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Driessen HP, Morsink S, Busschbach JJ, Hoogendijk WJ, Kranenburg LW. Eye Movement Desensitization and Reprocessing (EMDR) treatment in the medical setting: a systematic review. Eur J Psychotraumatol 2024; 15:2341577. [PMID: 38747113 PMCID: PMC11097707 DOI: 10.1080/20008066.2024.2341577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background: Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.Objective: This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.Methods: We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).Results: Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.Conclusions: Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed.
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Affiliation(s)
- Helen P.A. Driessen
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sid Morsink
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan J.V. Busschbach
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Witte J.G. Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Leonieke W. Kranenburg
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Slabe Z, Balesar RA, Verwer RWH, Van Heerikhuize JJ, Pechler GA, Zorović M, Hoogendijk WJ, Swaab DF. Alterations in pituitary adenylate cyclase-activating polypeptide in major depressive disorder, bipolar disorder, and comorbid depression in Alzheimer's disease in the human hypothalamus and prefrontal cortex. Psychol Med 2023; 53:7537-7549. [PMID: 37226771 PMCID: PMC10755247 DOI: 10.1017/s0033291723001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 03/01/2023] [Accepted: 04/13/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) is involved in the stress response and may play a key role in mood disorders, but no information is available on PACAP for the human brain in relation to mood disorders. METHODS PACAP-peptide levels were determined in a major stress-response site, the hypothalamic paraventricular nucleus (PVN), of people with major depressive disorder (MDD), bipolar disorder (BD) and of a unique cohort of Alzheimer's disease (AD) patients with and without depression, all with matched controls. The expression of PACAP-(Adcyap1mRNA) and PACAP-receptors was determined in the MDD and BD patients by qPCR in presumed target sites of PACAP in stress-related disorders, the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC). RESULTS PACAP cell bodies and/or fibres were localised throughout the hypothalamus with differences between immunocytochemistry and in situ hybridisation. In the controls, PACAP-immunoreactivity-(ir) in the PVN was higher in women than in men. PVN-PACAP-ir was higher in male BD compared to the matched male controls. In all AD patients, the PVN-PACAP-ir was lower compared to the controls, but higher in AD depressed patients compared to those without depression. There was a significant positive correlation between the Cornell depression score and PVN-PACAP-ir in all AD patients combined. In the ACC and DLPFC, alterations in mRNA expression of PACAP and its receptors were associated with mood disorders in a differential way depending on the type of mood disorder, suicide, and psychotic features. CONCLUSION The results support the possibility that PACAP plays a role in mood disorder pathophysiology.
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Affiliation(s)
- Zala Slabe
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
- University of Ljubljana, Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, Korytkova 2, 1000 Ljubljana, Slovenia
| | - Rawien A. Balesar
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - Ronald W. H. Verwer
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - Joop J. Van Heerikhuize
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - Gwyneth A. Pechler
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
- University of Ljubljana, Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, Korytkova 2, 1000 Ljubljana, Slovenia
| | - Maja Zorović
- University of Ljubljana, Faculty of Medicine, Institute of Pathophysiology, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Witte J.G. Hoogendijk
- Erasmus University Medical Centre, Department of Psychiatry, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Dick F. Swaab
- Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
- University of Ljubljana, Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, Korytkova 2, 1000 Ljubljana, Slovenia
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Broeks CW, Molenaar N, Brouwer M, van den Akker EL, van Rossum EF, Van R, van den Berg SA, Hillegers M, Hoogendijk WJ, Burger H, Bockting C, Kamperman AM, Lambregtse-Van den Berg MP. Intergenerational impact of childhood trauma on hair cortisol concentrations in mothers and their young infants. Compr Psychoneuroendocrinol 2023; 14:100167. [PMID: 36819463 PMCID: PMC9930158 DOI: 10.1016/j.cpnec.2023.100167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Background Alterations in stress regulation and function of the hypothalamic-pituitary-adrenal (HPA) axis during infancy may be a risk factor for the development of psychopathology later in life. Maternal childhood trauma, depression, anxiety and stressful life events are individually associated with HPA axis dysregulation. Less is known about their interdependent influence on maternal and infant stress regulation in at risk populations. In a sample of mothers with a history of depressive-, and/or anxiety disorders and their infants we explored if a history of maternal childhood trauma, current depressive and anxiety symptomatology, and recent life events were associated with maternal and infant long-term cortisol levels three months postpartum. Methods Data were available of 89 mothers and 49 infants. All mothers fulfilled criteria for a lifetime depressive or anxiety disorder. Diagnosis was established with a diagnostic interview. Current depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS), current anxiety with the State-Trait Anxiety Inventory (STAI), maternal childhood trauma with the Childhood Trauma Questionnaire (CTQ) and recent life events with the Everyday Problem Checklist (EPC). Maternal and infant hair cortisol concentrations (HCC) were quantified with liquid chromatography with tandem mass spectrometry (LC-MS/MS) three months after birth. Total scores of the CTQ and subscales, EPDS, STAI, and EPC were regressed on maternal and infant HCC using regression analyses. Differences in HCC regarding trauma history were tested with t-tests. Potential confounders were identified and adjusted for. Results In regression analyses, a positive curvilinear relationship was found between CTQ total score and maternal HCC (n = 83, B = 0.076, SE 0.033, p = .021), but not for current depression (n = 88, B = -0.001, SE 0.011, p = .931), current anxiety (n = 88, B = 0.002, SE 0.004, p = .650) or recent life events (n = 89, B = 0.018, SE 0.032, p = .568). Analyses were adjusted for confounders. A negative linear relationship was found between maternal CTQ score and infant HCC (n = 49, β = -0.264, B = -0.006, SE 0.003, p = .052), but not for current maternal depression (n = 45, β = -0.182, B = -0.011, SE 0.008, p = .164), current maternal anxiety (n = 45, β = -0.209, B = -0.005, SE 0.003, p = .113) or recent life events (n = 46, β = -0.128, B = -0.022, SE 0.023, p = .325). Analyses were adjusted for relevant infant hair characteristics. Specifically, maternal emotional and physical neglect were related to HCC in both mothers and infants. Conclusions Results suggest that maternal childhood trauma is more prominent in altering maternal and infant long-term cortisol levels than perinatal depressive and anxiety symptomatology or recent life stressors in mothers with a history of depressive and/or anxiety disorders, and their infants. As infants of mothers with psychopathology are at increased risk for later psychiatric disease, future studies should investigate the interplay of possible risk factors for transgenerational transmission, intra-uterine programming of the HPA axis, including (epi-)genetic phenomena, of the HPA axis, and the influence of parenting impairment.
