Potential biomarkers of major depression diagnosis and chronicity

PLoS One. 2021 Sep 29;16(9):e0257251. doi: 10.1371/journal.pone.0257251. eCollection 2021.

Abstract

Background: Molecular biomarkers are promising tools to be routinely used in clinical psychiatry. Among psychiatric diseases, major depression disorder (MDD) has gotten attention due to its growing prevalence and morbidity.

Methods: We tested some peripheral molecular parameters such as serum mature Brain-Derived Neurotrophic Factor (mBDNF), plasma C-Reactive Protein (CRP), serum cortisol (SC), and the salivary Cortisol Awakening Response (CAR), as well as the Pittsburgh sleep quality inventory (PSQI), as part of a multibiomarker panel for potential use in MDD diagnosis and evaluation of disease's chronicity using regression models, and ROC curve.

Results: For diagnosis model, two groups were analyzed: patients in the first episode of major depression (MD: n = 30) and a healthy control (CG: n = 32). None of those diagnosis models tested had greater power than Hamilton Depression Rating Scale-6. For MDD chronicity, a group of patients with treatment-resistant major depression (TRD: n = 28) was tested across the MD group. The best chronicity model (p < 0.05) that discriminated between MD and TRD included four parameters, namely PSQI, CAR, SC, and mBDNF (AUC ROC = 0.99), with 96% of sensitivity and 93% of specificity.

Conclusion: These results indicate that changes in specific biomarkers (CAR, SC, mBDNF and PSQI) have potential on the evaluation of MDD chronicity, but not for its diagnosis. Therefore, these findings can contribute for further studies aiming the development of a stronger model to be commercially available and used in psychiatry clinical practice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Area Under Curve
  • Biomarkers / metabolism*
  • Brain-Derived Neurotrophic Factor / blood
  • C-Reactive Protein / biosynthesis
  • Case-Control Studies
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / diagnosis*
  • Female
  • Humans
  • Hydrocortisone / blood
  • Hydrocortisone / metabolism
  • Male
  • Middle Aged
  • Models, Theoretical
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychiatry / standards
  • Psychometrics
  • ROC Curve
  • Regression Analysis
  • Saliva / metabolism
  • Sleep
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human
  • C-Reactive Protein
  • Hydrocortisone

Grants and funding

This study was funded by the Brazilian National Council for Scientific and Technological Development (CNPq, grants #466760/2014 & #479466/2013), and by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) (grants #1677/2012 & #1577/2013) from the Ministry of Science, Technology, Innovations and Communications, and Brazilian Ministry of Education, respectively. ACMG is supported by CAPES (Research Fellowship 88882.344060/2019-01). NLGC is supported by CAPES (Finance Code 001, Research Fellowship 88887.466701/2019-00) and National Science and Technology Institute for Translational Medicine (INCT-TM Fapesp 2014/50891-1; CNPq 465458/2014-9). JS is supported by an NHMRC Clinical Research Fellowship (APP1125000).