The Neuroscience of Depression

1st Edition - March 22, 2021
Imprint: Academic Press
Editors: Colin R. Martin, Lan-Anh Hunter, Vinood Patel, Victor R Preedy, Rajkumar Rajendram
Language: English
Paperback ISBN:
9 7 8 - 0 - 1 2 - 8 1 8 0 0 9 - 9
eBook ISBN:
9 7 8 - 0 - 1 2 - 8 1 8 0 1 0 - 5

The Neuroscience of Depression: Genetics, Cell Biology, Neurology, Behaviour and Diet is a comprehensive reference to the aspects, features and effects of depression. This book p… Read more

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The Neuroscience of Depression: Genetics, Cell Biology, Neurology, Behaviour and Diet is a comprehensive reference to the aspects, features and effects of depression. This book provides readers with the behavior and psychopathological effects of depression, linking anxiety, anger and PSTD to depression. Readers are provided with a detailed outline of the genetic aspects of depression including synaptic genes and the genome-wide association studies (GWAS) of depression, followed by a thorough analysis of the neurological and imaging techniques used to study depression. This book also includes three full sections on the various effects of depression, including diet, nutrition and molecular and cellular effects. The Neuroscience of Depression: Genetics, Cell Biology, Neurology, Behaviour and Diet is the only resource for researchers and practitioners studying depression.