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Affiliation(s)
- Carlinde W. Broeks
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Nina Molenaar
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Marlies Brouwer
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands,University of Amsterdam, Centre for Urban Mental Health, Amsterdam, the Netherlands
| | - Erica L.T. van den Akker
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital and Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F.C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rien Van
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Sjoerd A.A. van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Witte J.G. Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Huibert Burger
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - Claudi Bockting
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands,University of Amsterdam, Centre for Urban Mental Health, Amsterdam, the Netherlands
| | - Astrid M. Kamperman
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Epidemiological and Social Psychiatric Research Institute, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mijke P. Lambregtse-Van den Berg
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Corresponding author. P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands.
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4
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Scheepers FE, de Mul J, Boer F, Hoogendijk WJ. [Psychosis as an evolutionary adaptive mechanism to environmental changes; A plea for a functional explanatory model]. Tijdschr Psychiatr 2020; 62:472-480. [PMID: 32583868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
From an evolutionary perspective it is remarkable that psychotic disorders, mostly occurring during fertile age and decreasing fecundity, maintain in the human population.<br/> AIM: To argue the hypothesis that psychotic symptoms may not be viewed as an illness but as an adaptation phenomenon.<br/> METHOD: Philosophical consideration and literature study.<br/> RESULTS: Until now, biomedical research has not unraveled the definitive etiology of psychotic disorders. Findings are inconsistent and show non-specific brain anomalies and genetic variation with small effect sizes. However, compelling evidence was found for a relation between psychosis and stressful environmental factors, particularly those influencing social interaction. Psychotic symptoms may be explained as a natural defense mechanism or protective response to stressful environments. This is in line with the fact that psychotic symptoms most often develop during adolescence. In this phase of life, it is important for an individual's development to leave the familiar and safe home environment, and to build new social networks. This could cause symptoms of 'hyperconsciousness' and calls on the capacity for social adaptation. This mechanism can become out of control due to different underlying brain vulnerabilities and external stressors, leading to social exclusion. CONCLUSIONS There is theoretical ground to consider psychotic symptoms as an evolutionary maintained phenomenon. Research investigating psychotic disorders may benefit from a focus on underlying general brain vulnerabilities or prevention of social exclusion, instead of regarding psychotic symptoms as abnormal phenomena.
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Riga D, Schmitz LJ, Mourik Y, Hoogendijk WJ, De Vries TJ, Smit AB, Spijker S. Stress vulnerability promotes an alcohol-prone phenotype in a preclinical model of sustained depression. Addict Biol 2020; 25:e12701. [PMID: 30561063 PMCID: PMC6916303 DOI: 10.1111/adb.12701] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/28/2018] [Accepted: 11/05/2018] [Indexed: 12/15/2022]
Abstract
Major depression and alcohol‐related disorders frequently co‐occur. Depression severity weighs on the magnitude and persistence of comorbid alcohol use disorder (AUD), with severe implications for disease prognosis. Here, we investigated whether depression vulnerability drives propensity to AUD at the preclinical level. We used the social defeat–induced persistent stress (SDPS) model of chronic depression in combination with operant alcohol self‐administration (SA). Male Wistar rats were subjected to social defeat (five episodes) and prolonged social isolation (~12 weeks) and subsequently classified as SDPS‐prone or SDPS‐resilient based on their affective and cognitive performance. Using an operant alcohol SA paradigm, acquisition, motivation, extinction, and cue‐induced reinstatement of alcohol seeking were examined in the two subpopulations. SDPS‐prone animals showed increased alcohol SA, heightened motivation to acquire alcohol, persistent alcohol seeking despite alcohol unavailability, signs of extinction resistance, and increased cue‐induced relapse; the latter could be blocked by the α2 adrenoreceptor agonist guanfacine. In SDPS‐resilient rats, prior exposure to social defeat increased alcohol SA without affecting any other measures of alcohol seeking and alcohol taking. Our data revealed that depression proneness confers vulnerability to alcohol, emulating patterns of alcohol dependence seen in human addicts, and that depression resilience to a large extent protects from the development of AUD‐like phenotypes. Furthermore, our data suggest that stress exposure alone, independently of depressive symptoms, alters alcohol intake in the long‐term.
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Affiliation(s)
- Danai Riga
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam NeuroscienceVrije Universiteit Amsterdam The Netherlands
| | - Leanne J.M. Schmitz
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam NeuroscienceVrije Universiteit Amsterdam The Netherlands
| | - Yvar Mourik
- Department of Anatomy and Neurosciences, Amsterdam NeuroscienceVrije Universiteit Medical Center Amsterdam The Netherlands
| | | | - Taco J. De Vries
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam NeuroscienceVrije Universiteit Amsterdam The Netherlands
- Department of Anatomy and Neurosciences, Amsterdam NeuroscienceVrije Universiteit Medical Center Amsterdam The Netherlands
| | - August B. Smit
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam NeuroscienceVrije Universiteit Amsterdam The Netherlands
| | - Sabine Spijker
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Amsterdam NeuroscienceVrije Universiteit Amsterdam The Netherlands
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6
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Quispel C, Bangma M, Kazemier BM, Steegers EA, Hoogendijk WJ, Papatsonis DN, Paarlberg KM, Lambregtse-Van Den Berg MP, Bonsel GJ. The role of depressive symptoms in the pathway of demographic and psychosocial risks to preterm birth and small for gestational age. Midwifery 2014; 30:919-25. [DOI: 10.1016/j.midw.2014.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 01/24/2014] [Accepted: 03/10/2014] [Indexed: 10/25/2022]
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7
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Carvalho LA, Bergink V, Sumaski L, Wijkhuijs J, Hoogendijk WJ, Birkenhager TK, Drexhage HA. Inflammatory activation is associated with a reduced glucocorticoid receptor alpha/beta expression ratio in monocytes of inpatients with melancholic major depressive disorder. Transl Psychiatry 2014; 4:e344. [PMID: 24424390 PMCID: PMC3905228 DOI: 10.1038/tp.2013.118] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 09/09/2013] [Accepted: 10/29/2013] [Indexed: 01/01/2023] Open
Abstract
In this study, we used new technology to investigate whether a coherent pattern of enhanced expression of inflammatory and other immune activation genes in circulating monocytes is found in patients with major depression. Since a high inflammatory state of monocytes might be related to glucocorticoid resistance, we also included the genes for the two isoforms of the glucocorticoid receptor. For this study, we aimed at finding a similar coherent pattern of inflammatory and immune activation genes in monocytes of patients with MDD and recruited 47 medication-free melancholic MDD inpatients and 42 healthy controls. A quantitative-polymerase chain reaction (Q-PCR) monocyte gene expression analysis was performed using a panel of inflammatory-related genes previously identified as abnormally regulated in mood disorder patients. Selected serum cytokines/chemokines were assessed using a cytometric bead array. Depressive symptoms were analysed using Hamilton depression scores (HAMD). Thirty-four of the 47 monocyte inflammatory-related genes were significantly upregulated and 2 were significantly downregulated as compared to controls, the latter including the gene for the active GRα in particular in those with a high HAMD score. The reduced GRα expression correlated strongly to the upregulation of the inflammatory genes in monocytes. Serum levels of IL6, IL8, CCL2 and VEGF were significantly increased in patients compared to controls. Our data show the deregulation of two interrelated homoeostatic systems, that is, the immune system and the glucocorticoid system, co-occurring in major depression.
