Complementation of Pharmacogenetics with Biomarkers and Neuroimaging in Major Depression

  • Andreas MenkeEmail author
  • Nicola Dusi
  • Paolo Brambilla


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.


Glucocorticoid Receptor Depressed Patient Hippocampal Volume Plasma Vascular Endothelial Growth Factor Level Total Reactive Antioxidant Potential 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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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© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Psychiatry, Psychosomatics and PsychotherapyUniversity Hospital of WürzburgWürzburgGermany
  2. 2.Section of Psychiatry, Department of Public Health and Community MedicineInter-University Center for Behavioral Neurosciences (ICBN), University of VeronaVeronaItaly
  3. 3.Department of Neurosciences and Mental HealthFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of MilanMilanItaly
  4. 4.Scientific Institute IRCCS “E. Medea”Bosisio Parini (Lc)Italy
  5. 5.Department of Psychiatry and Behavioral SciencesUniversity of Texas Health Science Center at HoustonHoustonUSA

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