Role of inflammation in depression relapse

• Published in: Journal of neuroinflammation Vol. 16; no. 1; pp. 90 - 11
• Main Authors: Liu, Chun-Hong, Zhang, Guang-Zhong, Li, Bin, Li, Meng, Woelfer, Marie, Walter, Martin, Wang, Lihong
• Format: Journal Article
• Language: English
• Published: London BioMed Central 17.04.2019; BioMed Central Ltd; BMC
• Subjects: (Neuro) inflammation; Antidepressants; Biomedical and Life Sciences; Biomedicine; Brain - immunology; Brain - physiopathology; Brain research; Circuits; Cognition & reasoning; Complications and side effects; Cytokines; Degeneration; Depressive Disorder, Major - immunology; Depressive Disorder, Major - physiopathology; Development and progression; Diagnosis; Diseases; Dopamine; Epidemiology; Functional magnetic resonance imaging; Humans; Hypotheses; Immune system; Immunology; Inflammation; Inflammation - complications; Inflammation - physiopathology; Major depressive disorder; Mental depression; Metabolism; Metabolites; Nervous system; Neurobiology; Neuroimaging; Neurology; Neurosciences; Patient outcomes; Patients; Psychiatry; Recurrence; Recurrent major depressive disorder; Relapse; Review; Risk factors; Systematic review; Tumor necrosis factor-TNF; Vagus nerve; Vagus nerve stimulation; China; Functional magnetic resonance imaging; Vagus nerve stimulation; Recurrent major depressive disorder; (Neuro) inflammation
• ISSN: 1742-2094; 1742-2094
• DOI: 10.1186/s12974-019-1475-7

Major depressive disorder (MDD) is a leading cause of disability worldwide. After the first episode, patients with remitted MDD have a 60% chance of experiencing a second episode. Consideration of therapy continuation should be viewed in terms of the balance between the adverse effects of medication and the need to prevent a possible relapse. Relapse during the early stages of MDD could be prevented more efficiently by conducting individual risk assessments and providing justification for continuing therapy. Our previous work established the neuroimaging markers of relapse by comparing patients with recurrent major depressive disorder (rMDD) in depressive and remitted states. However, it is not known which of these markers are trait markers that present before initial relapse and, consequently, predict disease course. Here, we first describe how inflammation can be translated to subtype-specific clinical features and suggest how this could be used to facilitate clinical diagnosis and treatment. Next, we address the central and peripheral functional state of the immune system in patients with MDD. In addition, we emphasize the important link between the number of depressive episodes and rMDD and use neuroimaging to propose a model for the latter. Last, we address how inflammation can affect brain circuits, providing a possible mechanism for rMDD. Our review suggests a link between inflammatory processes and brain region/circuits in rMDD.