Cover image
Title page
Table of Contents
Copyright for Volume 1
Contributors for Volume 1
Foreword for Volume 1
Preface for Volume 1
Copyright for Volume 2
Contributors for Volume 2
Foreword for Volume 2
Preface for Volume 2
Volume 1
Part I: Depression: Introductory chapters
Chapter 1: Clinical staging in depression
Abstract
Introduction
Clinical staging in depression
Clinical staging and progression in depression
Clinical staging and treatment-resistant depression
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 2: Neurodevelopmental theory of depression
Abstract
Introduction
Early childhood experience and personality traits
The affective and rational system—The basis for personality formation
Emotional immunity or immune emotionality?—The key to understanding depression
Mother’s fear as well as grandmother’s fear as a source of depression
Early childhood trauma
Glucocorticoid cascade hypothesis—Epigenetics again?
Personality of the 21st century
Key facts
Summary points
Mini-dictionary of terms
Chapter 3: Depression after pregnancy
Abstract
Introduction
Epidemiology
Consequences of postpartum depression
Neurobiological basis of PPD
Management of PPD
Prevention of PPD
Summary points
Mini-dictionary of terms
Chapter 4: Modeling maternal depression during pregnancy: Rodent models of major depressive disorder with peripartum onset
Abstract
Introduction
Characteristics of animal models of maternal depression
Face validity of animal models of maternal depression; symptoms and other physiological markers that resemble those found in humans and are used to verify the model
Construct validity of maternal models of depression: The mode of induction of depression
Predictive validity of rodent models of maternal depression: Response to antidepressants
Summary of studies addressing the impact of maternal depression on preadolescent and adolescent offspring
Future animal models of maternal depression
Conclusions
Key facts of maternal depression during pregnancy
Summary points
Mini-dictionary of terms
Chapter 5: Depression in mothers and mental health in their children: Impact, risk factors, and interventions
Abstract
List of abbreviations
Introduction
Effects of maternal depression on mental health of children
Risk factors
Interventions to reduce the impact of maternal depression on children
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 6: The neuroscience of depression: Mechanisms and treatments
Abstract
Introduction
Overview of depression in students
Screening depression
Treatment and management
Risk behaviors in students
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 7: Depression in disasters and traumatic events
Abstract
Introduction
Clinical diagnosis and standardized assessment instruments for depression
Depression after natural disasters and traumatic events
Consequences of depression after natural disasters and traumatic events
Causes and risk factors of depression
Biological factors and depression after disaster events
Implications and suggestions
Key facts of depression
Summary points
Mini-dictionary of terms
Chapter 8: Depression and associated Alzheimer’s disease
Abstract
Introduction
Coexistence of depression and Alzheimer’s disease
Dysfunction of the hypothalamic-pituitary-adrenal axis
Chronic inflammation in depression and Alzheimer's disease
Alteration in monoamines level
TGF signaling
Long-term potentiation alteration
Oxidative stress
Therapeutic management of AD
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 9: Comorbidities of depression and Parkinson’s disease
Abstract
Introduction
Depression in Parkinson’s disease
Pathophysiology of stress leading to depression
Biochemical scheme of depression
Coexistence of Parkinson’ disease and depression
5HT receptors and Parkinson’s disease
Role of serotonin in depression associated with Parkinson’s disease
Clinically available serotonergic drugs
Noradrenergic systems in the central nervous system
The locus coeruleus (LC)
Role of NA in PD symptoms
Indication for the interaction between DA and NA in PD
The locus coeruleus noradrenergic system in PD
Conclusion
Key facts of comorbidities of depression and Parkinson’s disease
Mini-dictionary of terms
Summary points
Chapter 10: Understanding the relationship between depression and alcohol among students
Abstract
Introduction
Examining the association between alcohol and depression in students
Influence of mental health on alcohol and depression
Influence of sociodemographic variables on alcohol and depression
Influence of drinking motives on alcohol and depression
Other drinking motives and its relationship with depressive symptoms
Key facts of alcohol and depression among students
Summary points
Mini-dictionary of terms
Chapter 11: Depression in obesity
Abstract
Introduction
Obesity
Depression in obesity
Cross-sectional or prospective studies
Systematic reviews
Conclusion
Key facts of obese people in bariatric surgeries
Summary points
Examples of mini-dictionary of terms
Chapter 12: Heart rate variability and depression
Abstract
Introduction
HRV measurement
Association of depression and HRV
HRV in depression and cardiovascular comorbidity
The effect of antidepressants on HRV
HRV and response to depression treatment
Treating depression by intervention on the autonomic system
Key facts
Summary points
Mini-dictionary of terms
Chapter 13: Neuroinflammation and depression
Abstract
General aspects of neuroinflammation
Evidence about neuroinflammation in depression
Mechanisms whereby neuroinflammation leads to alterations in brain structure/function in depression: Lessons from animal models
Peripheral inflammation and brain function in depression
Possible origins of increased neuroinflammation in depression
Neuroinflammation-related mediators as biomarkers of depression
Neuroinflammation as commonplace for stress and depression
Anti-inflammatory effects of antidepressants
Antiinflammatory agents in depression
Clinical implications and future research
Key facts
Summary points
Mini-dictionary of terms
Chapter 14: Interlinking antidepressants and the immune system
Abstract
Introduction
The immune system in the depression
Influence of antidepressants on the immune system
Selective serotonin reuptake inhibitors
Conclusions
Key facts
Summary points
Mini-dictionary of terms
Part II: Biomarkers and diagnosis
Chapter 15: Assessment scoring tools of depression
Abstract
Introduction
Comments
Key facts
Summary points
Mini-dictionary of terms
Chapter 16: The Beck depression inventory: Uses and applications
Abstract
Introduction
Versions
Content description
Target population
Application
Guidelines
Interpretation of scores
Validity
Factors that affect the score
Limitations
Comments
How to obtain
Key facts
Summary points
Mini-dictionary of terms
Chapter 17: Hamilton depression rating scale: Uses and applications
Abstract
Introduction
Administration and uses
Scoring and interpretation
Indication for the use of the HDRS
Validity and reliability
Limitations
Key facts of the Hamilton depression rating scale
Summary points
Mini-dictionary of terms
Chapter 18: The patient health questionnaire (PHQ)
Abstract
Introduction
Content and scoring
Abbreviated versions
Psychometric characteristics
Screening and case-finding properties
Comparison with other psychometric instruments
Special populations
Conclusions
Key facts of PHQ
Summary points
Mini-dictionary of terms
Chapter 19: Screening for antenatal depression (AND) using self-report questionnaires: Conceptual issues and measurement limitations
Abstract
Introduction
The etiological paradox of PDD
Screening for AND: Measurement issues
Measuring continuity of PDD across the reproductive spectrum
Psychometric characteristics
Screening measure item content and overlaps
Screening for AND: Which measures perform best?
The nine-item Patient Health Questionnaire (PHQ-9)
The “Whooley questions”
Beyond guidelines: Other questionnaires for the detection of depression
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 20: Edinburgh postnatal depression scale: Description and applications
Abstract
Introduction
Edinburgh postnatal depression scale
Key facts
Summary points
Mini-dictionary of terms
Chapter 21: The death depression scale: Description and applications
Abstract
The death depression scale (DDS)
The DDS items
The death depression scale-revised (DDS-R)
Discussion
Key facts of the death depression scale (DDS)
Mini-dictionary of terms
Chapter 22: The Depression Anxiety Stress Scale: Features and applications
Abstract
Acknowledgments
Introduction
Psychometric properties
Validity of extending the DASS to additional populations and administration formats
Applications
Summary
Conclusion
Key facts of translations/adaptations of tests or measures
Summary points
Mini-dictionary of terms
Chapter 23: Arabic version of the two-question quick inventory of depression (QID-2-AR): Description and applications
Abstract
Disclosure of potential conflicts of interest
Introduction
Human plague
Negative impacts of depression
