biological finding may be applicable only to a subset of depressed patients. To illustrate this point, take a study from our own research laboratory ( Figure 1).(5) In this study, protein kinase A (PKA) activity was determined in fibroblasts in Mailing address: 1500 21st Avenue, South, Suite 2200, Nashville, TN 37212, Email: richard.shelton@vanderbilt.edu. Supported in part by NIMH grants MH073630, MH01741, and MH52339.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable fo...