Abstract
Research evidence that corticotropin-releasing factor (CRF) plays a role in the pathophysiology of major depressive disorder (MDD) has accumulated over the past 20 years. The elevation of lumbar cerebrospinal fluid (CSF) concentrations of CRF decreased responsiveness of pituitary CRF receptors to challenge with synthetic CRF, and increased levels of serum cortisol in MDD subjects support the hypothesis that CRF is chronically hypersecreted in at least the endocrine circuits of the hypothalamic–pituitary–adrenal (HPA) axis and may also involve other CRF brain circuits mediating emotional responses and/or arousal. One such circuit includes the excitatory CRF input to the locus coeruleus (LC), the major source of norepinephrine in the brain. Furthermore, there are now reports of decreased levels of CRF in lumbar CSF from MDD patients after symptom relief from chronic treatment with antidepressant drugs or electroconvulsive therapy. Whether this normalization reflects therapeutic effects on both endocrine- and limbic-associated CRF circuits has not yet been effectively addressed. In this brief report, we describe increased concentrations of CRF-like immunoreactivity in micropunches of post-mortem LC from subjects with MDD symptoms as established by retrospective psychiatric diagnosis compared to nondepressed subjects matched for age and sex.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Abercrombie ED, Zigmond MJ (1995). Modification of central catecholaminergic systems by stress and injury: Functional significance and clinical implications. In: Bloom FE, Kupfer DJ (eds) Psychopharmacology: The Fourth Generation of Progress. Raven Press: New York. pp 355–362.
Alonso G, Szafarczyk A, Balmerfrezol M, Assenmacher I (1986). Immunocytochemical evidence for stimulatory control by the ventral noradrenergic bundle of parvocellular neurons of the paraventricular nucleus secreting corticotropin-releasing hormone and vasopressin in rats. Brain Res 397: 297–307.
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn (revised). APA Press, Washington, DC.
Andreasen NC, Endicott J, Spitzer RL, Winokur G (1977). The family history method using diagnostic criteria. Reliability and validity. Arch Gen Psychiatry 34: 1229–1235.
Arato M, Banki CM, Bissette G, Nemeroff CB (1989). Elevated CSF CRF in suicide victims. Biol Psychiatry 25: 355–359.
Austin MC, Murphy HA (2000). Corticotropin-releasing hormone immunoreactivity is increased in pontine nuclei of depressed suicide victims. Soc Neurosci Abstr 26: 2312 867.3.
Austin MC, Rice PM, Mann JJ, Arango V (1995). Localization of corticotropin-releasing hormone in the human locus coeruleus and pedunculopontine tegmental nucleus: an immunocytochemical and in situ hybridization study. Neuroscience 64: 713–727.
Banki CM, Bissette G, Arato M, O'Connor L, Nemeroff CB (1987). Cerebrospinal fluid corticotropin-releasing factor-like immunoreactivity in depression and schizophrenia. Am J Psychiatry 144: 873–877.
Bissette G (2001). Effects of sertraline on regional neuropeptide concentrations in olfactory bulbectomized rats. Pharmacol Biochem Behav 69: 1–13.
Brunner J, Stalla GK, Stalla J, Uhr M, Grabner A, Wetter TC, Bronisch T (2001). Decreased corticotropin-releasing hormone (CRH) concentrations in the cerebrospinal fluid of eucortisolemic suicide attempters. J Psychiatr Res 35: 1–9.
Butler PD, Weiss JM, Stout JC, Nemeroff CB (1990). Corticotropin-releasing factor produces fear-enhancing and behavioral activating effects following infusion into the locus coeruleus. J Neurosci 10: 176–183.
Carroll BJ, Feinberg M, Greden JF, Tarika J, Albala AA, Haskett RF, James NM, Kronfol Z, Lohr N, Steiner M, deVigne JP, Young E (1981). A specific laboratory test for the diagnosis of melancholia: standardization, validation, and clinical utility. Arch Gen Psychiatry 38: 15–22.
Chappell PB, Smith MA, Kilts CD, Bissette G, Ritchie J, Anderson C, Nemeroff CB (1986). Alterations in corticotropin-releasing factor-like immunoreactivity in discrete rat brain regions after acute and chronic stress. J Neurosci 6: 2908–2914.
Charney DS, Bremner JD, Redmond DE (1995). Noradrenergic substrates for anxiety and fear: clinical associations based on preclinical research. In: Bloom FE, Kupfer DJ (eds) Psychopharmacology: The Fourth Generation of Progress. Raven Press: New York. pp 387–396.