Depression undetected and undiagnosed
Burden time and effort to screening of depression
Difficulty of detecting depression
Depressed mood and anhedonia
Effective screening
Multiple cultures recommended of QID-2
QID-2 test alternative of scales
Utility of QID-2
Description of QID-2
Description of diagnostic cutoff value for the QID-2
Recommendations the threshold score of QID-2
Applications of QID-2 and recommendations
Discussion
Implications of QID-2 in care for good clinical practice
QID-2, depression, clinicians, patients, busy clinics, and wartime
Conclusion
Key facts of depression
Key facts of QID-2
Summary points
Mini-dictionary of terms
Chapter 24: Depression and biomarkers of cardiovascular disease
Abstract
Depression and cardiovascular disease
What is a biomarker?
Associations between depression and biomarkers of cardiovascular disease
Functional biomarkers
Circulating biomarkers
Structural biomarkers
Psychosocial factors impacting the depression-biomarkers relationship
Limitations of measuring biomarkers
Future directions
Summary and conclusions
Key facts
Summary points
Mini-dictionary of terms
Chapter 25: Thioredoxin as an antioxidant protein as a marker in depression
Abstract
Introduction
Role of oxidative stress in depressive disorder
Key facts of thioredoxin
Summary points
Mini-dictionary of terms
Chapter 26: Methods of neuroimaging in depression: Applications to resting-state functional connectivity
Abstract
Acknowledgments
Disclosure of conflicts of interest
Introduction
Childhood and adolescence
Adulthood
Conclusions
Summary points
Chapter 27: Neural markers of depression in MRI
Abstract
Introduction
Introduction and concept of MRI and FMRI
Hypothetic model in depression
Structural neural marker in MDD: GM aspect
Structural neural marker in MDD: WM aspect
Functional neural marker in MDD: Task FMRI aspect
Functional neural marker in MDD: Rs-FMRI aspect
Key facts of neural MRI markers in MDD
Summary points
Mini-dictionary of terms
Part III: Pharmacological treatments for depression
Chapter 28: Angiotensin receptor 1 blockade as an antidepression strategy
Abstract
Introduction
Renin-angiotensin-aldosterone system in the brain
Experimental data and clinical studies
Brain-derived neurotrophic factor
Diabetes and comorbid depression
Key facts of role of RAAS in mood disorders
Summary points
Mini-dictionary of terms
Chapter 29: The link between cannabinoids and depression
Abstract
Introduction
Distribution of cannabinoid receptors in the central nervous system
Cannabinoid receptor signaling pathways
Cannabinoids and depression disorder: Clinical evidence
Cannabinoids and depression disorder: Preclinical evidence
Possible mechanisms in the effects of cannabinoids on depression
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 30: Agomelatine: Profile and applications to depression
Abstract
Introduction
Pharmacology
Pharmacodynamics
Pharmacokinetics, metabolism, and drug interactions
Clinical efficacy in depressive episodes
Bipolar depression
Depression in medical comorbidities
Side effect profile
Serious adverse events
Safety on overdose
Conclusions
Key facts of agomelatine
Mini-dictionary of terms
Chapter 31: Bumetanide and use in depressive states
Abstract
Summary points
Key facts
Mini-dictionary of terms
Chloride homeostasis and depression
Perspective in the use of bumetanide as a therapeutic agent
Chapter 32: Linking citalopram, serotonin reuptake inhibitors, and depressed pregnant women
Abstract
Introduction
Development of serotonergic systems
Role of 5-HT in neural development and behavior
Pharmacokinetics of SSRIs
Prenatal exposure to SSRIs in humans
Effects of prenatal SSRI administration in normal pregnant rodents
SSRI administration to stressed mothers: Effect on offspring behavior
Key facts
Summary points
Mini-dictionary of terms
Chapter 33: Citalopram and its use in sleep-deprivation-induced depression
Abstract
Acknowledgments
Introduction
Prevalence of SD
Sleep loss as a risk factor for depression
Sleep deprivation-induced molecular deficits—Effects of antidepressants
Synaptic plasticity and SD
Effects of CTM on SD-induced depression
Concluding remarks
Key facts about sleep deprivation
Summary points
Mini-dictionary of terms
Chapter 34: Monoaminergic system and antidepressants
Abstract
Introduction
Serotonin
Noradrenaline and adrenaline
Dopamine and antidepressants
Other monoamines (histamine, melatonin, and tryptamine hallucinogens)
Conclusion
Key facts of antidepressants
Summary points
Mini-dictionary of terms
Chapter 35: Duloxetine usage in depression
Abstract
Acknowledgment
Introduction
Pharmacokinetic profile
Duloxetine for depression and its associated symptoms
Effects of duloxetine on depression in gynecology and obstetrics
Effects of duloxetine on treatment–resistant depression
Effects of duloxetine on depression with comorbidities
Side effects
Key facts of duloxetine
Summary points
Mini-dictionary of terms
Chapter 36: Escitalopram and blonanserin as antidepressant agents linking in neurotrophic mechanisms
Abstract
Introduction: Modern molecular theory of depression
BDNF as a leading player in depression
Role of BDNF in corticosterone hormone stress-induced depression model
BDNF signaling activation and underlying mechanisms
Trophic mechanism in chronic, recurrent depression—Early life adversity
Trophic mechanism in chronic, recurrent depression—Adolescent
Possible antidepressant activity as adjunctive agent
Potential mechanism of antidepressant action induced by blonanserin
Possible BDNF/GABA activation by blonanserin through D3 receptors
Key facts
Summary points
Mini-dictionary of terms
Chapter 37: (2R,6R)-Hydroxynorketamine as a novel antidepressant and its role in the antidepressant actions of (R,S)-ketamine
Abstract
Introduction
Metabolism of (R,S)-ketamine
Antidepressant effects of (2R,6R)-HNK
Mechanisms underlying the antidepressant effects of (2R,6R)-HNK
Role of (2R,6R)-HNK in the antidepressant effects of (R)-ketamine
Conclusion
Key facts of major depressive disorder
Summary points
Mini-directory of terms
Chapter 38: Linking 5-hydroxytryptamine to antidepressant actions of (R)-ketamine and social stress model
Abstract
Introduction
(R,S)-Ketamine
Linking 5-HT and the antidepressant actions of (R)-ketamine in a chronic social stress model
Conclusion
Key facts
Summary points
Chapter 39: Mirtazapine: Multitarget strategies for treating substance use disorder and depression
Abstract
Introduction
Substance use disorder (SUD)
MDD-SUD comorbidity
Neurobiological mechanisms of DD (MDD-SUD)
Mirtazapine
Mirtazapine-SUD
Preclinical studies
Clinical trials
Preclinical studies in models of polydrug
Selective agent therapies
Multitarget therapy
Conclusion and future perspectives
Key facts
Summary points
Mini-dictionary of terms
Part IV: Counselling, psychotherapy and behavioural treatments for depression
Chapter 40: Mindfulness-based cognitive therapy and depression
Abstract
Overview
Mindfulness-based interventions and depression
MBCT for prevention of depressive relapse
MBCT in the treatment of current depression
MBCT for TRD
Mechanisms of change in MBCT
MBCT for depression associated with chronic illness
Summary and future directions in the use of MBCT
Key facts of mindfulness-based cognitive therapy and depression
Summary points
Mini-dictionary of terms
Chapter 41: Online programs for depression
Abstract
Introduction
The structure and function of online programs
Self-guided vs clinician-supported programs
Evidence for the effectiveness of online programs
Examples of effective programs
Opportunities and challenges in delivering online programs
The future of online programs
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 42: Clay art therapy on emotion regulation: Research, theoretical underpinnings, and treatment mechanisms
Abstract
Introduction
Section one: Emotion regulation: Research and theories relating visual art to neuroscience
Section two: Therapeutic functions of clay on emotion regulation
Section three: Treatment mechanisms of clay art therapy for emotion regulation
Concluding comments
Key facts
Summary points
Mini-dictionary of terms
Chapter 43: Solution-focused counseling and its use in postpartum depression
Abstract
List of abbreviations
Introduction
Solution-focused brief therapy and counseling
Solution-focused brief therapy principles
Solution-focused brief therapy methods and techniques
The structure of solution-focused brief therapy and counseling
Solution-focused brief therapy as a practical skill in preventing postpartum blues and depression
Mini-dictionary of terms
Key facts of solution-focused brief therapy
Summary points
Chapter 44: Transcranial direct current stimulation (tDCS) combined with cognitive emotional training (CET) as a novel treatment for depression
Abstract
Introduction
Transcranial direct current stimulation (tDCS)
Clinical effects of tDCS in MDD
Rationale for combining tDCS and CET in MDD
Cognitive emotional training (CET)
Clinical effects of CET