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Affiliation(s)
- L A Carvalho
- Department of Epidemiology and Public Health, University College London, London, UK,UCL Research Department of Epidemiology and Public Health, 1–19 Torrington Place, Rm356a, London, WC1E 7HB, UK. E-mail:
| | - V Bergink
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L Sumaski
- Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Universitatsklinikum Munster, Munster, Germany
| | - J Wijkhuijs
- Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - W J Hoogendijk
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - T K Birkenhager
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - H A Drexhage
- Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
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de Klerk OL, Nolte IM, Bet PM, Bosker FJ, Snieder H, den Boer JA, Bruggeman R, Hoogendijk WJ, Penninx BW. ABCB1 gene variants influence tolerance to selective serotonin reuptake inhibitors in a large sample of Dutch cases with major depressive disorder. Pharmacogenomics J 2012; 13:349-53. [PMID: 22641028 DOI: 10.1038/tpj.2012.16] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 04/02/2012] [Accepted: 04/11/2012] [Indexed: 01/16/2023]
Abstract
P-glycoprotein (P-gp), an ATP-driven efflux pump in the blood-brain barrier, has a major impact on the delivery of antidepressant drugs in the brain. Genetic variants in the gene ABCB1 encoding for P-gp have inconsistently been associated with adverse effects. In order to resolve these inconsistencies, we conducted a study in a large cohort of patients with major depressive disorder with the aim to unravel the association of ABCB1 variants with adverse effects of antidepressants and in particular with selective serotonin reuptake inhibitors (SSRIs), which display affinity as substrate for P-gp. The Netherlands Study of Depression and Anxiety (NESDA) study was used as a clinical sample. For 424 patients data were available on drug use, side effects. We selected six ABCB1 gene variants (1236T>C, 2677G>T/A, 3435T>C, rs2032583, rs2235040 and rs2235015) and analyzed them for association with adverse drug effects using multinomial regression analysis for both single variants and haplotypes. We found a significant association between the number of SSRI-related adverse drug effects and rs2032583 (P=0.001), rs2235040 (P=0.002) and a haplotype (P=0.002). Moreover, serotonergic effects (sleeplessness, gastrointestinal complaints and sexual effects) were significantly predicted by these variants and haplotype (P=0.002/0.003). We conclude that adverse drug effects with SSRI treatment, in particular serotonergic effects, are predicted by two common polymorphisms of the ABCB1 gene.
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Affiliation(s)
- O L de Klerk
- University Center of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
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Woudstra S, Bochdanovits Z, van Tol MJ, Veltman DJ, Zitman FG, van Buchem MA, van der Wee NJ, Opmeer EM, Demenescu LR, Aleman A, Penninx BW, Hoogendijk WJ. Piccolo genotype modulates neural correlates of emotion processing but not executive functioning. Transl Psychiatry 2012; 2:e99. [PMID: 22832909 PMCID: PMC3337071 DOI: 10.1038/tp.2012.29] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Major depressive disorder (MDD) is characterized by affective symptoms and cognitive impairments, which have been associated with changes in limbic and prefrontal activity as well as with monoaminergic neurotransmission. A genome-wide association study implicated the polymorphism rs2522833 in the piccolo (PCLO) gene--involved in monoaminergic neurotransmission--as a risk factor for MDD. However, the role of the PCLO risk allele in emotion processing and executive function or its effect on their neural substrate has never been studied. We used functional magnetic resonance imaging (fMRI) to investigate PCLO risk allele carriers vs noncarriers during an emotional face processing task and a visuospatial planning task in 159 current MDD patients and healthy controls. In PCLO risk allele carriers, we found increased activity in the left amygdala during processing of angry and sad faces compared with noncarriers, independent of psychopathological status. During processing of fearful faces, the PCLO risk allele was associated with increased amygdala activation in MDD patients only. During the visuospatial planning task, we found no genotype effect on performance or on BOLD signal in our predefined areas as a function of increasing task load. The PCLO risk allele was found to be specifically associated with altered emotion processing, but not with executive dysfunction. Moreover, the PCLO risk allele appears to modulate amygdala function during fearful facial processing in MDD and may constitute a possible link between genotype and susceptibility for depression via altered processing of fearful stimuli. The current results may therefore aid in better understanding underlying neurobiological mechanisms in MDD.
