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Complementation of Pharmacogenetics with Biomarkers and Neuroimaging in Major Depression

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Genetic Influences on Response to Drug Treatment for Major Psychiatric Disorders

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Abstract

Unlike other disciplines of medicine, the diagnostic process in psychiatry is based solely on clinical judgment, without incorporating lab-derived objective measures on a regular basis. Even with the advent of DMS-V, no biomarkers gathered from genomics, peripheral blood, or brain imaging have been established for the diagnostic process in psychiatric disorders. However, there is accumulating evidence of evolving biomarkers to improve diagnostic processes and treatment algorithm. Here, studies on the evaluation of markers derived from imaging and peripheral blood in patients with major depression are reviewed. An altered brain network that encompasses the anterior cingulate, the prefrontal cortex, and the hippocampus has been repeatedly found in major depression. Antidepressants exert neuroprotective effects, which determine a reduction of hippocampal and prefrontal cortex shrinkage, probably through an activation of neuromodulatory factors like BDNF. Lower BDNF plasma levels are observed in depressed patients and normalize after successful treatment. Very promising findings have also been observed within inflammatory pathways and the hypothalamic–pituitary–adrenal (HPA) axis. In both systems, there is growing evidence that drugs specifically targeting these systems may be beneficial for the treatment of depression, but only in these patients, who have marked alterations detected by the respective biomarkers.

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Acknowledgments

PB was partially supported by grants from the Italian Ministry of Health (RF‐2011‐02352308), the BIAL Foundation (Fellowship#262/12), and the IRCCS “E. Medea” (Ricerca Corrente).

AM inventor: Means and methods for diagnosing predisposition for treatment emergent suicidal ideation (TESI). European patent number: 2166112. International application number: PCT/EP2009/061575.

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Authors and Affiliations

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany

    Andreas Menke

  2. Section of Psychiatry, Department of Public Health and Community Medicine, Inter-University Center for Behavioral Neurosciences (ICBN), University of Verona, Verona, Italy

    Nicola Dusi

  3. Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Paolo Brambilla

  4. Scientific Institute IRCCS “E. Medea”, Bosisio Parini (Lc), Italy

    Paolo Brambilla

  5. Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA

    Paolo Brambilla

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  1. Andreas Menke
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  2. Nicola Dusi
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  3. Paolo Brambilla
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Correspondence to Andreas Menke .

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Editors and Affiliations

  1. Department of Adult Psychiatry, Poznan University of Medical Scienc, Poznan, Poland

    Janusz K. Rybakowski

  2. Department of Biomedical and Neuromotor, University of Bologna, Bologna, Italy

    Alessandro Serretti

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Menke, A., Dusi, N., Brambilla, P. (2016). Complementation of Pharmacogenetics with Biomarkers and Neuroimaging in Major Depression. In: Rybakowski, J., Serretti, A. (eds) Genetic Influences on Response to Drug Treatment for Major Psychiatric Disorders. Adis, Cham. https://doi.org/10.1007/978-3-319-27040-1_5

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