Preliminary evidence for clinical effects of tDCS combined with CET
Neurophysiological effects of tDCS combined with CET
Conclusions and future research
Key facts of tDCS and CET
Summary points
Part V: Other aspects of treatment: Specific groups, monitoring and novel regimens
Chapter 45: Putative effects of cannabidiol in depression and synaptic plasticity
Abstract
Acknowledgments
Disclosures
Introduction
Cannabidiol pharmacology and therapeutic potential
The effects of CBD in animal models of depression
CBD effects on depressed patients
Final considerations
Key facts
Summary points
Mini-dictionary of terms
Chapter 46: Transcutaneous auricular vagus nerve stimulation in the treatment of depression
Abstract
Introduction
Clinical trials on taVNS treatment of depression
Potential side effects of taVNS
Potential mechanisms underlying taVNS treatment of depression
Challenges and future directions
Key facts of taVNS
Summary points
Mini-dictionary of terms
Chapter 47: Exercise for depression as a primary and comorbid with obesity disorder: A narrative
Abstract
Introduction
Clinical attributes of trials reviewed by meta-analyses
Meta-analysis for AE in adult MDD patients in mental health services
Pragmatic evidence for exercise and depression
Ideographic vs nomothetic exercise
Pragmatic trial ideographic vs nomothetic exercise for depression
Individual clinical significant analysis
Exercise for depression as a comorbid with obesity disorder
Additional exercise trials for depression as a comorbid with obesity disorder
Collective evidence
Key facts of the safety of exercise for depressed patients
Summary points
Examples of mini-dictionary of terms
Chapter 48: Acupressure and depression: A scientific narrative
Abstract
Introduction
Basic concepts of acupressure
Application of acupressure
Research evidences for the effect of acupressure on depression
Key facts
Summary points
Mini-dictionary of terms
Chapter 49: Potential beneficial effects of Bifidobacterium breve A1 on cognitive impairment and psychiatric disorders
Abstract
Microbiota-gut-brain axis
MGB axis in Alzheimer’s disease
MGB axis in schizophrenia
Bifidobacterium breve A1 as probiotics
Administration of B. breve A1 to subjects with mild cognitive impairment
Effect of B. breve A1 on anxiety and depressive symptoms in schizophrenia
No significant change in the gut microbiota was observed, but B. breve A1 may have affected gut epithelial barrier function
Dietary habits and baseline gut microbiota could influence the effect of B. breve A1 on anxiety and depressive symptoms
Conclusions and perspectives
Key facts
Summary points
Mini-dictionary of terms
Chapter 50: Coenzyme Q10 and depression
Abstract
A brief introduction to depression treatment regimens
CoQ10 and its pharmacological application
Correlation of CoQ10 with depression
Conclusion
Key facts of mice behavioral tests
Key facts of human depression studies
Key facts of oxidative stress and antioxidants
Summary points
Mini-dictionary of terms
Chapter 51: Gene expression in major depressive disorder: Peripheral tissue and brain-based studies
Abstract
Introduction
Gene expression and its measurement
Candidate gene vs whole-genome approaches
Confounding, expression, and causality
Differential expression (DE) studies
Gene expression as mediators of genetic risk
Tissue specificity and the use of surrogate markers
Peripheral tissue studies in MDD
Brain-based studies in MDD
Single-cell sequencing
Emerging themes
Integration with genetic risk
Future directions
Triangulation and strengthening of causal claims
Summary
Summary points
Mini-dictionary of terms
Chapter 52: Electroconvulsive therapy for depression: Effectiveness, cognitive side-effects, and mechanisms of action
Abstract
Summary of ECT effectiveness research
Cognitive effects
ECT’s mechanism of action models
Future directions: Testing an integrated model
Key facts for electroconvulsive therapy
Summary points
Mini-dictionary of terms
Chapter 53: Prenatal depression and offspring DNA methylation
Abstract
Prenatal maternal depression
Developmental origins of health and disease (DOHaD)
Epigenetics mechanisms
Epigenetics studies of fetal exposure to maternal depression
Recommendations for future research
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 54: Treating depression with theta burst stimulation (TBS)
Abstract
Introduction
Role of transcranial magnetic stimulation in depression
Mechanism of action of theta-burst stimulation and its types
Key facts
Summary
Mini-dictionary terms
Volume 2
Part I: Genetic aspects of depression
Chapter 1: Epigenetics in depression
Abstract
Introduction
DNA methylation
Early-life events, DNA methylation, and depression
Different gene methylation profiles in depression models
Histone modifications
Histone acetylation and depression
Histone methylation and depression
HDAC inhibitors as antidepressants
Histone modification associated with gestational stress and gender differences
miRNA mechanisms of action
miRNAs and neuroplasticity in depression
miRNAs and animal models of depression
miRNAs and postmortem brain
miRNAs as a peripheral markers of depression
Conclusion
Key facts of epigenetics
Summary points
Mini-dictionary of terms
Chapter 2: Genes, depression, and nuclear DNA
Abstract
Introduction
Heritability of depression
Heterogeneity of depression
The multifactorial background of depression
The candidate gene approach in depression
Genome-wide analytical studies (GWAS) in depression
Phenotyping of depression in genetic studies
Genetic architecture of depression
Implications of genetic studies of depression for clinical practice
Conclusion
Summary points
Key facts
Mini-dictionary of terms
Chapter 3: Gene expression in depression: Molecular aspects of postpartum depression
Abstract
Introduction
What is known about PPD etiology?
Molecular biology approaches for the study of PPD: The experimental models
Genetic factors for PPD: The female reproductive hormones
Genetic factors for PPD: The neuropeptides and mood modulators
Genetic factors for PPD: The HPA axis
Genetic factors for PPD: The immunoinflammatory response
Genetic factors for PPD: The microarray studies
Genetic factors for PPD: The epigenetics
The importance of the molecular markers for the PPD diagnosis
Key facts of PPD
Summary points
Mini-dictionary of terms
Chapter 4: Genetics and epigenetics of the SLC6A4 gene in depression
Abstract
List of abbreviations
Introduction
The role of the serotoninergic system in neurodevelopment depression
Genetic variations in the serotonin transporter gene and the risk for depression
Stress events and epigenetic changes
Perspectives on the SLC6A4 contribution for depression etiology
Key facts of SLC6A4
Summary points
Mini-dictionary of terms
Chapter 5: Molecular basis of tryptophan metabolism disorders associated with depression
Abstract
Introduction
Genetic background of disorders of tryptophan metabolism in depression
Disorders of tryptophan metabolism and antidepressant therapy
Compensatory (anti)inflammatory reflex system in depression
Disorders of tryptophan metabolism in the development of postpartum depression
Conclusion
Key facts
Summary points
Mini-dictionary terms
Chapter 6: Metalloproteinases genes and their relationship with depression
Abstract
Introduction
Overview
Structure, history, classification, and regulation
Pathophysiological role
Pathophysiology of depression
Pharmacotherapy
Conclusion
Key facts of matrix metalloproteinases in depression
Summary points
Mini-dictionary of terms
Chapter 7: Linking gene regions jointly with environment and depression
Abstract
Introduction
Candidate gene methods in GxE research
Gene-region analyses: A primer
Selecting gene regions
Gene-region analyses in depression research
Challenges and future directions
Key facts of gene region x environment analysis in depression
Summary points
Mini-dictionary of terms
Part II: Molecular and cellular effects of depression
Chapter 8: Linking depression, mRNA translation, and serotonin
Abstract
Introduction
mRNA translation: A central process in regulating gene expression
Dysregulated inflammation in MDD
Conclusions
Key facts
Summary points
Mini-dictionary of terms
Chapter 9: Changes in cortical gene expression in major depressive disorders: More evidence implicating inflammatory-related pathways in disease etiology
Abstract
Cortical dysfunction in major depressive disorders
Gene x environment interactions in major depressive disorders
Cortical gene expression in major depressive disorders
Regional changes in cortical gene expression in major depressive disorders
Changes in gene expression in the frontopolar cortex
Changes in gene expression in the orbitofrontal cortex
Changes in gene expression in the dorsolateral prefrontal cortex
Changes in gene expression in the ventrolateral prefrontal cortex
Changes in gene expression in the cingulate cortex
Changes in gene expression in the premotor and primary motor cortices
Changes in gene expression in the temporal cortex
Changes in gene expression in the pre-visual cortex
