Yang Ding, Zhan Xianyan, Fan Yajuan, Gao Yuan, Ma Qingyan, Ma Xiancang, Jia Min
Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, China.
Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, China.
BMC Psychiatry. 2025 Aug 26;25(1):814. doi: 10.1186/s12888-025-07277-2.
Cognitive impairments constitute a core manifestation of major depressive disorder (MDD), albeit the precise mechanisms governing these impairments remain elusive. Inflammation may contribute to cognitive impairment and clinical symptoms in MDD. We conducted an investigation into the inflammatory markers present in patients with MDD, including white blood cell (WBC) counts, monocytes, lymphocytes, neutrophils, platelets, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), and their associations with symptoms and cognitive performance.
A cohort comprising 95 patients diagnosed with MDD and 65 healthy controls (HCs) was enrolled. Clinical symptomatology was evaluated utilizing the Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Rating Scale (HAMA). Cognitive performance was evaluated using the THINC-Integrated Tool (THINC-it), whereas inflammatory markers were measured via complete blood count (CBC). Multiple linear regression analyses investigated correlations of CBC indicators with symptoms and cognitive performance.
Patients with MDD exhibited cognitive impairments and elevated WBC, lymphocyte, monocyte, and MLR levels compared with those of the HCs. WBC and PLR negatively correlated with HAMD and HAMA scores, respectively. MLR was positively correlated with HAMD scores of female patients; it was negatively correlated with cognitive performance. Gender-specific analyses revealed distinct patterns among male and female patients.
Immune dysregulation in MDD was associated with emotional symptoms and cognitive impairment. Inflammatory markers correlated with attention, executive function and working memory in males, whereas in females, they were linked to subjective cognition, executive function, and composite cognition. Gender differences should be considered in immune-cognitive interactions, which may inform personalized therapeutic interventions.
认知障碍是重度抑郁症（MDD）的核心表现，尽管导致这些障碍的确切机制仍不清楚。炎症可能导致MDD中的认知障碍和临床症状。我们对MDD患者的炎症标志物进行了调查，包括白细胞（WBC）计数、单核细胞、淋巴细胞、中性粒细胞、血小板、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和单核细胞与淋巴细胞比值（MLR），以及它们与症状和认知表现的关联。
招募了一个由95名诊断为MDD的患者和65名健康对照（HCs）组成的队列。使用汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评估临床症状。使用THINC综合工具（THINC-it）评估认知表现，而通过全血细胞计数（CBC）测量炎症标志物。多元线性回归分析研究了CBC指标与症状和认知表现的相关性。
与HCs相比，MDD患者表现出认知障碍以及白细胞、淋巴细胞、单核细胞和MLR水平升高。白细胞和PLR分别与HAMD和HAMA评分呈负相关。MLR与女性患者的HAMD评分呈正相关；它与认知表现呈负相关。性别特异性分析揭示了男性和女性患者之间的不同模式。
MDD中的免疫失调与情绪症状和认知障碍有关。炎症标志物与男性的注意力、执行功能和工作记忆相关，而在女性中，它们与主观认知、执行功能和综合认知相关。在免疫-认知相互作用中应考虑性别差异，这可能为个性化治疗干预提供依据。
