Arch Neurol 2001 Jul;58(7):1081-6
Mohr DC, Goodkin DE, Islar J, Hauser
SL, Genain CP
OBJECTIVE:
To examine the relationship between
depression, treatment of depression, and interferon gamma (IFN-gamma) production
by peripheral blood mononuclear cells in patients with comorbid diagnoses
of relapsing-remitting multiple sclerosis (MS) and major depressive disorder.
DESIGN: A randomized comparative outcome trial of three 16-week treatments
for depression. Assessments were conducted at baseline, week 8, and treatment
cessation.
SETTING:
An academic outpatient treatment
and clinical research center.
PATIENTS:
Fourteen patients who met the criteria
for relapsing-remitting MS and major depressive disorder.
INTERVENTIONS:
Individual cognitive behavioral therapy,
group psychotherapy, or sertraline therapy.
MAIN OUTCOME MEASURES:
Depression was assessed using the
Beck Depression Inventory. Interferon gamma production by peripheral blood
mononuclear cells was measured following stimulation with OKT3 or recombinant
human myelin oligodendrocyte glycoprotein (MOG). Variability in immune
assays was controlled using 8 nondepressed healthy subjects who were enrolled
at times corresponding with the enrollment of MS patients.
RESULTS:
Results of the Beck Depression Inventory
were significantly related to IFN-gamma production stimulated with OKT3
or MOG at baseline (P< or = .03 for all). Level of depression, OKT3-stimulated
IFN-gamma production, and MOG-stimulated IFN-gamma production all declined
significantly over the 16-week treatment period (P< or = .03 for all).
Among controls, there were no significant changes over time in OKT3- or
MOG-stimulated IFN-gamma, or in depression (P> or = .25 for all).
CONCLUSIONS:
These findings suggest that the production
of the proinflammatory cytokine IFN-gamma by autoaggressive T cells in
relapsing-remitting MS is related to depression and that treatment of depression
may decrease IFN-gamma production. Thus, treatment of depression may provide
a novel disease-modifying therapeutic strategy as well as a symptomatic
treatment for patients with MS.
Department of Psychiatry, University
of California, San Francisco, USA. dmohr@itsa.ucsf.edu