Summary of changed cortical gene expression in major depressive disorders
From transcriptomics to a biology of major depressive disorders
Conclusions
Key facts
Summary points
Chapter 10: FKBP5 gene expression as a biomarker for treatment outcome in depression
Abstract
Depression—A stress-related mental disorder
Role of FKBP5 in stress response regulation and mood disorders
FKBP5 gene expression and antidepressant treatment outcome
FKBP5 as a promising antidepressant drug target
Key facts and summary points
Mini-dictionary of terms
Chapter 11: Neuroimaging a cytokine storm by transducing IL-1α to hippocampal cornu ammonis: COVID-19 SARS-CoV-2
Abstract
Acknowledgments
Introduction
Main text
Nanobiotechnology model: The device and the circuits
Key facts
Summary points
Mini-dictionary of terms
Chapter 12: Linking interleukin-6 and depression
Abstract
Introduction
Interlinking interleukin-6 and depression
Historical background
Review of IL-6 function
Preclinical studies
Clinical studies of immune system disorders or immunoactive treatments
Clinical studies of patients with MDD or other depressive disorders
Clinical treatments involving blockade of IL-6 activity
Mechanisms of interaction of IL-6 and depression
Limitations
Future areas of research
Conclusion
Key facts
Summary points
Chapter 13: The role of inflammatory signaling in comorbid depression and epilepsy
Abstract
Introduction
Inflammation in depression and epilepsy
The role of inflammation in epilepsy and depression comorbidity
Conclusions
Key facts of inflammation in comorbid depression and epilepsy
Summary points
Mini-dictionary of terms
Chapter 14: Brain inflammasomes in depression
Abstract
Introduction
Inflammasomes, structure-function relationship and role in brain diseases
Major depressive disorders
Linking depressive disorders to neuroinflammation
Inflammasomes are key players in MDD
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 15: Inflammatory factors and depression in substance use disorder
Abstract
Introduction
Substance use disorder
Comorbidity: Substance use disorder and depression
Inflammation in substance use disorder and depression
Conclusions and identification of inflammatory biomarkers
Key facts of substance use disorder
Key facts of inflammation
Summary points
Mini-dictionary of terms
Chapter 16: Linking Huntington disease, brain-derived neurotrophic factor, and depressive-like behaviors
Abstract
Huntington’s disease
Brain-derived neurotrophic factor
The role of brain-derived neurotrophic factor in depression
Alterations of brain-derived neurotrophic factor signaling in HD
Depression in HD: A putative role for brain-derived neurotrophic factor
Conclusions
Key facts on Huntington’s disease
Summary points
Mini-dictionary of terms
Chapter 17: Depression and the NMDA receptor/NO/cGMP pathway
Abstract
Introduction
The glutamatergic system and the l-arginine/NO/cGMP pathway
NMDA receptor/NO/cGMP pathway as therapeutic target for depression
NMDA receptor antagonists
l-arginine/NO/cGMP pathway inhibitors
Prospects and future directions
Conclusion
Key facts of antidepressants
Summary points
Mini-dictionary of terms
Chapter 18: Translocator protein (18 kDa TSPO) binding in depression
Abstract
Introduction: The inflammatory theory of depression
Postmortem studies and central markers of inflammation
The translocator protein: A putative marker of neuroinflammation
In vivo imaging of neuroinflammation in MDD: Initial findings, controversies, and clinical implications
TSPO binding and cognitive functions in depression
TSPO binding and response to psychotherapy
Limitations and future directions
Key facts of translocator protein (TSPO 18 kDa)
Key facts of inflammation and depression
Summary points
Mini-dictionary of terms
Chapter 19: Axonal transport proteins: What they are and how they relate to depressive behaviors
Abstract
What is axonal transport?
Axonal transport and brain function
Axonal transport proteins and neuroinflammation
Axonal transport proteins and neurodegeneration
Axonal transport proteins and depressive-like behavior
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 20: Molecular features of adenylyl cyclase isoforms and cAMP signaling: A link between adenylyl cyclase 7 and depression
Abstract
Acknowledgments
Introduction
Overview of adenylyl cyclases
cAMP signaling and depression
Adenylyl cyclase 7
Adenylyl cyclase 7 and depression
Conclusions
Key facts of cAMP signaling
Key facts of AC7
Summary points
Mini-dictionary of terms
Chapter 21: Neurobiology of depression: The role of glycogen synthase kinase 3
Abstract
Introduction
Posttranslational mechanisms regulating GSK3 activity
GSK3β in mood disorders and depression
GSK3 and experimental models of depression-like behaviors
Role of GSK3 in regulating intrinsic excitability
GSK3 and voltage-gated sodium (Nav) channels
GSK3 and accessory proteins of the voltage-gated sodium (Nav) channel complex
GSK3 phosphorylation of the voltage-gated sodium (Nav) channel in experimental models of vulnerability to depression-like behavior
GSK3 and voltage-gated potassium (Kv) channels
Functional implications of GSK-3-dependent Kv4.2 phosphorylation
GSK3 and Kv channels in experimental models of depression-like behaviors
Conclusions
Key facts of GSK3
Summary points
Mini-dictionary of terms
Chapter 22: Sortilin/neurotensin receptor-3 and its derived peptides in depression
Abstract
Introduction
How TREK-1 became a target in depression
How sortilin was shown to be involved in depression
Spadin and spadin analogs are selective fast-acting antidepressants
Posttranslational products of NTSR3/sortilin as biomarkers
The role of spadin as a link between obesity/diabetes and depression
Conclusions
Key facts
Summary points
Mini-dictionary of terms
Chapter 23: Implication of Wnt/beta-catenin signaling and its components in depression and neuropsychiatric disorders
Abstract
Introduction
The canonical Wnt signaling pathway
Noncanonical Wnt signaling pathway
Wnt/Ca+ 2 pathway
Wnt/PCP pathway
Wnt/β-catenin signaling components in depression
Disheveled
GSK-3β
Wnts
Frizzled
Crosstalk between neurogenesis and Wnt signaling in depression and psychiatric disorders
Antidepressants utilize Wnt signaling and its components for the action
Concluding remarks
Key facts of Wnt signaling and depression
Summary points
Mini-dictionary of terms
Chapter 24: The prefrontal cortex in depression: Use of proteomics
Abstract
Introduction
OMICS allowed a new insight into neuronal phenotype
The basics of proteomic studies
Proteomic studies in depression research
Proteome changes in depression
Limitations and perspectives
Key facts of proteomics
Summary points
Mini-dictionary of terms
Part III: Neurological and imaging features
Chapter 25: How brain single photon emission computed topography imaging informs the diagnosis and treatment of mood disorders
Abstract
Introduction
Imaging does not match the DSM, but can enhance it
Brain SPECT imaging
SPECT mood disorder literature
Hypofrontality
Hyperfrontality
Overall decreased perfusion
Brain trauma
Cognitive disorders vs depression
How SPECT changes clinical practice and may improve outcomes
SPECT, mood disorders, and treatment response
Key facts
Key points
Summary
Mini-dictionary of terms
Chapter 26: Resting-state functional magnetic resonance imaging (rsfMRI) in bipolar and unipolar depression
Abstract
Introduction
A framework for synthesizing rsfMRI results: Distributed functional networks
Resting-state functional connectivity in unipolar depression
Resting-state functional connectivity in bipolar depression
Functional connectivity differences between unipolar and bipolar depression
Challenges to interpretation of resting-state studies
Future directions
Key facts about unipolar and bipolar depression
Summary points
Mini-dictionary of terms
Chapter 27: Linking amygdala blood oxygenation-level-dependent (BOLD) activity and frontal EEG in depression
Abstract
Introduction
Emotion regulation system
Emotion regulation in depression
Frontal EEG asymmetry and depression
Linking amygdala BOLD activity and frontal EEG
Amygdala real-time fMRI neurofeedback with simultaneous EEG
EEG activity during the real-time fMRI neurofeedback procedure
Frontal EEG asymmetry changes and depression severity
EEG coherence enhancement and depression severity
Correlations of amygdala BOLD activity and frontal EEG asymmetry
Conclusion
Key facts of amygdala and frontal EEG in depression
Summary points
Mini-dictionary of terms
Chapter 28: The rostromedial tegmental nucleus: Features and links with alcohol and depression
Abstract
Background
RMTg: Characteristics, inputs, and outputs associated with alcohol and depression
RMTg activity in alcohol consumption and depression
Role of the RMTg in alcohol withdrawal-induced negative affect
Conclusion
Key facts of comorbid alcohol use disorders and depression
Summary points
Mini-dictionary of terms
Chapter 29: Human serotonergic neurons, selective serotonin reuptake inhibitor (SSRI) resistance and major depressive disorder
