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Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank

BACKGROUND: Psoriasis is a chronic systemic inflammatory skin disease, coexisting with depression in up to 25% of patients. Little is known about the drivers of comorbidity, including shared neurobiology and depression brain imaging patterns in patients. An immune-mediated crosstalk between the brai...

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Autores principales: Lada, Georgia, Talbot, Peter S., Chinoy, Hector, Warren, Richard B., McFarquhar, Martyn, Kleyn, C. Elise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719019/
https://www.ncbi.nlm.nih.gov/pubmed/36471870
http://dx.doi.org/10.1016/j.bbih.2022.100565
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author Lada, Georgia
Talbot, Peter S.
Chinoy, Hector
Warren, Richard B.
McFarquhar, Martyn
Kleyn, C. Elise
author_facet Lada, Georgia
Talbot, Peter S.
Chinoy, Hector
Warren, Richard B.
McFarquhar, Martyn
Kleyn, C. Elise
author_sort Lada, Georgia
collection PubMed
description BACKGROUND: Psoriasis is a chronic systemic inflammatory skin disease, coexisting with depression in up to 25% of patients. Little is known about the drivers of comorbidity, including shared neurobiology and depression brain imaging patterns in patients. An immune-mediated crosstalk between the brain and skin has been hypothesized in psoriasis. With the aim of investigating brain structure and connectivity in psoriasis in relation to depression comorbidity, we conducted a brain imaging study including the largest psoriasis patient sample to date (to our knowledge) and the first to investigate the role of depression and systemic inflammation in brain measures. Effects of coexisting psoriatic arthritis (PsA), which represents joint involvement in psoriasis and a higher putative inflammatory state, were further explored. METHODS: Brain magnetic resonance imaging (MRI) data of 1,048 UK Biobank participants were used (131 comorbid patients with psoriasis and depression, age-and sex-matched to: 131 non-depressed psoriasis patients; 393 depressed controls; and 393 non-depressed controls). Interaction effects of psoriasis and depression on volume, thickness and surface of a-priori defined regions of interest (ROIs), white matter tracts and 55x55 partial correlation resting-state connectivity matrices were investigated using general linear models. Linear regression was employed to test associations of brain measures with C-reactive protein (CRP) and neutrophil counts. RESULTS: No differences in regional or global brain volumes or white matter integrity were found in patients with psoriasis compared to controls without psoriasis or PsA. Thickness in right precuneus was increased in psoriasis patients compared to controls, only when depression was present (β = 0.26, 95% CI [Confidence Intervals] 0.08, 0.44; p = 0.02). In further analysis, psoriasis patients who had PsA exhibited fronto-occipital decoupling in resting-state connectivity compared to patients without joint involvement (β = 0.39, 95% CI 0.13, 0.64; p = 0.005) and controls (β = 0.49, 95% CI 0.25, 0.74; p < 0.001), which was unrelated to depression comorbidity. Precuneus thickness and fronto-occipital connectivity were not predicted by CRP or neutrophil counts. Precuneus thickening among depressed psoriasis patients showed a marginal correlation with recurrent lifetime suicidality. CONCLUSIONS: Our findings provide evidence for a combined effect of psoriasis and depression on the precuneus, which is not directly linked to systemic inflammation, and may relate to suicidality or altered somatosensory processing. The use of the UK Biobank may limit generalizability of results in populations with severe disease.
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spelling pubmed-97190192022-12-04 Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank Lada, Georgia Talbot, Peter S. Chinoy, Hector Warren, Richard B. McFarquhar, Martyn Kleyn, C. Elise Brain Behav Immun Health Full Length Article BACKGROUND: Psoriasis is a chronic systemic inflammatory skin disease, coexisting with depression in up to 25% of patients. Little is known about the drivers of comorbidity, including shared neurobiology and depression brain imaging patterns in patients. An immune-mediated crosstalk between the brain and skin has been hypothesized in psoriasis. With the aim of investigating brain structure and connectivity in psoriasis in relation to depression comorbidity, we conducted a brain imaging study including the largest psoriasis patient sample to date (to our knowledge) and the first to investigate the role of depression and systemic inflammation in brain measures. Effects of coexisting psoriatic arthritis (PsA), which represents joint involvement in psoriasis and a higher putative inflammatory state, were further explored. METHODS: Brain magnetic resonance imaging (MRI) data of 1,048 UK Biobank participants were used (131 comorbid patients with psoriasis and depression, age-and sex-matched to: 131 non-depressed psoriasis patients; 393 depressed controls; and 393 non-depressed controls). Interaction effects of psoriasis and depression on volume, thickness and surface of a-priori defined regions of interest (ROIs), white matter tracts and 55x55 partial correlation resting-state connectivity matrices were investigated using general linear models. Linear regression was employed to test associations of brain measures with C-reactive protein (CRP) and neutrophil counts. RESULTS: No differences in regional or global brain volumes or white matter integrity were found in patients with psoriasis compared to controls without psoriasis or PsA. Thickness in right precuneus was increased in psoriasis patients compared to controls, only when depression was present (β = 0.26, 95% CI [Confidence Intervals] 0.08, 0.44; p = 0.02). In further analysis, psoriasis patients who had PsA exhibited fronto-occipital decoupling in resting-state connectivity compared to patients without joint involvement (β = 0.39, 95% CI 0.13, 0.64; p = 0.005) and controls (β = 0.49, 95% CI 0.25, 0.74; p < 0.001), which was unrelated to depression comorbidity. Precuneus thickness and fronto-occipital connectivity were not predicted by CRP or neutrophil counts. Precuneus thickening among depressed psoriasis patients showed a marginal correlation with recurrent lifetime suicidality. CONCLUSIONS: Our findings provide evidence for a combined effect of psoriasis and depression on the precuneus, which is not directly linked to systemic inflammation, and may relate to suicidality or altered somatosensory processing. The use of the UK Biobank may limit generalizability of results in populations with severe disease. Elsevier 2022-11-21 /pmc/articles/PMC9719019/ /pubmed/36471870 http://dx.doi.org/10.1016/j.bbih.2022.100565 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Full Length Article
Lada, Georgia
Talbot, Peter S.
Chinoy, Hector
Warren, Richard B.
McFarquhar, Martyn
Kleyn, C. Elise
Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title_full Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title_fullStr Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title_full_unstemmed Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title_short Brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the UK biobank
title_sort brain structure and connectivity in psoriasis and associations with depression and inflammation; findings from the uk biobank
topic Full Length Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719019/
https://www.ncbi.nlm.nih.gov/pubmed/36471870
http://dx.doi.org/10.1016/j.bbih.2022.100565
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