Higher zinc concentrations in hair of Parkinson's disease are associated with psychotic complications and depression.
Parkinson's disease (PD) is classically considered a motor disease; however, several non-motor symptoms are also present, including psychiatric complaints. In recent decades, the metals Ca, Fe, and Zn have gained prominence as potential etiologic factors in motoric signs of PD. However, metal alterations could be associated with the non-motor symptoms of PD. We wished to correlate the levels of these metals with the co-occurrence of depression, anxiety, and psychotic symptoms in PD patients. To this end, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Scales for Outcomes in Parkinson's disease-Psychiatric Complications (SCOPA-PC) were implemented to evaluate mood disorders and psychiatric complications. Flame atomic absorption spectrometry (FAAS) was used to assess concentrations of Ca, Fe, and Zn in hair samples collected from 22 clinically diagnosed PD patients, which represented the entire cohort of accessible patients in a Brazilian health registry, and 33 healthy individuals. While Ca and Fe alterations were not found to be associated with psychiatric complaints in the PD group, significantly higher levels of Zn were correlated in PD patients with depression and some psychotic symptoms. Within individual domains of the SCOPA-PC, significantly higher levels of Zn were correlated with the presence of hallucination, illusion, and paranoid ideation when compared to controls and PD patients who did not present these symptoms. Although our sample size is small and findings need to be replicated in larger and heterogeneous populations, our results provide a new perspective on the use of monitoring of Zn levels as a potential biomarker of psychiatric complaints, and may be useful in the development of more effective therapeutic approaches for the management of PD patients with co-occurrence of psychiatric disorders.
EPA and DHA as markers of nutraceutical treatment response in major depressive disorder.
Depression clinical trials are increasingly studying biomarkers to predict and monitor response to treatment. Assessment of biomarkers may reveal subsets of patients who are responsive to nutraceutical treatment, which may facilitate a personalized approach to treating depression.
This is a post hoc analysis of an 8-week, double-blind, randomized, controlled trial (n = 158) investigating a combination nutraceutical comprising Omega-3 (EPA 1 g/DHA 656 mg), SAMe, zinc, 5-HTP, folinic acid, and co-factors versus placebo for the treatment of Major Depressive Disorder. The study explored levels of polyunsaturated fatty acids, folate, vitamin B12, zinc, homocysteine, and BDNF as possible predictors and correlates of response to nutraceutical supplementation.
Concentrations of EPA and DHA in red cell membranes increased in response to treatment and were significantly correlated with a decrease in depressive symptoms during active treatment (p = 0.003 and p = 0.029; respectively). Higher baseline levels of omega-6 fatty acid also correlated with depression reduction in the active treatment group ( p = 0.011). No other biomarkers were associated with a lessening of depressive symptoms.
Changes in fatty acid levels resulting from a nutraceutical combination containing EPA and DHA provide a response biomarker in treating depression.
Nutrient and genetic biomarkers of nutraceutical treatment response in mood and psychotic disorders: a systematic review.
Objective: Nutrient and genetic biomarkers in nutraceutical trials may allow for the personalisation of nutraceutical treatment and assist in predicting treatment response. We aimed to synthesise the findings of trials which have included these biomarkers to determine which may be most useful for predicting nutraceutical response in mood and psychotic disorders. Methods: A systematic review was conducted assessing available literature concerning nutraceutical clinical trials in mood and psychotic disorders (major depression, bipolar disorder, schizophrenia) with baseline and endpoint blood nutrient markers or genetic data available. Results: We identified 35 eligible studies (total n = 3836 participants) examining baseline and endpoint nutrient biomarkers and/or genetic polymorphisms. The key result, as reported in 10 out of 11 omega-3 studies, was a strong association between polyunsaturated fatty acid concentrations (mostly EPA and DHA) and psychiatric outcomes, although the exact nature of the association varied between studies and diagnoses. There was no consistent evidence for levels of other nutrients (including Vitamin D, SAM/SAH ratios, carnitine, folate and vitamin B12) relating to treatment response. The evidence for associations between one-carbon cycle genotypes (e.g. MTHFR C677 T, MTR and FOLH1) and treatment response was also inconsistent. Discussion: The available data tentatively supports omega-3 indices as biomarkers of response to omega-3 treatments in mood disorders. Further research with larger samples examining combinations of polymorphisms is required to determine if any genetic factors influence nutraceutical response in mood and psychotic disorders.
B-vitamins in Relation to Depression in Older Adults Over 60 Years of Age: The Trinity Ulster Department of Agriculture (TUDA) Cohort Study.
Mental health disorders are major contributors to disease burden in older people. Deficient status of folate and the metabolically related B vitamins may be implicated in these conditions. This study aimed to investigate folate, vitamin B12, vitamin B6, and riboflavin in relation to depression and anxiety in aging and also considered the role of fortified foods as a means of optimizing B-vitamin status and potentially reducing the risk of these mental health disorders.
The Trinity Ulster Department of Agriculture (TUDA) aging study was a cross-sectional cohort study.
SETTING AND PARTICIPANTS:
Community-dwelling adults (n = 5186; ≥60 years) recruited from 2 jurisdictions within the island of Ireland from 2008 to 2012.
Depression and anxiety were assessed using the Centre for Epidemiological Studies Depression (CES-D) and the Hospital Anxiety and Depression (HAD) scales, respectively. The following B-vitamin biomarkers were measured: red blood cell folate, serum total vitamin B12, plasma pyridoxal-5-phosphate (PLP; vitamin B6), and erythrocyte glutathione reductase activation coefficient (EGRac; riboflavin).
Biomarker values in the lowest 20% of status for folate (odds ratio [OR] 1.79; 95% CI 1.23-2.61), vitamin B6 (OR 1.45, 95% CI 1.01-2.06), or riboflavin (OR 1.56, 95% CI 1.10-2.00), but not vitamin B12, were each associated with an increased risk of depression (CES-D score ≥16). Correspondingly, B vitamin-fortified foods if consumed daily were associated with a reduced risk of depression (OR 0.54, 95% CI 0.41-0.70). A deficient status of vitamin B6 (OR 1.73, 95% CI 1.07-2.81), but not other vitamins, was associated with increased anxiety.
Better B-vitamin status may have a role in impacting positively on mental health in older adults. Regular intake of fortified foods can provide a means of optimizing B-vitamin status and thus could contribute to reducing depression. If confirmed by a randomized trial, these results may have implications for nutrition and mental health policy, and thus quality of life, in older people.
Posted 10 January 2020 - 01:47 PM
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