Systemic Catecholaminergic Deficiency in Depressed Patients with and without Coronary Artery Disease

Measurement of differential activation by heart-rate-variability for youth MDD discrimination

OBJECTIVE

Major depression disorder (MDD) is a common illness that severely limits psychosocial functioning and diminishes quality of life, particularly in young adults. Thus, it is imperial to identify MDD youth patients efficiently. This study aims to determine whether differential activation (DA) oriented recognizers can work efficiently.

METHODS

This study collected heart rate variability (HRV) data and demographic information from 50 youth patients diagnosed with MDD and 53 healthy control participants. We developed six datasets, comprising baseline, stress, rest, differential activation period, Difference values between rest and stress period and combined dataset. From the provided data sets, we have developed machine learning models and also deep learning models. We then proceed to compare the performance metrics.

RESULTS

Models that utilized DA period and integration data sets exhibited superior performance compared to others. The deep learning model based on Long Short-Term Memory model we developed demonstrated the highest performance among all the models in each data set. Specifically, in the integration dataset, the model attained a mean cross-validation accuracy of 0.806 (95 % Confidential Interval (CI) 0.785-0.827), with a mean Area under Receiver Operating Characteristic Curve of 0.805 (95 % CI 0.784-0.826) and a mean Area under the Precision-Recall Curve of 0.863 (95 % CI 0.848-0.878).

CONCLUSION

The combination of DA theory and HRV record provides a new insight and also an efficient way for youth MDD identification.

Alamandine enhanced spatial memory in rats by reducing neuroinflammation and altering BDNF levels in the hippocampus and prefrontal cortex

Our study aims to determine the effects of alamandine, the newest component of the renin-angiotensin system, on cognitive functions, neuroinflammation, and oxidative stress in the pathophysiology of depression. 35 male Sprague dawley rats, three months old, weighing between 300 and 350 g, were used. The chronic, unpredictable mild stress model of depression was performed. Experimental animals were divided into five groups: control (C), depression (D), alamandine (50 µg/kg, ip) (D + ALA), A779 (300 µg/kg, ip) (D + A779), and both alamandine and A779 treatment groups (D + ALA + A779). After confirming the development of depression through behavioral tests, the animals' learning and memory performances were measured using the Morris water maze test. At the end of the experiment, the animals' prefrontal cortex, hippocampus, and blood samples were isolated for biochemical studies and gene expression analyses. The sucrose preference, open field, elevated plus maze, tail suspension, and forced swimming tests were performed to determine the animals' anxiety levels. There was a significant increase in anxiety-like behaviors in the D group and the A779-treated group, while alamandine exhibited an anxiolytic effect. Moreover, improvements in cognitive skills observed in the Morris water maze test were paralleled by molecular changes, including an increase in BDNF protein levels and NMDA receptor expression and a decrease in GABA levels. In addition, the levels of TNF-α, IL-1β, IL-6, and oxidative stress markers were increased in the depression groups while significantly decreased with alamandine treatment. It was concluded that alamandine has an anxiolytic effect and facilitates spatial memory by reducing neuroinflammation and oxidative stress.

Depression Paradox in Cardiovascular Outcomes of Adult Patients with Obstructive Sleep Apnea: Insights from 2 Million Nationwide Hospitalizations

OBJECTIVE

Depression is a frequent comorbidity in obstructive sleep apnea (OSA) patients. There is a scarcity of data on the impact of depression on the outcomes of OSA.

MATERIAL AND METHODS

Using the National Inpatient Sample (2018), we identified hospitalizations in the US with OSA. Following propensity-score matching, the two cohorts of OSA with depression (OSA+D+) vs. without depression (OSA+D-) were compared for demographic and comorbidities profiles differences. Multivariable regression analyses were performed to assess the odds of events with depression versus those without.

