The neuroprogressive nature of major depressive disorder: Pathways to disease evolution and resistance, and therapeutic implications

Moylan, S., Maes, M., Wray, N. R. and Berk, M. (2013) The neuroprogressive nature of major depressive disorder: Pathways to disease evolution and resistance, and therapeutic implications. Molecular Psychiatry, 18 5: 595-606. doi:10.1038/mp.2012.33

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Author Moylan, S.
Maes, M.
Wray, N. R.
Berk, M.
Title The neuroprogressive nature of major depressive disorder: Pathways to disease evolution and resistance, and therapeutic implications
Journal name Molecular Psychiatry   Check publisher's open access policy
ISSN 1476-5578
1359-4184
Publication date 2013-05
Year available 2012
Sub-type Article (original research)
DOI 10.1038/mp.2012.33
Open Access Status
Volume 18
Issue 5
Start page 595
End page 606
Total pages 12
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Collection year 2013
Language eng
Abstract In some patients with major depressive disorder (MDD), individual illness characteristics appear consistent with those of a neuroprogressive illness. Features of neuroprogression include poorer symptomatic, treatment and functional outcomes in patients with earlier disease onset and increased number and length of depressive episodes. In such patients, longer and more frequent depressive episodes appear to increase vulnerability for further episodes, precipitating an accelerating and progressive illness course leading to functional decline. Evidence from clinical, biochemical and neuroimaging studies appear to support this model and are informing novel therapeutic approaches. This paper reviews current knowledge of the neuroprogressive processes that may occur in MDD, including structural brain consequences and potential molecular mechanisms including the role of neurotransmitter systems, inflammatory, oxidative and nitrosative stress pathways, neurotrophins and regulation of neurogenesis, cortisol and the hypothalamic-- pituitary --adrenal axis modulation, mitochondrial dysfunction and epigenetic and dietary influences. Evidence-based novel treatments informed by this knowledge are discussed.
Keyword Cytokines
Depression
Inflammation
Neuroprogression
Nitrosative stress
Oxidative stress
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Advance online publication: 24 April 2012.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Queensland Brain Institute Publications
Official 2013 Collection
 
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Created: Tue, 10 Jul 2012, 16:49:59 EST by Debra McMurtrie on behalf of Queensland Brain Institute