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Transcriptomic signatures of treatment response to the combination of escitalopram and memantine or placebo in late-life depression. | LitMetric

Transcriptomic signatures of treatment response to the combination of escitalopram and memantine or placebo in late-life depression.

Mol Psychiatry

Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Pscyhiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Published: September 2021

AI Article Synopsis

Article Abstract

Drugs that target glutamate neuronal transmission, such as memantine, offer a novel approach to the treatment of late-life depression, which is frequently comorbid with cognitive impairment. The results of our recently published double-blind, randomized, placebo-controlled trial of escitalopram or escitalopram/memantine in late-life depression with subjective memory complaints (NCT01902004) indicated no differences between treatments in depression remission, but additional benefits in cognition at 12-month follow-up with combination treatment. To identify pathways and biological functions uniquely induced by combination treatment that may explain cognitive improvements, we generated transcriptional profiles of remission compared with non-remission from whole blood samples. Remitters to escitalopram compared with escitalopram/memantine combination treatment display unique patterns of gene expression at baseline and 6 months after treatment initiation. Functional enrichment analysis demonstrates that escitalopram-based remission associates to functions related to cellular proliferation, apoptosis, and inflammatory response. Escitalopram/memantine-based remission, however, is characterized by processes related to cellular clearance, metabolism, and cytoskeletal dynamics. Both treatments modulate inflammatory responses, albeit via different effector pathways. Additional research is needed to understand the implications of these results in explaining the observed superior effects of combination treatment on cognition observed with prolonged treatment.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922535PMC
http://dx.doi.org/10.1038/s41380-020-0752-2DOI Listing

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