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Affiliation(s)
- S Woudstra
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
| | - Z Bochdanovits
- Department of Medical Genomics, VU University Medical Center, Amsterdam, The Netherlands,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - M-J van Tol
- BCN Neuroimaging Center and Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Leibniz Institute for Neurobiology, Otto von Guericke University, Magdeburg, Germany
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - F G Zitman
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - M A van Buchem
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands,Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - N J van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands,Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - E M Opmeer
- BCN Neuroimaging Center and Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L R Demenescu
- BCN Neuroimaging Center and Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - A Aleman
- BCN Neuroimaging Center and Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - B W Penninx
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands,BCN Neuroimaging Center and Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - W J Hoogendijk
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands,Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
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10
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Bosker FJ, Hartman CA, Nolte IM, Prins BP, Terpstra P, Posthuma D, van Veen T, Willemsen G, DeRijk RH, de Geus EJ, Hoogendijk WJ, Sullivan PF, Penninx BW, Boomsma DI, Snieder H, Nolen WA. Poor replication of candidate genes for major depressive disorder using genome-wide association data. Mol Psychiatry 2011; 16:516-32. [PMID: 20351714 DOI: 10.1038/mp.2010.38] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Data from the Genetic Association Information Network (GAIN) genome-wide association study (GWAS) in major depressive disorder (MDD) were used to explore previously reported candidate gene and single-nucleotide polymorphism (SNP) associations in MDD. A systematic literature search of candidate genes associated with MDD in case-control studies was performed before the results of the GAIN MDD study became available. Measured and imputed candidate SNPs and genes were tested in the GAIN MDD study encompassing 1738 cases and 1802 controls. Imputation was used to increase the number of SNPs from the GWAS and to improve coverage of SNPs in the candidate genes selected. Tests were carried out for individual SNPs and the entire gene using different statistical approaches, with permutation analysis as the final arbiter. In all, 78 papers reporting on 57 genes were identified, from which 92 SNPs could be mapped. In the GAIN MDD study, two SNPs were associated with MDD: C5orf20 (rs12520799; P=0.038; odds ratio (OR) AT=1.10, 95% CI 0.95-1.29; OR TT=1.21, 95% confidence interval (CI) 1.01-1.47) and NPY (rs16139; P=0.034; OR C allele=0.73, 95% CI 0.55-0.97), constituting a direct replication of previously identified SNPs. At the gene level, TNF (rs76917; OR T=1.35, 95% CI 1.13-1.63; P=0.0034) was identified as the only gene for which the association with MDD remained significant after correction for multiple testing. For SLC6A2 (norepinephrine transporter (NET)) significantly more SNPs (19 out of 100; P=0.039) than expected were associated while accounting for the linkage disequilibrium (LD) structure. Thus, we found support for involvement in MDD for only four genes. However, given the number of candidate SNPs and genes that were tested, even these significant may well be false positives. The poor replication may point to publication bias and false-positive findings in previous candidate gene studies, and may also be related to heterogeneity of the MDD phenotype as well as contextual genetic or environmental factors.
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Affiliation(s)
- F J Bosker
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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11
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Klumpers UM, Boellaard R, Veltman DJ, Kloet RW, Hoogendijk WJ, Lammertsma AA. Parametric methods for quantification of [11C]Flumazenil studies. Neuroimage 2010. [DOI: 10.1016/j.neuroimage.2010.04.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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12
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Remijnse PL, Nielen MMA, van Balkom AJLM, Hendriks GJ, Hoogendijk WJ, Uylings HBM, Veltman DJ. Differential frontal-striatal and paralimbic activity during reversal learning in major depressive disorder and obsessive-compulsive disorder. Psychol Med 2009; 39:1503-1518. [PMID: 19171077 DOI: 10.1017/s0033291708005072] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Several lines of research suggest a disturbance of reversal learning (reward and punishment processing, and affective switching) in patients with major depressive disorder (MDD). Obsessive-compulsive disorder (OCD) is also characterized by abnormal reversal learning, and is often co-morbid with MDD. However, neurobiological distinctions between the disorders are unclear. Functional neuroimaging (activation) studies comparing MDD and OCD directly are lacking. METHOD Twenty non-medicated OCD-free patients with MDD, 20 non-medicated MDD-free patients with OCD, and 27 healthy controls performed a self-paced reversal learning task in an event-related design during functional magnetic resonance imaging (fMRI). RESULTS Compared with healthy controls, both MDD and OCD patients displayed prolonged mean reaction times (RTs) but normal accuracy. In MDD subjects, mean RTs were correlated with disease severity. Imaging results showed MDD-specific hyperactivity in the anterior insula during punishment processing and in the putamen during reward processing. Moreover, blood oxygen level-dependent (BOLD) responses in the dorsolateral prefrontal cortex (DLPFC) and the anterior PFC during affective switching showed a linear decrease across controls, MDD and OCD. Finally, the OCD group showed blunted responsiveness of the orbitofrontal (OFC)-striatal loop during reward, and in the OFC and anterior insula during affective switching. CONCLUSIONS This study shows frontal-striatal and (para)limbic functional abnormalities during reversal learning in MDD, in the context of generic psychomotor slowing. These data converge with currently influential models on the neuropathophysiology of MDD. Moreover, this study reports differential neural patterns in frontal-striatal and paralimbic structures on this task between MDD and OCD, confirming previous findings regarding the neural correlates of deficient reversal learning in OCD.
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Affiliation(s)
- P L Remijnse
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
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13
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Riemersma-van der Lek RF, Swab DF, Twisk J, Hol EM, Hoogendijk WJ, Van Someren E. Melatonin in elderly patients 1. BIOL RHYTHM RES 2009. [DOI: 10.1080/09291010802067155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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15
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Schoevers RA, Bremmer MA, Beekman AT, Hoogendijk WJ, Deeg DJ, van Tilburg W. [Explanations for the relation between depression and increased mortality]. Ned Tijdschr Geneeskd 2004; 148:1133-7. [PMID: 15211962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Depression is a highly prevalent disorder at all levels of health-care delivery. Depression has an unfavourable effect on the prognosis of somatic illnesses, and is associated with excess mortality. Several mechanisms may contribute to these relationships. First of all, depression affects behaviour. Depressed patients show more unhealthy living habits, less compliance with medical treatment, and a higher number of accidents and suicides. Secondly, biological aspects of depression are important. Dysregulation of the neuro-immune system, hyperactivity of the hypothalamic pituitary adrenal axis, and autonomic dysregulation may all have a negative effect on both the prognosis of somatic illnesses and the lifespan. Although studies have suggested beneficial effects of the treatment of depression in (somatic) patients, it remains unclear whether treatment may also affect survival. Further research is needed to investigate the occurrence of and to unravel the mutual influences of depression and somatic illnesses, to search for possible pathogenetic mechanisms that may underlie both depression and medical disorders, and to assess the effects of depression treatment on biological parameters and survival.