RESULTS

Of 2,169.730 hospitalizations in patients with OSA, 20.1% had comorbid depression. Matched cohorts included 846,150 admissions in both groups: OSA+D+ and OSA+D-. Both cohorts predominantly comprised Caucasians, the elderly (median age, 64 vs. 65 years), and females (55.5% vs. 55.2%). OSA+D+ cohort had a higher prevalence of hypertension, diabetes, hyperlipidemia, congestive heart failure, anemia, smoking, substance abuse, prior myocardial infarction (MI), transient ischemic attack (TIA), TIA/stroke, and venous thromboembolism than the OSA+D- group (all P < 0.001). Paradoxically, there was decreased risk of all-cause mortality [odds ratios (OR): 0.79, 95% confidence interval (CI): 0.73-0.86], major adverse cardiac and cerebrovascular events (OR: 0.83, 95% CI: 0.80-0.87), acute MI (OR: 0.80, 95% CI: 0.76-0.85), dysrhythmia/atrial fibrillation (OR: 0.81, 95% CI: 0.79-0.83), and cardiac arrest including ventricular fibrillation (OR: 0.65, 95% CI: 0.73-0.82) in the OSA+D+ cohort (P < 0.001).

CONCLUSION

OSA+D+ patients had better in-hospital outcomes as compared to OSA+D- despite having a higher burden of comorbidities. Additional research is warranted to validate this paradoxical effect of depression in OSA.

Sertraline in depressed patients with or at risk for coronary heart disese: a systemic review

BACKGROUND AND AIMS

Depression is a prevalent comorbidity among patients with coronary heart disease (CHD). While recent studies have hinted at a possible association between CHD and antidepressant medications like sertraline, the existing evidence remains inconclusive. To investigate this potential link, we conducted a comprehensive systematic review.

METHODS

We systematically searched PubMed, Google Scholar, and Scopus for relevant articles published up to March 2023. After a thorough screening of titles and abstracts, 12 studies were included in our review.

RESULTS

The included studies, spanning from 1999 to 2021, comprised 11 randomized controlled trials (RCTs) and one pilot study. A total of 2767 participants with major depressive disorder and a history of cardiovascular disease or at risk for such events were included. The majority of these studies demonstrated improvements in mood status among patients treated with serotonin-targeting antidepressants and a reduced risk of cardiovascular events, as measured by various outcomes. While some cardiac adverse effects were observed with serotonin treatment, these did not reach statistical significance.

CONCLUSION

Our findings provide evidence supporting the beneficial effects of serotonin-targeting antidepressants for both depressive symptoms and the prevention of coronary adverse outcomes. These results highlight the potential value of serotonin-based treatments for depression in high-risk populations.

Boric Acid Functionalized Hypercrosslinked Polymers for Selective Extraction of Trace Catecholamines and Their Metabolites in Rat Serum

Abnormal levels of catecholamine (CA) neurotransmitters and their metabolites in biological fluids can lead to various neurological disorders. Herein, a boric acid-functionalized hypercrosslinked polymer was prepared and utilized as a sorbent for the dispersive solid-phase extraction of CAs and their metabolites in rat serum. By combination with a high-performance liquid chromatography-fluorescence detector, the extraction parameters for the seven target analytes were optimized. Under the optimal extraction condition, the methodology for the quantitative analysis of CAs and their metabolites in rat serum samples was established. The limits of detection and limits of quantification were found to be in the ranges of 0.010-0.015 and 0.033-0.050 ng/mL, respectively. The results demonstrated satisfactory recoveries, with values ranging from 88.02% to 113.27%, accompanied by relative standard deviations within the range of 2.69%-9.59%. In addition, the method showed good anti-interference ability (matrix effect ranged from 2.64% to 18.07%). The developed method was validated for the determination of CAs and their metabolites in normal and Alzheimer's disease model rats' serum, which proved the promising application of the method for CAs neurotransmitter analysis in biological samples.

