Sustained Molecular Pathology Across Episodes and Remission in Major Depressive Disorder
Open accessAbstract
Background Major depressive disorder (MDD) is a debilitating mental illness and a major cause of lost productivity worldwide. MDD patients often suffer from lifelong recurring episodes of increasing severity, reduced therapeutic response, and shorter remission periods, suggesting the presence of a persistent and potentially progressive pathology.Methods Subgenual anterior cingulate cortex postmortem samples from four MDD cohorts (single episode, n = 20; single episode in remission, n = 15; recurrent episode, n = 20; and recurrent episode in remission, n = 15), and one control cohort (n = 20) were analyzed by mass spectrometry-based proteomics (n = 3630 proteins) combined with statistical analyses. The data was investigated for trait and state progressive neuropathologies in MDD using both unbiased approaches and tests of a priori hypotheses.Results The data provided weak evidence for proteomic differences as a function of state (depressed/remitted) or number of previous episodes. Instead it suggested the presence of persistent MDD effects, regardless of episodes or remitted state, namely on proteomic measures related to presynaptic neurotransmission, synaptic function, cytoskeletal rearrangements, energy metabolism, phospholipid biosynthesis/metabolism, and calcium ion homeostasis. Selected proteins (dihydropyrimidinase-related protein 1, synaptosomal-associated protein 29, glutamate decarboxylase 1, metabotropic glutamate receptor 1, and excitatory amino acid transporter 3) were validated by Western blot analysis. The findings were independent of technical, demographic (sex or age), or other clinical parameters (death by suicide and drug treatment).Conclusions Collectively, the results provide evidence for persistent MDD effects across current episodes or remission, in the absence of detectable progressive neuropathology.
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It shows imbalance in cortical-subcortical limbic regions with decreased GABAergic signaling and increased glutamatergic signaling.
“It shows the imbalance in cortical-subcortical limbic regions with decreased GABAergic signaling and increased glutamatergic signaling. 210 , 211”
From Major depressive disorder: hypothesis, mechanism, prevention and treatment (2024) · cites this paper as [211]
The Introduction (page not specified) describes reduced inhibitory GABA levels and an altered excitation–inhibition balance in MDD. The Discussion (page not specified) reports downregulated GABA- and glutamate-related proteins, but does not establish increased glutamatergic signaling or demonstrate that imbalance across cortical–subcortical limbic regions. (LLM, conf=0.87)
Experimental — accuracy not yet measuredScifo and colleagues did not observe differences in protein expression within the MDD groups, suggesting that synapse-related changes may persist in stress-related disorders.
“they did not observe differences in protein expression within the MDD groups, suggesting that synapse-related changes may persist in stress-related disorders”
From Challenges and rewards of in vivo synaptic density imaging, and its application to the study of depression (2025) · cites this paper as [84]
Scifo and colleagues found robust changes in proteins that regulate synaptic plasticity and transmission in individuals with MDD (current or remitted at time of death) relative to controls.
“Scifo and colleagues examined cellular pathology in individuals with MDD (current or remitted at time of death) relative to controls, and found robust changes in proteins that regulate synaptic plasticity and transmission”
From Challenges and rewards of in vivo synaptic density imaging, and its application to the study of depression (2025) · cites this paper as [84]
D2HGDH encodes for the enzyme D-2-hydroxyglutarate dehydrogenase, and is suggested to be downregulated in depressed patients during remission.
“D2HGDH encodes for the enzyme D-2-hydroxyglutarate dehydrogenase, and is suggested to be downregulated in depressed patients during remission54.”
From Methylome-wide change associated with response to electroconvulsive therapy in depressed patients (2021) · cites this paper as [54]
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Self-citationRisks for Major Depression: Searching for Stable Traits
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- Authors
- Scifo, E., Pabba, M., Kapadia, F., Ma, T., Lewis, D. A., Tseng, G. C., & Sibille, E.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Pittsburgh (US)
- Corresponding author
- Sibille, Etienne
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 83
- Issue
- 1
- Pages
- 81-89
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC5705452
- OpenAlex
- W2766558591
- Cited by
- 41
- References
- 52
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 3 · 2021: 8 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 1
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH077159)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- major depressive disorder, subgenual anterior cingulate cortex, remission, recurrent depression, presynaptic neurotransmission, synaptic function, energy metabolism, phospholipid metabolism, calcium homeostasis, metabotropic glutamate receptor 1, GAD1
- MeSH terms
- Adult, Chromatography, Liquid, Major Depressive Disorder, Female, Gyrus Cinguli, Humans, Male, Middle Aged, Mass Spectrometry, Blotting, Western, Cohort Studies, Disease Progression, Proteome, Proteomics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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