Immunological Disturbances and Neuroimaging Findings in Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) Comorbid Patients

2020 ◽  
Vol 20 (9) ◽  
pp. 759-769
Author(s):  
Andriana Kakanakova ◽  
Stefan Popov ◽  
Michael Maes

: Mood disorders and Major Depressive Disorder, in particular, appear to be some of the most common psychiatric disorders with a high rate of comorbidity most frequently of anxiety or substance abuse disorders (alcohol use disorder). In both cases – MDD and AUD, a number of immunological disturbances are observed, such as chronic mild inflammation response, increased level of cytokines, hypercortisolaemia, which lead to specific changes in brain neurotransmitter functions. : Some of the contemporary brain imaging techniques are functional magnetic resonance imaging (fMRI) and magnetic spectroscopy which are most commonly used to assess the brain metabolism and functional connectivity changes such as altered responses to emotional stimuli in MDD or overactivation of ventromedial prefrontal areas during delayed and underactivation of dorsolateral prefrontal regions during impulsive reward decisions in AUD and dysfunction of gamma-aminobutyric acid (GABA) and/or glutamate neurotransmitter systems, low NAA and myo-Inositol in both MDD and AUD.

2021 ◽  
Vol 12 (1) ◽  
pp. 48
Author(s):  
Victor M. Tang ◽  
Bernard Le Foll ◽  
Daniel M. Blumberger ◽  
Daphne Voineskos

Major depressive disorder (MDD) and alcohol use disorder (AUD) are leading causes of disability, and patients are frequently affected by both conditions. This comorbidity is known to confer worse outcomes and greater illness severity. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation method that has demonstrated antidepressant effects. However, the study of rTMS for patients with MDD and commonly associated comorbidities, such as AUD, has been largely overlooked, despite significant overlap in clinical presentation and neurobiological mechanisms. This narrative review aims to highlight the interrelated aspects of the literature on rTMS for MDD and rTMS for AUD. First, we summarize the available evidence on the effectiveness of rTMS for each condition, both most studied through stimulation of the dorsolateral prefrontal cortex (DLPFC). Second, we describe common symptom constructs that can be modulated by rTMS, such as executive dysfunction, that are transdiagnostic across these disorders. Lastly, we describe promising approaches in the personalization and optimization of rTMS that may be applicable to both AUD and MDD. By bridging the gap between research efforts in MDD and AUD, rTMS is well positioned to be developed as a treatment for the many patients who have both conditions concurrently.


2017 ◽  
Vol 41 (S1) ◽  
pp. S79-S79 ◽  
Author(s):  
A.V. Samokhvalov ◽  
S. Awan ◽  
B. Le Foll ◽  
C. Probst ◽  
P. Voore ◽  
...  

BackgroundBoth major depressive disorder (MDD) and alcohol use disorder are highly prevalent, often comorbid and cause significant socioeconomic burden. At CAMH, we have developed and integrated care pathway (ICP) to treat these disorders and evaluated its effectiveness in comparison to treatment as usual (TAU)MethodsChart review; descriptive statistics, c2 and t-tests, linear mixed effects models, Kaplan–Meier and log-rank analyses.ResultsOverall, 81 patients were enrolled into ICP. Comparisons of treatment retention rates between ICP patients and matched historical controls (n = 81) showed significantly lower dropout rate in ICP cohort (18.5% vs. 69.1%, P < 0.001, Fig. 1). The ICP patients demonstrated significant reduction in depressive symptoms severity (QIDS: 14.6 vs. 10.0, P < 0.001; BDI 26.3 vs. 16.2, P < 0.001), reduction in the amount of alcohol consumed weekly from 44.6 standard drinks at baseline to 12.6 (P < 0.001) by the end of treatment, which was significantly better compared to controls (56.9 vs. 25.2, P < 0.001), P = 0.014 (Fig. 2).ConclusionsThe ICP is a feasible approach to treatment of concurrent AUD and MDD with significantly higher retention rates than TAU. Patients demonstrate improvements on several levels including depressive symptoms, and changes in alcohol drinking patterns.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2014 ◽  
Vol 50 (2) ◽  
pp. 195-199 ◽  
Author(s):  
Stéphanie Baggio ◽  
Katia Iglesias ◽  
Joseph Studer ◽  
Marc Dupuis ◽  
Jean-Bernard Daeppen ◽  
...  

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shiyi Xie ◽  
Yan Hu ◽  
Li Fang ◽  
Shijia Chen ◽  
Benson O.A. Botchway ◽  
...  

Abstract Major depressive disorder is a genetic susceptible disease, and a psychiatric syndrome with a high rate of incidence and recurrence. Because of its complexity concerning etiology and pathogenesis, the cure rate of first-line antidepressants is low. In recent years, accumulative evidences revealed that oxytocin act as a physiological or pathological participant in a variety of complex neuropsychological activities, including major depressive disorder. Six electronic databases (Web of Science, PubMed, Scopus, Google Scholar, CNKI, and Wanfang) were employed for researching relevant publications. At last, 226 articles were extracted. The current review addresses the correlation of the oxytocin system and major depressive disorder. Besides, we summarize the mechanisms by which the oxytocin system exerts potential antidepressant effects, including regulating neuronal activity, influencing neuroplasticity and regeneration, altering neurotransmitter release, down regulating hypothalamic–pituitary–adrenal axis, anti-inflammatory, antioxidation, and genetic effects. Increasing evidence shows that oxytocin and its receptor gene may play a potential role in major depressive disorder. Future research should focus on the predictive ability of the oxytocin system as a biomarker, as well as its role in targeted prevention and early intervention of major depressive disorder.


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