# Neural response to inflammatory challenge in major depressive disorder

> **NIH NIH R01** · LAUREATE INSTITUTE FOR BRAIN RESEARCH · 2022 · $687,812

## Abstract

PROJECT SUMMARY: Chronic inflammation likely underlies the pathogenesis of major depressive disorder
(MDD) in a significant number of cases but we do not understand why these individuals get stuck in an
inflammatory state. We hypothesize that this subgroup of depressed patients has a defective homeostatic or
regulatory response to inflammatory stimuli such that appropriate, acute inflammatory responses fail to resolve,
leading to chronic inflammation which increases the risk for (a) developing depression, (b) its recurrence, and
(c) treatment failure. To test this hypothesis, we propose challenging the immune system of both MDD subjects
and healthy controls (HC) with an inflammatory stimulus (lipopolysaccharide, LPS) to induce a homeostatic
response. Specifically, 90 MDD and 90 HC participants will be randomized (2:1) to LPS (0.8ng/kg) or saline.
Serial blood draws will be obtained to quantify the pattern of inflammatory response using several inflammatory
markers. At the same time, participants will complete clinical ratings and undergo a pre- and post-LPS MRI
scan to measure how the transient inflammatory response affects the brain processing of interoceptive (bodily-
relevant) stimuli. Participants will also return one day and one week after LPS/saline infusion to complete
identical psychometric measures and blood draws. The MDD group, only, will also complete psychological
assessments once per month for 6 months in order to determine whether the acute response to LPS predicts
the clinical course of MDD. The main hypotheses are that: (1) relative to HC, the MDD group will show a
greater acute increase in inflammatory mediators but a blunted acute response of the neural circuitry mediating
interoceptive processes (insula and cingulate cortex) in the LPS vs. placebo condition. For the acute outcomes
we focus on the changes that occur at the peak of the inflammatory response, i.e. 2 hours post-infusion. (2).
Within the MDD group, LPS-associated changes in interoceptive processing and functional connectivity will be
correlated with the strength of the acute pro-inflammatory response. (3) These acute effects will be more
salient in MDD participants with chronic inflammation (baseline CRP ³3mg/L). That is, relative to the low
inflammation MDD group (CRP £1mg/L), the high inflammation MDD group will display a blunted
hemodynamic response of the insula and cingulate during internally-focused attention. In exploratory analyses
we will also examine whether there is a sex by diagnosis interaction effect on inflammatory and insular
response to LPS and whether the acute effects of LPS will relate to depressive symptoms over the 6-month
follow-up. This research is innovative and highly impactful because it will open up a new program of research
that will allow us to draw strong conclusions about the biological mechanisms underlying the failure to resolve
inflammation-related depressive behavior. This knowledge can ultimately be used to develop new brain or
...

## Key facts

- **NIH application ID:** 10405489
- **Project number:** 5R01MH123652-02
- **Recipient organization:** LAUREATE INSTITUTE FOR BRAIN RESEARCH
- **Principal Investigator:** Jonathan Savitz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $687,812
- **Award type:** 5
- **Project period:** 2021-05-14 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10405489

## Citation

> US National Institutes of Health, RePORTER application 10405489, Neural response to inflammatory challenge in major depressive disorder (5R01MH123652-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10405489. Licensed CC0.

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