White matter integrity and pro-inflammatory cytokines as predictors of antidepressant response in MDD

Major depressive disorder (MDD) is a multifactorial, serious and heterogeneous mental disorder that can lead to chronic recurrent symptoms, treatment resistance and suicidal behavior. MDD often involves immune dysregulation with high peripheral levels of inflammatory cytokines that might have an influence on the clinical course and treatment response. Moreover, patients with MDD show brain volume changes as well as white matter (WM) alterations that are already existing in the early stage of illness. Mounting evidence suggests that both neuroimaging markers, such as WM integrity and blood markers, such as inflammatory cytokines might serve as predictors of treatment response in MDD. However, the relationship between peripheral inflammation, WM structure and antidepressant response is not yet clearly understood. The aim of the present review is to elucidate the association between inflammation and WM integrity and its impact on the pathophysiology and progression of MDD as well as the role of possible novel biomarkers of treatment response to improve MDD prevention and treatment strategies.

Automated summary

Major depressive disorder (MDD) is a complex and serious mental disorder that can result in chronic recurrent symptoms, treatment resistance, and suicidal behavior. Immune dysregulation and brain volume changes, particularly in white matter (WM), are associated with MDD. Neuroimaging markers and blood markers, such as inflammation-related cytokines, may serve as predictors of treatment response in MDD, but the relationship between peripheral inflammation, WM integrity, and antidepressant response is still not clearly understood. This review aims to explore the association between inflammation and WM integrity, and their impact on MDD pathophysiology and progression, as well as the potential role of novel biomarkers in improving MDD prevention and treatment strategies.