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Cardiovascular disease (CVD) and major depressive disorders (MDD) are frequent diseases worldwide with a high comorbidity rate. Omega-3 fatty acids have been suggested as disease modulators for both CVD and MDD.
Objective and aims
Therefore, we studied whether polyunsaturated fatty acids and the Omega-3 Index may represent markers for assessment of the cardiovascular risk in physically healthy patients suffering from MDD.
Case-control study in 166 adults (86 MDD patients without CVD, 80 matched healthy controls). Baseline examinations included depression ratings, conventional cardiovascular risk factors, fatty acid, and interleukin-6 determinations.
Several conventional risk factors were more prevalent in MDD patients. The Omega-3 Index and individual omega-3 fatty acids were significantly lower in MDD patients. An Omega-3 Index < 4% was associated with high concentrations of the proinflammatory cytokine IL-6.
Conventional cardiovascular risk factors, the Omega-3 Index and IL-6 indicated an elevated cardiovascular risk profile in MDD patients currently free of CVD. Our results support the employment of strategies to reduce the cardiovascular risk in yet cardiovascularly healthy MDD patients by targeting conventional risk factors and the Omega-3 Index.
In this study, the impact of quetiapine fumarate extended release (QXR) and escitalopram (ESC) on HPA axis activity was investigated in depressed patients in relationship to antidepressant efficacy.
In a randomized, open-label 5-week trial 60 inpatients suffering from major depression (DSM-IV criteria) were treated for 5 weeks with either QXR (300 mg/day) or ESC (10 mg/day). The dexamethasone/CRH (DEX/CRH) test was performed before treatment, after 1, and after 5 weeks of treatment. Cortisol (COR) AUC values were used to assess HPA axis function. The Hamilton Depression Rating Scale was used weekly to estimate antidepressant efficacy.
QXR and ESC showed comparable antidepressant effects but strongly differed in their impact on HPA axis activity. In the QXR group, a marked inhibition of COR AUC levels was observed which was most pronounced after one week of treatment but showed a partial re-increase after 5 weeks of treatment. In contrast, ESC transiently stimulated COR AUC values (week 1) whereas COR AUC levels at week 0 and week 5 were comparable. COR improvement at week 1 (defined as COR peak value reduction between DEX/CRH test 1 and 2) was significantly associated with better clinical outcome.
Apparently, different effects on HPA axis activity reflect distinct pharmacoendocrinological properties of psychotropic drugs.
Depression occurs frequently in patients suffering from Parkinson's disease (PD). However, the neural basis of depression in PD remains unclear. Diffusion magnetic resonance imaging (DMRI) connectometry is based on the spin distribution function (SDF), which quantifies the density of diffusing water.
The aim of this study was to assess the microstructural changes in the brain connectivity of PD patients with and without depressive symptoms.
DMRI was used to assess microstructural abnormalities in the brains of 16 PD patients with depressive symptoms compared to 11 PD patients without depressive symptoms. Data used in the preparation of this paper were obtained from the Parkinson's progression markers initiative (PPMI) database (http://www.ppmi-info.org/data/). This dataset was acquired on a 3-Tesla scanner (Siemens), producing 64 DWI at b = 1000 s/mm2 and one b0 image. Diffusion MRI data were corrected for subject motion, eddy current distortions, and susceptibility artefacts due to magnetic field inhomogeneity. DMRI connectometry was conducted in a total of 27 patients using percentage measurement.
PD Patients with depressive symptoms showed decreased anisotropy (FDR < 0.05) in the fornix bilaterally, left inferior longitudinal fasciculus (ILF) and corticospinal tract bilaterally compared to PD patients without depressive symptoms.
Lesser WM integrity of the left ILF fibers, which connect visual face recognition areas to the amygdala and hippocampus, seems to be associated with depressive symptoms in PD patients. Our study supports the hypothesis that neurodegenerative processes in projections from the somatosensory, cingulate, and insular cortices may be related to depression in PD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
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