Abstract
Introduction
IPSC reprogramming
Generating human serotonergic neurons
Studying serotonergic neurotransmission in patient serotonergic neurons
Studying serotonergic neurotransmission in patient cortical neurons
Limitations in iPSC work
Key facts of serotonergic neurons
Key facts of induced pluripotent stem cells (iPSCS)
Summary points
Mini-dictionary of terms
Chapter 30: Role of nesfatin-1 in major depression
Abstract
Introduction
Structure and distribution of NUCB protein family
Molecular structure of nesfatin-1
Distribution and effects of nesfatin-1
Nesfatin-1 and psychiatric disorders
Nesfatin-1 and depression
Key facts of nesfatin-1
Summary points
Mini dictionary of terms
Chapter 31: Impact of NGF signaling on neuroplasticity during depression: Insights in neuroplasticity-dependent therapeutic approaches
Abstract
Acknowledgments
Introduction
Changes in neuroplasticity during the pathophysiology of depression
NGF and neuroplasticity: The evidence
Role of NGF in the plasticity of hippocampal and basal forebrain cholinergic neurons
NGF dysregulation in depression
Clinical evidence
Preclinical evidence
NGF regulation in antidepressants treatment
New perspectives for refining future treatment approaches: Neuroplasticity-dependent therapeutic approaches
Concluding remarks
Key facts of depression
Summary points
Mini-dictionary of terms
Chapter 32: Inherited depression and psychological disorders and mental illness by germ cells and their memory
Abstract
Disclosure of potential conflicts of interest
Introduction
Psychiatric pathologies
Depression and degradation of germ cells
Genetic memory
Do the same causes produce the same effects in humans?
Wartime, depression, and germ cells
Psychological and environmental factors and female–male germ cells-fertility
Transmission of trauma via germ cells
Reverse process
Exercise, nutritional status, seasonal variations, and germ cells
What is happening inside and beyond the uterus?
Psychotherapy and sexual behavior
Cognitive/physical activities and sexual behavior
Relaxation and music/dance therapy
Discussion
Conclusion
Key facts of human germ cells
Summary points
Mini-dictionary of terms
Part IV: Behaviour and psychopathological effects
Chapter 33: Cognitive function and neurocognitive deficits in depression
Abstract
The “hot” and “cold” cognitive processes in depression
Cognitive predictors of depression
Cognitive function associated with a depressive episode
Cognitive function following depressive episode remission
Conclusion and future directions
Key facts of cognitive functioning
Summary points
Mini-dictionary of Terms
Chapter 34: Cognitive and interpersonal contributors to relationship distress and depression: A review of the dyadic partner-schema model
Abstract
Acknowledgment
Introduction
An overview of the dyadic partner-schema model
Clinical implications of the dyadic partner-schema model
Directions for future research
Conclusion
Key facts of schemas
Summary points
Mini-dictionary of terms
Chapter 35: Cognitive vulnerability to depression in adolescence
Abstract
Introduction
Developmental antecedents to cognitive vulnerability to depression
Childhood maltreatment and cognitive vulnerability to depression
Peer victimization and cognitive vulnerability to depression
Limitations of the research on early life influences of cognitive vulnerability to depression
Neurobiological findings for early life adversities
Neurobiological findings for cognitive vulnerability to depression
Conclusion and future directions
Key facts of cognitive vulnerability to depression
Summary points
Mini-dictionary of terms
Chapter 36: Determining the cognitive performance in the first episode of depression
Abstract
Introduction
Cognitive dysfunction in MDD
A brief history of cognitive dysfunction in MDD
Impact of cognitive dysfunction in MDD
Cognitive dysfunction in the first episode of MDD
Conclusions
Key facts of cognitive dysfunction in the first episode of MDD
Summary points
Mini-dictionary of terms
Chapter 37: Body image and depression
Abstract
Introduction
Tripartite model of body image
Reciprocal shaping: Body image is shaped by interaction and body image shapes interaction
Systems view: The neurological layers of embodiment
Body image assessment
Studies of the body image in patients with depression
Discomfort in sensing the body
Body memory contents of the depressed patients’ body image
Body image quality and recovery from depression
Addressing and accepting body image contents in the treatment of depression
Dance movement therapy in the treatment of patients with depression
Key facts—Summary points
Mini-dictionary terms
Chapter 38: Sleep, anxiety, and depression
Abstract
Introduction
Fundamentals of sleep
Sleep architecture
Available treatments for insomnia
Anxiety disorders
Treatments for anxiety disorders
Mechanisms of sleep, anxiety, and depression
Conclusion
Key facts
Mini-dictionary of terms
Chapter 39: Depression, anxiety, and quality of life
Abstract
Introduction
Measures of qualify of life
Depression and quality of life
Effect of treatment for depression on quality of life
Anxiety and quality of life
Effect of treatment for anxiety on quality of life
Conclusions
Summary points
Key facts of depression, anxiety, and quality of life
Mini-dictionary of terms
Chapter 40: Reward processing and depression: Current findings and future directions
Abstract
Introduction
Theory linking reward processing and depression
Reward processing and depression: A review of behavioral studies
An ERP measure of reward processing
Reward processing and depression: A review of ERP studies
fMRI measurement of reward processing
Reward processing and depression: A review of fMRI studies
Life stress, reward processing, and depression
Conclusion and future directions
Key facts of reward learning
Summary points
Mini-dictionary of terms
Chapter 41: Sexual functioning in depression
Abstract
Introduction
The problem statement: Sexual dysfunction in depressed individuals
Pathophysiology of sexual dysfunction in depression
Incidence and pathophysiology of TESD/antidepressant-induced sexual dysfunction
Impact of sexual dysfunction on depression
Risk factors for developing sexual dysfunction during antidepressant therapy
Assessment of sexual functioning in patients with depression
Management of sexual dysfunctions in depression
Conclusions
Summary points
Key facts
Part V: Diet, nutrition and botanicals
Chapter 42: Linking dietary glycemic index and depression
Abstract
Introduction
Carbohydrates and glycemic index
Glycemic responses and depression
Observational studies
Clinical trials
Possible mechanisms
Conclusion
Key facts of carbohydrates
Summary points
Mini-dictionary of terms
Chapter 43: Gut microbiota and depression
Abstract
Introduction
Gut microbiota and brain communication
The mechanisms of action
Key facts
Summary points
Mini-dictionary of terms
Chapter 44: Linking dietary methyl donors, maternal separation, and depression
Abstract
Introduction
Experimental models of depression based on stress in perinatal life
Methyl donors and depression
Mutations related to depression in genes of one-carbon metabolism
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 45: Convolvulus pluricaulis usage and depression
Abstract
Introduction
Pathology
Current synthetic treatment for depression
Introduction to herbal medicines
Scientific classification
Description
Pharmacological activities of C. pluricaulis
Effect of C. pluricaulis extract (CPE) in the mouse forced swim and tail suspension tests
Effect of C. pluricaulis extract (CPE) behavior induced by chronic unpredictable mild stress in rat
Effect of C. pluricaulis against H2O2-induced neurotoxicity in SH-SY5Y human neuronal cells
Effect of scopoletin, phytochemical constituent of C. pluricaulis in tail suspension tests
Effect of Kaempferol, a phytochemical constituent of C. pluricaulis in TST and FST
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 46: Antidepressant activity of Crocus sativus L. and its main constituents: A review
Abstract
Introduction
Antidepressant activity of saffron
Antidepressant activity of saffron constituents and its bioactive fractions
Bioactive fractions of C. sativus L.
Conclusion
Summary points
Key facts
Mini-dictionary of terms
Chapter 47: Mechanisms of action of herbal antidepressants
Abstract
Introduction
Herbal antidepressants
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Chapter 48: Antidepressant-like effects and mechanisms of the herbal formula Xiaochaihutang in depression
Abstract
Introduction
Effects of XCHT on depressive animal models
Antidepressant mechanisms of XCHT
Conclusion
Key facts
Summary points
Mini-dictionary of terms
Part VI: Resources
Chapter 49: Recommended resources on the neuroscience of depression: Genetics, cell biology, neurology, behavior, and diet
Abstract
Acknowledgments
Introduction
Resources
Summary points
Mini-dictionary of terms
Key facts
Index for Volume 1
Index for Volume 2

