A Kynurenine Pathway-based Molecular Imaging Study of Individualized Diagnosis and Treatment for Major Depressive Disorder
A Kynurenine Pathway-based Molecular Imaging Study of Individualized Diagnosis and Treatment for Major Depressive Disorder
Major depressive disorder (MDD) is a chronic disease with high incidence rate, high recurrent
 rate and need whole course medical management. Varied clinical symptoms and unclear
 pathogenesis cause a series of clinical problem, such as low diagnostic rate and low
 effective treatment rate. Based on neuroimmune mechanisms of MDD, our previous study
 indicates that kynurenine pathway (KP) in serum may be the connections between central immune
 and peripheral immune, that key factors of KP may change the brain structure and function
 through affecting the central immune. The core research issue of this project are the
 inherent associations between metabonomics of inflammatory factors in KP, clinical phenotypes
 of MDD, and neuroimaging features. This project will focus on first-episode MDD, mass
 spectrometry analysis of KP factors will be conducted first, also multi-modal neuroimaging
 techniques will be applied to detect topological characteristics of brain structure and
 function in MDD and extract standard models, then correlation analyses will be performed
 between these molecular biological features and multi-dimensional clinical data in order to
 integrate KP metabonomics, core clinical characteristics (depressed mood, energy loss,
 interest loss and so on), neuroimaging biomarkers, and finally construct the deep learning
 based standard diagnostic technique of MDD. Additionally, this project will follow up MDD
 patients with different core clinical characteristics to certificate the aforementioned
 diagnostic technique as well as explore optimized treatment for different clinical subtypes.
Inclusion Criteria:

 1. 18-60 years old;

 2. Meeting with the criteria of major depressive disorder in the Diagnostic and
 Statistical Manual of Mental Disorders (DSM)-5;

 3. Scored 20 or higher on the Hamilton's Depression Scale with 24 items (HAMD-24);

 4. With enough audio-visual ability and comprehensive ability to accomplish the visits;

 5. Be necessary and suitable to accept the treatment of antidepressants;

 6. Scored less than 14 on Hamilton's Anxiety Scale (HAMA) and scored less than 14 on the
 Hypomania Symptom Checklist-32 (HCL-32);

 7. With 2 or more atypical symptoms including significant weight gain or increase in
 appetite, hypersomnia, leaden paralysis, and a long-standing pattern of interpersonal
 rejection sensitivity that results in significant social or occupational impairment.

 Exclusion Criteria:

 1. Severe medical or neurological problems;

 2. Previous mania or hypomania episodes;

 3. Female patients who are pregnant, planning to be pregnant or breastfeeding;

 4. Actively suicide ascertained by research psychiatrist or 3rd item of HAMD
 scored≥3(suicidality);

 5. Had electroconvulsive therapy, modified electroconvulsive therapy or repetitive
 transcranial magnetic stimulation in the past 6 months;

 6. Experienced severe personality disorder, mental retardation, anorexia/bulimia nervosa.