THE USE OF MRS AND CYTOKINE MEASUREMENTS TO INVESTIGATE DEPRESSION

使用 MRS 和细胞因子测量来研究抑郁症

• 批准号: 7604587
• 负责人: ADAM Ian KAPLIN
• 金额: $ 0.02万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-01 至 2007-09-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7604587
• 关键词: Animals; Attenuated; Autoimmune Diseases; Autoimmune Process; Behavioral; Brain; Chronic Disease; Cognition; Comorbidity; Computer Retrieval of Information on Scientific Projects Database; Diagnosis; Elevation; Emotional; Epidemiology; Evaluation; Funding; Grant; HPSE gene; Heterogeneity; Human; Hydrocortisone; Immune; Immune response; Immune system; Impaired cognition; Inflammatory; Institution; Investigation; Lesion; Link; Magnetic Resonance Spectroscopy; Major Depressive Disorder; Measurement; Mediating; Mental Depression; Modeling; Moods; Multiple Sclerosis; Neurological outcome; Neurosecretory Systems; Patients; Prevalence; Production; Rate; Relative (related person); Research; Research Personnel; Resources; Source; Spinal Cord; Spinal Cord Diseases; Spinal cord injury; Transverse Myelitis; United States National Institutes of Health; cytokine; hypercortisolemia; hypothalamic-pituitary-adrenal axis; neurochemistry; neuropsychiatry

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Investigation of depression has been hampered by the heterogeneity of its causes and presentations. To overcome these impediments, a lesion model of depression would significantly enhance our understanding of this illness. Multiple Sclerosis (MS) has the highest rate of depression of any chronic disease. MS has a 50% prevalence of cognitive impairment. Evidence supports both demyelinated brain lesions and cytokine effects as causes of depression and cognitive dysfunction in MS patients. Transverse Myelitis (TM) is an autoimmune disorder like MS but with demyelinating lesions present only in the spinal cord. We found rates of severe depression in subjects with TM to be higher than those of MS controls and selective cognitive impairments in TM subjects comparable to their MS counterparts. In humans and animals, cytokines induce depression (or its behavioral equivalent) and cognitive impairment. Elevated pro-inflammatory cytokine levels are found in patients with idiopathic depression, which is a state of relative hypercortisolemia. In a homeostatic regulatory cycle, pro-inflammatory cytokines stimulate the HPA axis to release cortisol, which in turn attenuates the immune response. Thus, there is a plausible link in autoimmune disorders between immune system activation with cytokine production and changes in emotional brain states and cognition. We propose that TM provides a model of cytokine-mediated depression and cognitive impairment. We will investigate the epidemiology of these neuropsychiatric phenomena in TM subjects compared to MS and non-autoimmune myelopathy controls including traumatic and non-traumatic spinal cord injury. Our study will then employ neuropsychiatric evaluations, cytokine profiling, and Magnetic Resonance Spectroscopy (MRS) of TM and control subjects to elucidate cytokine elevations and brain neurochemical changes that correlate with depression and cognitive dysfunction. Subjects will be followed longitudinally to determine if changes in cytokine levels and brain metabolites parallel changes in mood, cognition and neurologic outcomes. Neuroendocrine correlates of depression in TM and MS subjects will be ascertained through examination of the function of their HPA axis. We anticipate that the results of this study will have direct implications for the neuropsychiatric comorbidities of TM and MS. These findings could significantly expand our ability to diagnose, prognosticate, and treat neuropsychiatric sequelae in patients with diverse types of autoimmune disorders. These studies also have the potential to illuminate immune mechanisms in idiopathic Major Depression.

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 抑郁症的病因和表现的异质性阻碍了对抑郁症的研究。为了克服这些障碍，抑郁症的病变模型将显著增强我们对这种疾病的理解。多发性硬化症(MS)是所有慢性病中抑郁发生率最高的。多发性硬化症的认知障碍患病率为50%。有证据支持脱髓鞘脑损伤和细胞因子效应是多发性硬化症患者抑郁和认知功能障碍的原因。横贯性脊髓炎(TM)是一种与MS类似的自身免疫性疾病，但脱髓鞘病变仅存在于脊髓。我们发现，患有多发性硬化症的受试者严重抑郁的发生率高于多发性硬化症对照组，而多发性硬化症受试者的选择性认知损害与多发性硬化症患者相当。 在人类和动物中，细胞因子导致抑郁(或其行为等价物)和认知障碍。特发性抑郁症患者的促炎细胞因子水平升高，这是一种相对高皮质醇血症的状态。在动态平衡调节周期中，促炎症细胞因子刺激HPA轴释放皮质醇，进而减弱免疫反应。因此，在自身免疫性疾病中，免疫系统激活与细胞因子的产生以及情绪大脑状态和认知的变化之间存在可信的联系。 我们认为TM提供了一种细胞因子介导的抑郁和认知障碍的模型。我们将调查TM受试者与多发性硬化症和非自身免疫性脊髓病对照组(包括创伤性和非创伤性脊髓损伤)的这些神经精神现象的流行病学。然后，我们的研究将使用神经精神病学评估、细胞因子图谱和磁共振波谱(MRS)对TM和对照受试者进行研究，以阐明与抑郁和认知功能障碍相关的细胞因子升高和脑神经化学变化。研究人员将对受试者进行纵向跟踪，以确定细胞因子水平和大脑代谢物的变化是否与情绪、认知和神经结果的变化平行。TM和MS受试者抑郁的神经内分泌相关性将通过检查他们的HPA轴的功能来确定。 我们预计，这项研究的结果将对TM和MS的神经精神共病有直接的影响。这些发现可以显著扩展我们诊断、预测和治疗不同类型自身免疫性疾病患者的神经精神后遗症的能力。这些研究也有可能阐明特发性抑郁症的免疫机制。