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16
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van der Wurff FB, Beekman AT, Comijs HC, Stek ML, Hoogendijk WJ, Renes JW, Jonker C, Heeren T. [Apathy syndrome: a clinical entity?]. Tijdschr Gerontol Geriatr 2003; 34:146-50. [PMID: 14524140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Apathy is defined as a disorder of motivation that expresses itself at an emotional, cognitive and behavioural level. Apathy can occur as a symptom and a syndrome. In the recent years diagnostic criteria and a number of scales for measuring apathy in elderly with psychiatric or neurological disorders have been introduced. Two scales are specifically developed to measure apathy, the Apathy Evaluation Scale (AES) from Marin and the Apathy Scale (AS) from Starkstein. Both scales have been translated into Dutch. The AS is more convenient. The AS in addition can be used when applying the criteria for the apathy syndrome which has been introduced in 2001 by Starkstein. In addition, the Neuropsychiatric Inventory (NPI) and the 'Gedragsobservatieschaal voor de Intramurale Psychogeniatrie' (GIP) (a scale in Dutch) have an apathy domain. Conceptual problems surrounding apathy have only partly been resolved. The criteria for the apathy syndrome can only be used for assessing the extent of the problem. Apathy and depression are strongly correlated. Studies show that apathy as a syndrome can occur without concomitant depression in the elderly, but regularly occurs besides a depressive disorder, in percentages varying between 9% and 53% of the population under study. Especially the varying validity of an apathy syndrome in relation to late life depression needs further clarification.
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Affiliation(s)
- F B van der Wurff
- Academische afdeling psychiatrie GGZ-Buitenamstel/Vumc, Valeriusplein 9, 1075 BG Amsterdam.
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17
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Müller MB, Lucassen PJ, Yassouridis A, Hoogendijk WJ, Holsboer F, Swaab DF. Neither major depression nor glucocorticoid treatment affects the cellular integrity of the human hippocampus. Eur J Neurosci 2001; 14:1603-12. [PMID: 11860455 DOI: 10.1046/j.0953-816x.2001.01784.x] [Citation(s) in RCA: 185] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In major depression, decreased hippocampal volume has been attributed to hypercortisolemia, a frequent sign of the disorder, because in animals an excess of corticosteroids has led to dendritic atrophy, astrogliosis and loss of neurons in this brain region. The present study is the first to investigate the structural integrity of the human hippocampus in major depression and following glucocorticoid treatment. Post-mortem hippocampal tissue from 15 patients who had had major depression or bipolar affective disorder, 10 patients who had been treated with glucocorticoids and 16 controls was assessed using haematoxylin-eosin, Nissl and Bodian staining. The patterns of reactive astrogliosis (glial fibrillary acidic protein, GFAP), synaptic density (synaptophysin), synaptic reorganization (growth-associated protein B-50) and early signs of Alzheimer's disease (Alz-50) were examined immunocytochemically. Multivariate analysis, with the patients' age, tissue fixation time and postmortem delay as covariates, was performed. There was no evidence of neuronal cell loss or other major morphological alterations in any of the groups, nor was there a significant change in the distribution pattern of synaptophysin or Alz-50. Changes in B-50 and GFAP staining were observed in the steroid-treated and depressed patients in areas CA1 and CA2 only. The human hippocampus in major depression and after glucocorticoid treatment does not reveal any major morphological changes or signs of neuronal cell death, but does show subtle alterations in B-50 and GFAP expression in selected parts of the pyramidal cell layer.
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Affiliation(s)
- M B Müller
- Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany.
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18
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Zhou JN, Riemersma RF, Unmehopa UA, Hoogendijk WJ, van Heerikhuize JJ, Hofman MA, Swaab DF. Alterations in arginine vasopressin neurons in the suprachiasmatic nucleus in depression. Arch Gen Psychiatry 2001; 58:655-62. [PMID: 11448372 DOI: 10.1001/archpsyc.58.7.655] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Circadian rhythm disturbances are frequently found in depressed subjects. Although it has been presumed that these disturbances may reflect a disorder of the circadian pacemaker, this has never been established. The suprachiasmatic nucleus (SCN) is the pacemaker of the circadian timing system in mammals, and arginine vasopressin (AVP) is one of its major neuropeptides. As peptide content is often taken as a measure for activity, we hypothesized that a decreased number of AVP-immunoreactive (AVP-IR) neurons and amount of AVP-messenger RNA (mRNA) would be present in the SCN of depressed subjects. METHODS Brains of 11 subjects suffering from major depression (8 cases) and bipolar disorder (3 cases), and of 11 controls, matched for sex, age, and clock time at death, were collected. The number of AVP-IR neurons in the SCN was determined by means of a digitizer (CalComp Inc, Reading, England). The amount of AVP-mRNA expression in the SCN was quantified with the Interaktive Bild Analyse System image analysis system (Kontron, Munich, Germany). RESULTS In depressed subjects, the number of AVP-IR neurons in the SCN was more than one and a half times higher than in controls, while the total masked area of silver grains, as an estimate of the amount of AVP-mRNA, was about one half that of controls. CONCLUSIONS Contrary to our hypothesis, an increase in the number of AVP-IR neurons in the SCN in depression was found, together with an expected decrease in AVP-mRNA. These findings suggest that, in depressed patients, both the synthesis and release of AVP in the SCN is reduced, resulting in an impaired functional ability. A disbalance between AVP production and transport needs further investigation in future studies.
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Affiliation(s)
- J N Zhou
- Netherlands Institute for Brain Research, Meibergdreef 33, 1105 AZ Amsterdam, The Netherlands
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19
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Swaab DF, Fliers E, Hoogendijk WJ, Veltman DJ, Zhou JN. Interaction of prefrontal cortical and hypothalamic systems in the pathogenesis of depression. Prog Brain Res 2001; 126:369-96. [PMID: 11105658 DOI: 10.1016/s0079-6123(00)26025-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- D F Swaab
- Netherlands Institute for Brain Research, Amsterdam, The Netherlands.
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20
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Hoogendijk WJ, Meynen G, Feenstra MG, Eikelenboom P, Kamphorst W, Swaab DF. [Increased activity of stress-regulating systems in Alzheimer disease]. Tijdschr Gerontol Geriatr 2001; 32:17-23. [PMID: 11293840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Behavioral, i.e. non-cognitive, disturbances, such as anxiety, agitation, sleep disturbances and depression occur in the majority of Alzheimer's disease (AD) patients, but their neurobiological basis is unknown. Disturbance of stress regulating systems, like the locus coeruleus, could play an important role. The locus coeruleus, the main production site of noradrenaline in the central nervous system, is involved in phenomena like attention, arousal and the response to the environment. In Alzheimer's disease, there is a marked reduction of noradrenergic neurons in the locus coeruleus. We studied the activity in the remaining locus coeruleus neurons and found an inverse relationship between the number of remaining neurons and the noradrenergic activity. This could indicate compensatory activity and loss of flexibility of this system. Clinically, the loss of flexibility could result in an impairment to focus attention and to respond to the environment. These results can be related to another stress related system, the hypothalamo-pituitary-adrenal-(HPA)axis. This means that further evaluation of both of these systems is necessary.
