Citation

Holmes SE, Hinz R, Conen S, Gregory CJ, Matthews JC, Anton-Rodriguez JM, Gerhard A, Talbot PS. Biol. Psychiatry 2018; 83(1): 61-69.

Affiliation

Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom. Electronic address: peter.talbot@manchester.ac.uk.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.biopsych.2017.08.005

PMID

28939116

Abstract

BACKGROUND: Major depressive disorder is associated with raised peripheral inflammatory markers. Mounting evidence also suggests that inflammation is involved in suicidal behavior. However, the involvement of inflammation in the brains of individuals with depression, and its association with suicidal ideation, needs further clarification. Translocator protein (TSPO), which is upregulated in activated glia (predominantly microglia), can be measured as an indication of neuroinflammation in vivo using positron emission tomography and TSPO-specific radioligands.

METHODS: We used [(11)C](R)-PK11195 positron emission tomography to compare TSPO availability in the anterior cingulate cortex (ACC), prefrontal cortex, and insula between 14 medication-free patients in a major depressive episode of at least moderate severity and 13 matched healthy control subjects. In a post hoc analysis, we also compared TSPO availability between patients with and without suicidal thoughts.

RESULTS: Multivariate analysis of variance indicated significantly higher TSPO in patients compared with control subjects (p =.005). The elevation was of large effect size and significant in the ACC (p =.022, Cohen's d = 0.95), with smaller nonsignificant elevations in the prefrontal cortex (p =.342, Cohen's d = 0.38) and insula (p =.466, Cohen's d = 0.29). TSPO was not elevated in patients without suicidal thinking but was significantly increased in those with suicidal thoughts compared with those without, most robustly in the ACC (p =.008) and insula (p =.023).

CONCLUSIONS: We confirm evidence for increased TSPO availability, suggestive of predominantly microglial activation, in the ACC during a moderate to severe major depressive episode. Our findings provide further incentive for evaluating anti-inflammatory therapies in major depressive disorder.

Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Anterior cingulate; Depression; Inflammation; Microglia; PET; Suicide