Depression in Heart Failure with Reduced Ejection Fraction, an Undervalued Comorbidity: An Up-To-Date Review

Introduction: Depression is a common and severe comorbidity among individuals with heart failure (HF). Up to a third of all HF patients are depressed, and an even higher proportion have symptoms of depression. Aim: In this review, we evaluate the relationship between HF and depression, explain the pathophysiology and epidemiology of both diseases and their relationship, and highlight novel diagnostic and therapeutic options for HF patients with depression. Materials and Methods: This narrative review involved keyword searches of PubMed and Web of Science. Review search terms included ["Depression" OR "Depres*" OR "major depr*"] AND ["Heart Failure" OR "HF" OR "HFrEF" OR "HFmrEF" OR "HFpEF" OR "HFimpEF"] in all fields. Studies included in the review met the following criteria: (A) published in a peer-reviewed journal; (B) described the impact of depression on HF and vice versa; and (C) were opinion papers, guidelines, case studies, descriptive studies, randomized control trials, prospective studies, retrospective studies, narrative reviews, and systematic reviews. Results: Depression is an emergent HF risk factor and strongly relates with worse clinical outcomes. HF and depression share multiple pathways, including platelet dis-reactivity, neuroendocrine malfunction, inappropriate inflammation, tachi-arrhythmias, and frailty in the social and community setting. Existing HF guidelines urge evaluation of depression in all HF patients, and numerous screening tools are available. Depression is ultimately diagnosed based on DSM-5 criteria. There are both non-pharmaceutical and pharmaceutical treatments for depression. Regarding depressed symptoms, non-pharmaceutical treatments, such as cognitive-behavioral therapy and physical exercise, have shown therapeutic results, under medical supervision and with an effort level adapted to the patient's physical resources, together with optimal HF treatment. In randomized clinical studies, selective serotonin reuptake inhibitors, the backbone of antidepressant treatment, did not demonstrate advantage over the placebo in patients with HF. New antidepressant medications are currently being studied and could provide a chance to enhance management, treatment, and control of depression in patients with HF. Conclusions: Despite the substantial link between depression and HF, their combination is underdiagnosed and undertreated. Considering the hopeful yet unclear findings of antidepressant trials, further research is required to identify people who may benefit from antidepressant medication. The goal of future research should be a complete approach to the care of these patients, who are anticipated to become a significant medical burden in the future.

Associations Between Disordered Microbial Metabolites and Changes of Neurotransmitters in Depressed Mice

Backgrounds

Many pieces of evidence demonstrated that there were close relationships between gut microbiota and depression. However, the specific molecular mechanisms were still unknown. Here, using targeted metabolomics, this study was conducted to explore the relationships between microbial metabolites in feces and neurotransmitters in prefrontal cortex of depressed mice.

Methods

Chronic unpredictable mild stress (CUMS) model of depression was built in this study. Targeted liquid chromatography-mass spectrometry analysis was used to detect the microbial metabolites in feces and neurotransmitters in prefrontal cortex of mice. Both univariate and multivariate statistical analyses were applied to identify the differential microbial metabolites and neurotransmitters and explore relationships between them.

Results

Ninety-eight differential microbial metabolites (mainly belonged to amino acids, fatty acids, and bile acids) and 11 differential neurotransmitters (belonged to tryptophan pathway, GABAergic pathway, and catecholaminergic pathway) were identified. Five affected amino acid-related metabolic pathways were found in depressed mice. The 19 differential microbial metabolites and 10 differential neurotransmitters were found to be significantly correlated with depressive-like behaviors. The two differential neurotransmitters (tyrosine and glutamate) and differential microbial metabolites belonged to amino acids had greater contributions to the overall correlations between microbial metabolites and neurotransmitters. In addition, the significantly decreased L-tyrosine as microbial metabolites and tyrosine as neurotransmitter had the significantly positive correlation (r = 0.681, p = 0.0009).

Conclusions

These results indicated that CUMS-induced disturbances of microbial metabolites (especially amino acids) might affect the levels of neurotransmitters in prefrontal cortex and then caused the onset of depression. Our findings could broaden the understanding of how gut microbiota was involved in the onset of depression.