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Affiliation(s)
- W J Hoogendijk
- Vakgroep psychiatrie, Vrije Universiteit Amsterdam/GGZ Buitenamstel, Valeriusplein 9, 1075 BG Amsterdam
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21
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Liu RY, Zhou JN, Hoogendijk WJ, van Heerikhuize J, Kamphorst W, Unmehopa UA, Hofman MA, Swaab DF. Decreased vasopressin gene expression in the biological clock of Alzheimer disease patients with and without depression. J Neuropathol Exp Neurol 2000; 59:314-22. [PMID: 10759187 DOI: 10.1093/jnen/59.4.314] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Circadian rhythm disturbances are frequently present in Alzheimer disease (AD). In the present study, we investigated the expression of vasopressin (AVP) mRNA in the human suprachiasmatic nucleus (SCN). The in situ hybridization procedure on formalin-fixed paraffin-embedded material was improved to such a degree that we could, for the first time, visualize AVP mRNA expressing neurons in the human SCN and carry out quantitative measurements. The total amount of AVP mRNA expressed as masked silver grains in the SCN was 3 times lower in AD patients (n = 14; 2,135 +/- 597 microm2) than in age- and time-of-death-matched controls (n = 11; 6,667 +/- 1466 microm2) (p = 0.003). No significant difference was found in the amount of AVP mRNA between AD patients with depression (n = 7) and without depression (n = 7) (2,985 +/-1103 microm2 and 1,285 +/- 298 microm2, respectively; p = 0.38). In addition, the human SCN AVP mRNA expressing neurons showed a marked day-night difference in controls under 80 years of age. The amount of AVP mRNA was more than 3 times higher during the daytime (9,028 +/- 1709 microm2, n = 7) than at night (2,536 +/- 740 microm2, n = 4; p = 0.02), whereas no clear diurnal rhythm of AVP mRNA in the SCN was observed in AD patients. There was no relationship between the amount of AVP mRNA in the SCN and age at onset of dementia, duration of AD and the neuropathological changes in the cerebral cortex. These findings suggest that the neurobiological basis of the circadian rhythm disturbances that are responsible for behavioral rhythm disorders is located in the SCN. It also explains the beneficial effects of light therapy on nightly restlessness in AD patients.
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Affiliation(s)
- R Y Liu
- The Netherlands Institute for Brain Research, Amsterdam
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22
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Tilders FJ, Schmidt ED, Hoogendijk WJ, Swaab DF, Hoogedijk WJ. Delayed effects of stress and immune activation. Baillieres Best Pract Res Clin Endocrinol Metab 1999; 13:523-40. [PMID: 10903812 DOI: 10.1053/beem.1999.0040] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Stress responses play a crucial adaptive role but impose potentially subversive demands on the organism. The same holds for the symptoms of illness as seen after immune activation by pathogens or tissue damage. The responses to immune stimuli and stressors show remarkable similarities and rely on similar control mechanisms in the brain: i.e. they involve neuropeptides of the corticotropin releasing factor (CRF) family. Immune and non-immune challenges lead to responses that normally show a temporal relationship with the duration and intensity of the stimulus and the (re)activity of the stress-responsive systems return to their pre-challenged state within hours or days. However, exposure of animals or man to specific stimuli can induce delayed and long-lasting (weeks, months) alternation in stress responsive systems, resulting in a prolonged period of increased stress vulnerability. Immune stimuli are particularly powerful in eliciting such a stress vulnerable state. Various adaptive changes in the (neuro)biological substrate as seen during this stress vulnerable state also occur in depression, and may be causally related to the depressive symptoms that are often associated with infectious and inflammatory diseases.
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Affiliation(s)
- F J Tilders
- Department of Pharmacology, Vrije Universiteit, Amsterdam, The Netherlands
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23
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Abstract
Dementia is the most common risk factor for delirium in the elderly. Here we will review the evidence that proposed pathogenetic mechanisms for delirium (such as reduced cerebral metabolism, imbalance of the noradrenergic/cholinergic neurotransmission, inflammation, disturbances in neuronal systems which regulate stress and the sleep/wake cycle) are also a part of the pathophysiology of Alzheimer's disease. In particular, the role of inflammatory mechanisms in both disorders will be discussed.
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Affiliation(s)
- P Eikelenboom
- Graduate School Neurosciences Amsterdam, Research Institute Neurosciences Vrije Universiteit, Department of Psychiatry, Valeriuskliniek, Amsterdam, The Netherlands
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24
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Hoogendijk WJ, Sommer IE, Pool CW, Kamphorst W, Hofman MA, Eikelenboom P, Swaab DF. Lack of association between depression and loss of neurons in the locus coeruleus in Alzheimer disease. Arch Gen Psychiatry 1999; 56:45-51. [PMID: 9892255 DOI: 10.1001/archpsyc.56.1.45] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Depression, one of the most frequent psychiatric disturbances in Alzheimer disease (AD), is proposed to have its neurobiological basis in neuron loss in the noradrenergic locus coeruleus, although this is not the case in idiopathic depression. METHODS We performed image analyzer-assisted morphometry of the locus coeruleus in 6 depressed, 6 transiently depressed, and 6 nondepressed patients with AD and in 8 control subjects, emphasizing longitudinal psychiatric evaluations and matching for the clinical and neuropathological severity of dementia. RESULTS The mean (+/-SD) number of pigmented neurons in the locus coeruleus in controls (11 607+/-946) was higher than in patients with AD, regardless of being depressed (5165+/-928; P=.001), transiently depressed (5647+/-1163; P=.003), or nondepressed (3717+/-661; P=.001). No significant difference was found in the number of pigmented neurons between patients with AD who were depressed, transiently depressed, and nondepressed. Patients who had depression at the onset of AD had a higher pigmented neuron number than other patients with AD. CONCLUSIONS We confirmed the loss of pigmented neurons in the locus coeruleus of patients with AD; however, no supplementary loss of pigmented neurons in the locus coeruleus was found in patients with depression and AD. This finding resembles the situation in idiopathic depression, but is in contrast with earlier studies on depression in AD.
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Affiliation(s)
- W J Hoogendijk
- Netherlands Institute for Brain Research, Department of Psychiatry, Valerius Clinic, Amsterdam.
