BSMB Neuroscience Teaching Week 2016

Neuroimmunology of
Psychiatric Disorders

Stefan M. Gold
stefan.gold@charite.de

UNIVERSITTSMEDIZIN BERLIN
Immune system and psychosis

Khandaker et al., Lancet Psychiatry (2015)

Epidemiology: Infections and schizophrenia

Nielsen et al., Schizophr Bull (2014)

Epidemiology: Infections and depression

Benros et al., JAMA Psychiatry (2013)

NMDA receptor antibodies
Interim summary
On a group level, patients with MDD and SCZ have
increased levels of circulating cytokines and markers
of neuroinflammation
Infections, autoimmune disorders and elevated
markers of inflammation are risk factors for
subsequent psychiatric disorders
MS and risk of depression

Previous diagnosis of autoimmune disease increases risk

for development of mood disorder

Benros et al., JAMA Psychiatry 2013

Microglial activation in the hippocampus

Nistico et al., PLoS One 2013

Imaging the hippocampus
Hippocampus damage in MS

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Control MS

Gold et al., Biol Psychiatry 2010

Hippocampus damage in MS

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10000

7500

5000

2500

0
Control MS

Gold et al., Biol Psychiatry 2010

Hippocampus damage and MS-depression

Gold et al., Biol Psychiatry 2010

Interim summary
Depressive symptoms occur frequently in
neuroinflammatory disorders (such as MS)
Depression in MS is associated with
Damage to the hippocampus
Microglial activation
Synaptic alterations
There is overlap between neurobiological correlates
of depressive symptoms in psychiatric and
neurological disorders
Relevance for therapy?
Summary

Several lines of evidence suggest a role of the

immune system in the pathobiology of psychiatric
disorders (e.g. MDD, SCZ)
A pathogenetic role seems biologically plausible
Findings are not specific to any given disorder but
may represent a transdiagnostic mechanism
accounting for symptomatic overlap (psychiatry,
neurology)