Colin R. Martin

Colin R. Martin RN, BSc, MSc, PhD, MBA, YCAP, FHEA, C.Psychol, AFBPsS, C.Sci is Professor of Clinical Psychobiology and Applied Psychoneuroimmunology and Clinical Director of the Institute of Health and Wellbeing at the University of Suffolk, UK. He is a Chartered Health Psychologist and a Chartered Scientist. He also trained in analytical biochemistry, this aspect reflecting the psychobiological focus of much of his research within mental health. He has published or has in press well over 300 research papers and book chapters. He is a keen book author and editor having written and/or edited more than 50 books. These outputs include the prophetic insight into the treatment of neurological disease, Handbook of Behavior, Food and Nutrition (2011), Nanomedicine and the Nervous System (2012), Oxidative Stress and Dietary Antioxidants in Neurological Disease (2020), Zika Virus Impact, Diagnosis, Control and Models (2021), Factors Affecting Neurodevelopment: Genetics, Neurology, Behavior and Diet (2021), Diagnosis and Treatment of Spinal Cord Injury (2022), The Neurobiology, Physiology, and Psychology of Pain (2022) and The Handbook of Lifespan Cognitive Behavioral Therapy: Childhood, Adolescence, Pregnancy, Adulthood, and Aging (2023). Professor Martin is particularly interested in all aspects of the relationship between underlying physiological substrates and behavior, particularly in how these relationships manifest in both acute and chronic psychiatric disorder. He has published original research germane to significant mental health disorders including the areas of schizophrenia, anxiety, depression, self-esteem, alcohol and drug dependency, high secure forensic mental health and personality disorder. He has a keen interest in the impact of postviral illness and is actively involved in clinical research post-Covid pandemic and in particular, the impact of Long Covid on psychological, neurological, physiological and social functioning. He is involved in collaborative International research with many European and Non-European countries.