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25
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Hoogendijk WJ, Feenstra MG, Botterblom MH, Gilhuis J, Sommer IE, Kamphorst W, Eikelenboom P, Swaab DF. Increased activity of surviving locus ceruleus neurons in Alzheimer's disease. Ann Neurol 1999; 45:82-91. [PMID: 9894881 DOI: 10.1002/1531-8249(199901)45:1<82::aid-art14>3.0.co;2-t] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In Alzheimer's disease (AD) there is neuronal loss in the locus ceruleus (LC), and the noradrenergic system may be even more affected in depressed AD patients. However, this neuronal loss may go together with an increase in activity of the remaining noradrenergic neurons. We prospectively evaluated 16 AD patients (6 depressed, 5 transiently depressed, and 5 nondepressed) and 10 controls. We determined norepinephrine and its metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in various brain areas, and compared these data with previously established neuron numbers in the LC in the same patients. We could not confirm earlier studies reporting lower norepinephrine concentrations in depressed than in nondepressed dementia patients. The mean norepinephrine concentrations in AD patients were significantly lower than those in control patients, whereas the mean concentrations of MHPG were not different. Moreover, we found significant inverse relationships between the number of remaining pigmented LC neurons and the MHPG/norepinephrine ratio in the frontal cortex and LC. These data are the first to provide direct evidence for the hypothesis that remaining LC neurons are activated to compensate for decreased cerebral norepinephrine levels in AD, by demonstrating that the MHPG/norepinephrine ratio is significantly higher in AD, indicating increased metabolism.
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Affiliation(s)
- W J Hoogendijk
- Netherlands Institute for Brain Research, and Department of Psychiatry, Valerius Clinic, Amsterdam
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26
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Hoogendijk WJ, Sommer IE, Tissingh G, Deeg DJ, Wolters EC. Depression in Parkinson's disease. The impact of symptom overlap on prevalence. Psychosomatics 1998; 39:416-21. [PMID: 9775698 DOI: 10.1016/s0033-3182(98)71300-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The reported prevalence of depression concomitant with Parkinson's disease varies greatly in the literature, which may partly be explained by symptom overlap. To determine the impact of symptom overlap on the prevalence, the authors tested 100 Parkinson's disease patients for major depression (DSM-III-R) with both a standard, inclusive method and a diagnostic-etiologic, exclusive method. The authors found that the prevalence detected with the inclusive method (23%) decreased when the exclusive method was used (13%), which was mainly caused by lower scores on the item "loss of interest." The study's findings give empirical support for the relevance of the new category in DSM-IV "mood disorder due to a general medical condition."
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Affiliation(s)
- W J Hoogendijk
- Graduate School of Neurosciences Amsterdam, Department of Psychiatry, Free University, The Netherlands
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Hoogendijk WJ, Purba JS, Hofman MA, de Vos RA, Jansen EN, Swaab DF. Depression in Parkinson's disease is not accompanied by more corticotropin-releasing hormone expressing neurons in the hypothalamic paraventricular nucleus. Biol Psychiatry 1998; 43:913-7. [PMID: 9627747 DOI: 10.1016/s0006-3223(97)00338-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Depression is frequently encountered in Parkinson's disease (PD). In addition, more than half of the PD patients have a disturbed dexamethasone suppression test, which is associated with increased activity of corticotropin-releasing hormone (CRH) neurons. We recently found an increase in CRH neuron number, CRH-messenger RNA, and vasopressin colocalization in CRH neurons in the paraventricular nucleus (PVN) of depressed patients, which may be involved in the pathogenesis of depression. METHODS The number of neurons expressing CRH was determined in the PVN of 6 depressed PD patients with a high score (> or = 13) on the Hamilton Depression Rating Scale, 6 nondepressed PD patients, and 6 controls. RESULTS The three groups did not differ in the number of neurons expressing CRH. CONCLUSIONS We hypothesize that activation of CRH neurons in the PVN, as we recently observed in idiopathic depression, does not play an essential role in depression in PD.
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Affiliation(s)
- W J Hoogendijk
- Graduate School Neurosciences Amsterdam, Netherlands Institute for Brain Research, The Netherlands
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28
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Purba JS, Hoogendijk WJ, Hofman MA, Swaab DF. Increased number of vasopressin- and oxytocin-expressing neurons in the paraventricular nucleus of the hypothalamus in depression. Arch Gen Psychiatry 1996; 53:137-43. [PMID: 8629889 DOI: 10.1001/archpsyc.1996.01830020055007] [Citation(s) in RCA: 292] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cerebrospinal fluid levels of arginine vasopressin (AVP) and oxytocin (OXT) have been found to change in mood disorders. In the present study, the numbers of AVP-immunoreactive (IR) and OXT-IR neurons were determined in the paraventricular nucleus (PVN) of the human hypothalamus. METHODS Postmortem brain tissue was fixed in formalin, embedded in paraffin, and stained for AVP and OXT using immunocytochemical techniques. The number of IR neurons in the PVN was estimated by morphometry in eight depressed patients ranging in age from 21 to 85 years and eight age-matched controls ranging in age from 23 to 88 years. RESULTS The numbers of AVP-IR and OXT-IR neurons in the PVN of patients with mood disorder were increased by 56% and 23%, respectively. No differences were found in AVP-IR or OXT-IR cell numbers between three patients with major depression and three patients with bipolar depression. The numbers of AVP-IR and OXT-IR neurons in two patients with depression not otherwise specified were within the same range as in the six other patients with a mood disorder. CONCLUSIONS The AVP and OXT neurons were activated in the PVN in patients with major depression or bipolar disorder. This activation may be associated with activation of the hypothalamic-pituitary-adrenal axis in these patients, since both AVP and OXT are known to potentiate the effects of corticotropin-releasing hormone. Because of their central effects, activation of AVP and OXT neurons may also be related to symptoms of major depression or bipolar disorder.
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Affiliation(s)
- J S Purba
- Netherlands Institute for Brain Research, Amsterdam, The Netherlands
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Hoogendijk WJ, van Someren EJ, Mirmiran M, Hofman MA, Lucassen PJ, Zhou JN, Swaab DF. Circadian rhythm-related behavioral disturbances and structural hypothalamic changes in Alzheimer's disease. Int Psychogeriatr 1996; 8 Suppl 3:245-52; discussion 269-72. [PMID: 9154571 DOI: 10.1017/s1041610297003426] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Age-related changes in circadian rhythm (e.g., fragmented sleep-wake patterns) occur in many older persons but are particularly pronounced in patients with Alzheimer's disease. In these patients, disruptions of circadian rhythms can be severe enough to increase mental decline, agitation during the day, and restlessness at night. Moreover, patients whose nocturnal restlessness disrupts the sleep of the caregiver are more likely to be institutionalized than those who have cognitive impairment alone.
