Plasma levels of soluble TNF receptors 1 and 2 after tDCS and sertraline treatment in major depression: Results from the SELECT-TDCS trial.

TitlePlasma levels of soluble TNF receptors 1 and 2 after tDCS and sertraline treatment in major depression: Results from the SELECT-TDCS trial.
Publication TypeJournal Article
Year of Publication2015
AuthorsBrunoni AR, Machado-Vieira R, Sampaio-Junior B, Vieira ELM, Valiengo L, Benseñor IM, Lotufo PA, Carvalho AF, Cho HJin, Gattaz WF, Teixeira AL
JournalJ Affect Disord
Date Published2015 Oct 1
KeywordsAdult, Antidepressive Agents, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Prospective Studies, Receptors, Tumor Necrosis Factor, Type I, Receptors, Tumor Necrosis Factor, Type II, Sertraline, Transcranial Direct Current Stimulation, Treatment Outcome

BACKGROUND: The cytokine hypothesis of depression postulates that the pathophysiology of this illness incorporates an increased production of pro-inflammatory cytokines, which leads to an over-activation of the hypothalamic-pituitary-adrenal axis as well as monoaminergic disturbances. Nevertheless, it remains unclear whether the amelioration of depressive symptoms could decrease cytokine levels. Notwithstanding antidepressant drug therapy might exert anti-inflammatory effects, the effects of non-invasive neuromodulatory approaches like transcranial direct current stimulation (tDCS) on pro-inflammatory cytokine networks are largely unknown.

METHODS: We evaluated, in the Sertraline vs. Electric Current Therapy for Treating Depression Clinical Study (SELECT-TDCS) trial, whether the plasma levels of the soluble TNF receptors 1 and 2 (sTNFRs) changed after antidepressant treatment in a sample of 73 antidepressant-free patients with unipolar depressive disorder in an episode of at least moderate intensity.

RESULTS: Although both tDCS and sertraline exerted antidepressant effects, the plasma levels of sTNFRs did not change over time regardless of the intervention and clinical response. Also, baseline sTNFRs levels did not predict antidepressant response.

LIMITATIONS: Our negative findings could be a type II error, as this trial did not use an equivalence design.

CONCLUSIONS: To conclude, in this novel placebo-controlled trial prospectively evaluating the changes of sTNFRs in depressed patients, we found that these molecules are not surrogate biomarkers of treatment response of tDCS, whose antidepressant effects occurred regardless of normalization of immunological activity.

Alternate JournalJ Affect Disord
PubMed ID26241865