Affiliations and expertise

Professor of Clinical Psychobiology and Applied Psychoneuroimmunology and Clinical Director: Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK

Lan-Anh Hunter

Dr Lan-Anh Hunter BSc MBBS DFFP DRCOG MRCGP qualified from Guys, King’s & St. Thomas’ Medical School, London in 2001, where she developed an early interest in psychological medicine. She went on to study culture bound syndromes, whilst reading Medical Anthropology Honours degree at University College London, focusing on the cultural aspects of anorexia nervosa in her thesis. She subsequently worked in Australia and explored the psychological aspects of diabetes and its many complications on the aboriginal population. Prior to becoming a GP Principal, she lectured at Charing Cross Hospital teaching doctors in training, continuing this passion, as a GP trainer in her current role. Much has been written about depression in primary care and hence her call to this area. She specialises in psychological medicine, with training in coaching, narrative based medicine, cognitive behaviour therapy and she continues to see, support, treat and manage clinical depression on an everyday basis as a family GP in her Maidenhead practice.

Affiliations and expertise

Rosemead Surgery, Maidenhead, Berkshire, UK

Vinood Patel

Vinood B. Patel, BSc, PhD, FRSC, is currently Professor in Clinical Biochemistry at the University of Westminster. In 2014 Dr Patel was elected as a Fellow to The Royal Society of Chemistry. Dr Patel graduated from the University of Portsmouth with a degree in Pharmacology and completed his PhD in protein metabolism from King’s College London in 1997. His postdoctoral work was carried out at Wake Forest University Baptist Medical School, NC, USA studying structural-functional alterations to mitochondrial ribosomes, where he developed novel techniques to characterize their biophysical properties. Research is being undertaken to study the role of nutrients, antioxidants, phytochemicals, iron, alcohol and fatty acids in the pathophysiology of liver disease. Other areas of interest are identifying new biomarkers that can be used for the diagnosis and prognosis of disease and understanding mitochondrial oxidative stress in neurological disorders and iron dysregulation in diabetes. Dr Patel is a nationally and internationally recognized researcher and has several edited biomedical books related to the use or investigation of active agents or components. These books include The Handbook of Nutrition, Diet, and Epigenetics, Branched Chain Amino Acids in Clinical Nutrition, Cancer: Oxidative Stress and Dietary Antioxidants, Toxicology: Oxidative Stress and Dietary Antioxidants, Molecular Nutrition: Vitamins, The Neuroscience of Pain, Cognitive Behavioural Therapy. He is Editor of the ten-volume series Biomarkers in Disease: Methods, Discoveries and Applications.

Affiliations and expertise

Reader, Clinical Biochemistry, University of Westminster, London, UK

Victor R Preedy

Victor R. Preedy BSc, PhD, DSc, FRSB, FRSPH, FRSC, FRCPath graduated with an Honours Degree in Biology and Physiology with Pharmacology. After gaining his University of London PhD, he received his Membership of the Royal College of Pathologists. He was later awarded his second doctorate (DSc), for his contribution to protein metabolism in health and disease. He is Professor of Clinical Biochemistry (Hon) at King’s College Hospital and Emeritus Professor of Nutritional Biochemistry at King’s College London. He has Honorary Professorships at the University of Hull, and the University of Suffolk. Professor Preedy was the Founding Director and then long-term Director of the Genomics Centre at King’s College London from 2006 to 2020. Professor Preedy has been awarded fellowships of the Royal Society of Biology, the Royal College of Pathologists, the Royal Society for the Promotion of Health, the Royal Institute of Public Health, the Royal Society for Public Health, the Royal Society of Chemistry and the Royal Society of Medicine. He carried out research when attached to the National Heart Hospital (part of Imperial College London), The School of Pharmacy (now part of University College London) and the MRC Centre at Northwick Park Hospital. He has collaborated with international research groups in Finland, Japan, Australia, USA, and Germany. To his credit, Professor Preedy has published over 750 articles, which includes peer-reviewed manuscripts based on original research, abstracts and symposium presentations, reviews and edited books.

Affiliations and expertise

Professor, Department of Clinical Biochemistry, King’s College Hospital, London, UK; Emeritus Professor, Faculty of Life Sciences and Medicine, King’s College London, UK Visiting Professor, University of Hull, UK

Rajkumar Rajendram

Dr Rajkumar Rajendram is a clinician scientist with a focus on internal medicine, anaesthesia, intensive care and peri-operative medicine. He graduated with distinctions from Guy’s, King’s and St. Thomas Medical School, King’s College London in 2001. As an undergraduate he was awarded several prizes, merits and distinctions in pre-clinical and clinical subjects.

Dr Rajendram began his post-graduate medical training in general medicine and intensive care in Oxford. He attained membership of the Royal College of Physicians (MRCP) in 2004 and completed specialist training in acute and general medicine in Oxford in 2010. Dr Rajendram subsequently practiced as a Consultant in Acute General Medicine at the John Radcliffe Hospital, Oxford.

Dr Rajendram also trained in anaesthesia and intensive care in London and was awarded a fellowship of the Royal College of Anaesthetists (FRCA) in 2009. He completed advanced training in regional anaesthesia and intensive care. He was awarded a fellowship of the Faculty of Intensive Care Medicine (FFICM) in 2013 and obtained the European diploma of intensive care medicine (EDIC) in 2014. He then moved to the Royal Free London Hospitals as a Consultant in Intensive Care, Anaesthesia and Peri-operative Medicine. He has been a fellow of the Royal College of Physicians of Edinburgh (FRCP Edin) and the Royal College of Physicians of London (FRCP Lond) since 2017 and 2019 respectively. He is currently a Consultant in Internal Medicine at King Abdulaziz Medical City, National Guard Heath Affairs, Riyadh, Saudi Arabia.

Dr Rajendram’s focus on improving outcomes from Coronavirus Disease 2019 (COVID-19) has involved research on point of care ultrasound and phenotypes of COVID-19. Dr Rajendram also recognises that nutritional support is a fundamental aspect of medical care. This is particularly important for patients with COVID-19. As a clinician scientist he has therefore devoted significant time and effort into nutritional science research and education. He is an affiliated member of the Nutritional Sciences Research Division of King’s College London and has published over 400 textbook chapters, review articles, peer-reviewed papers and abstracts.

Affiliations and expertise

Consultant in Internal Medicine, King Abdulaziz Medical City, National Guard Heath Affairs, Riyadh, Saudi Arabia

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