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Affiliation(s)
- W J Hoogendijk
- The Netherlands Institute for Brain Research, Amsterdam, The Netherlands
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Raadsheer FC, van Heerikhuize JJ, Lucassen PJ, Hoogendijk WJ, Tilders FJ, Swaab DF. Corticotropin-releasing hormone mRNA levels in the paraventricular nucleus of patients with Alzheimer's disease and depression. Am J Psychiatry 1995; 152:1372-6. [PMID: 7653697 DOI: 10.1176/ajp.152.9.1372] [Citation(s) in RCA: 307] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Greater activity of the hypothalamic-pituitary-adrenal (HPA) axis is associated with specific neurological and psychiatric disorders, including Alzheimer's disease and depression. Hyperactivation of paraventricular corticotropin-releasing hormone (CRH) neurons may form the basis of this increased activity of the HPA axis. METHOD Activation of the CRH neurons was determined through measurement of the amount of CRH-mRNA in the paraventricular nucleus by using quantitative, in situ hybridization histochemistry with systematically sampled frontal sections through the hypothalamus of routinely formalin-fixed and paraffin-embedded autopsy brain material of 10 comparison subjects, 10 patients with Alzheimer's disease, and seven depressed patients. RESULTS CRH-mRNA levels in the paraventricular nucleus of Alzheimer's patients were markedly higher than those of comparison subjects, whereas CRH-mRNA levels in the paraventricular nucleus of depressed patients were even higher than the levels of Alzheimer's patients. CONCLUSIONS Paraventricular CRH neurons in Alzheimer's disease and depression are hyperactivated, and this hyperactivation may contribute to the etiology of these disorders.
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Affiliation(s)
- F C Raadsheer
- Netherlands Institute for Brain Research, Graduate School Neurosciences Amsterdam
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Hoogendijk WJ, Pool CW, Troost D, van Zwieten E, Swaab DF. Image analyser-assisted morphometry of the locus coeruleus in Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis. Brain 1995; 118 ( Pt 1):131-43. [PMID: 7894999 DOI: 10.1093/brain/118.1.131] [Citation(s) in RCA: 104] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Several observations suggest that neuronal shrinkage rather than cell death is the major phenomenon in neurodegenerative diseases. In order to make this distinction, smaller cells should also be included in cell counts. Also, morphometric determination of total cell numbers of brain structures is required. Morphometry was performed on the locus coeruleus using a newly developed method to delineate this nucleus from five patients who had died with Alzheimer's disease, five with Parkinson's disease, five with amyotrophic lateral sclerosis and from five control subjects who had died from causes that would not have affected the locus coeruleus. The length and volume of the locus coeruleus and its total number of large pigmented neurons, small unpigmented neurons and glial cells were determined. Since reliable delineation of the boundaries of the locus coeruleus is a requirement for the determination of total cell numbers, an image analyser-assisted procedure was developed. In Alzheimer's disease we found an 82% decrease in the number of large pigmented neurons and a 39% decrease of small unpigmented neurons. In Parkinson's disease, we found a 39% decrease of large pigmented neurons but also a 44% (though not significant) increase of small unpigmented neurons, which is indicative of a shift from large pigmented neurons to small unpigmented neurons in Parkinson's disease. The large pigmented/small unpigmented neuron number ratio was greatly and significantly reduced in Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis. These findings support the hypothesis that the decrease of large pigmented neurons of the locus coeruleus in some neurodegenerative diseases is not entirely due to cell death, but rather to cell shrinkage and a loss of phenotype. This hypothesis may have consequences for the development of therapeutic strategies since atrophied cells can be activated. On the other hand our data confirm that, at least in Alzheimer's disease, large pigmented neurons do also undergo cell death.
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Raadsheer FC, Hoogendijk WJ, Stam FC, Tilders FJ, Swaab DF. Increased numbers of corticotropin-releasing hormone expressing neurons in the hypothalamic paraventricular nucleus of depressed patients. Neuroendocrinology 1994; 60:436-44. [PMID: 7824085 DOI: 10.1159/000126778] [Citation(s) in RCA: 436] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The hypothalamo-pituitary-adrenal (HPA) axis is known to be activated in depressed patients. Although direct evidence is lacking, this activation is hypothesized to be due to hyperactivity of corticotropin-releasing hormone (CRH) neurons of the hypothalamic paraventricular nucleus (PVN). Recent immunocytochemical studies in experimental animals and in humans showed that the number of CRH-expressing neurons correlated with the activity of these neurons. In addition, colocalization of AVP in CRH neurons has been shown to be an index for the secretory activity. Therefore, we estimated the total number of CRH-immunoreactive neurons and their fraction showing colocalization with AVP in the PVN of 10 control subjects and of 6 depressed patients who were diagnosed to be suffering from a major depression or a bipolar disorder. The mean total number of CRH-expressing neurons of the 6 depressed patients was four times higher, and the number of CRH neurons co-expressing AVP was almost three times higher than those in the control group. We also determined the two activity parameters of CRH neurons in the PVN of 2 subjects with a depressive organic mood syndrome or a depressive disorder not otherwise specified. In these two 'non-major depressed' subjects, the activity parameters of CRH neurons were comparable to those of control subjects. Our observations strongly support the hypothesis that CRH neurons in the PVN are hyperactivated in major depressed patients. This hyperactivity might be causally related to at least part of the symptomatology of depression.
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Abstract
The vasopressin (VP) innervation of the human locus coeruleus (LC) was immunocytochemically investigated in Alzheimer's disease (AD) patients and non-demented controls. A dense innervation of VP fibers was present throughout the entire rostro-caudal length of the LC in both, controls and AD-patients. The VP immunoreactivity was confined to fibers; no signs of cell body staining could be found. Comparison of five non-demented control subjects and five AD patients on fifteen different levels throughout the LC revealed that the VP innervation of this nucleus remained intact in AD, even in the rostral part of the LC, which is the most affected region with respect to neuronal loss.
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Affiliation(s)
- E J van Zwieten
- Graduate School Neurosciences Amsterdam, Netherlands Institute for Brain Research
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Hollak CE, Hoogendijk WJ, Griffioen FM, Oosting IJ. Anthropometric study of Dominican pre-school children. J Trop Pediatr 1988; 34:42-8. [PMID: 3346942 DOI: 10.1093/tropej/34.1.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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