Conti LH, Foote SL (1996). Reciprocal cross-desensitization of locus coeruleus electrophysiological responsivity to corticotropin-releasing factor and stress. Brain Res 722: 19–29.
Curtis AL, Grigoriadis DE, Page ME, Rivier J, Valentino RJ (1994). Pharmacological comparison of two corticotropin-releasing factor antagonists: in vivo and in vitro studies. J Pharmacol Exp Ther 268: 359–365.
Curtis AL, Pavcovich LA, Grigoriadis DE, Valentino RJ (1995). Previous stress alters corticotropin-releasing factor neurotransmission in the locus coeruleus. Neuroscience 65: 541–550.
Curtis AL, Pavcovich LA, Valentino RJ (1999). Long-term regulation of locus coeruleus sensitivity to corticotropin-releasing factor by swim stress. J Pharmacol Exp Ther 289: 1211–1219.
DeBellis MD, Gold PW, Geracioti TD, Listwak SJ, Kling MA (1993). Association of fluoxetine treatment with reductions in CSF concentrations of corticotropin-releasing hormone and arginine vasopressin in patients with major depression. Am J Psychiatry 150: 656–657.
Endicott J, Spitzer RL (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 35: 837–844.
Feldman S, Weidenfeld J (1993). Hypothalamic norepinephrine depletion inhibits CRF-41 release following neural stimuli. Neuroreport 5: 258–260.
Foote SL, Aston-Jones GS (1995). Pharmacology and physiology of central noradrenergic systems. In: Bloom FE, Kupfer DJ (eds) Psychopharmacology: The Fourth Generation of Progress. Raven Press: New York. pp 335–346.
Geracioti TD, Loosen PT, Orth DN (1997). Low cerebrospinal fluid corticotropin-releasing hormone concentrations in eucortisolemic depression. Biol Psychiatry 42: 165–174.
Heuser I, Bissette G, Dettling M, Schweiger U, Gotthardt U, Schmider J, Lammers C-H, Nemeroff CB, Holsboer F (1998). Cerebrospinal fluid concentrations of corticotropin-releasing hormone, vasopressin and somatostatin in depressed patients and healthy controls: response to amitriptyline treatment. Depression Anxiety 8: 71–79.
Heuser I, Yassouridis A, Holsboer F (1994). The combined dexamethasone/CRH test: a refined laboratory test for psychiatric disorders. J Psychiatr Res 28: 341–356.
Hucks D, Lowther S, Crompton MR, Katona CL, Horton RW (1997). Corticotropin-releasing factor binding sites in cortex of depressed suicides. Psychopharmacology 134: 174–178.
Jedema HP, Finlay JM, Sved AF, Grace AA (2001). Chronic cold exposure potentiates CRF-evoked increases in electrophysiologic activity of locus coeruleus neurons. Biol Psychiatry 49: 351–359.
Kasckow JW, Baker D, Geracioti TD (2001). Corticotropin-releasing hormone in depression and post-traumatic stress disorder. Peptides 22: 845–851.
Keck ME, Holsboer F (2001). Hyperactivity of CRH neuronal circuits as a target for therapeutic interventions in affective disorders. Peptides 22: 835–844.
Klimek V, Stockmeier CA, Overholser J, Meltzer HY, Kalka S, Dilley G, Ordway GA (1997). Reduced levels of norepinephrine transporters in the locus coeruleus in major depression. J Neurosci 17: 8451–8458.
Kling MA, Geracioti TD, Licinio J, Michelson D, Oldfield EH, Gold PW (1994). Effects of electroconvulsive therapy on the CRH-ACTH-cortisol system in melancholic depression: preliminary findings. Psychopharmacol Bull 30: 489–494.
Koob GF (1999). Corticotropin-releasing factor, norepinephrine, and stress. Biol Psychiatry 46: 1167–1180.
Koob G, Britton K (1990). Behavioral effects of corticotropin-releasing factor. In: DeSouza EB, Nemeroff CB (eds) Corticotropin-Releasing Factor: Basic and Clinical Studies of a Neuropeptide. CRC Press: Boca Raton, FL, 253–265.
Lavicky J, Dunn AJ (1993). Corticotropin-releasing factor stimulates catecholamine release in hypothalamus and prefrontal cortex in freely moving rats as assessed by microdialysis. J Neurochem 60: 602–612.
Leake A, Perry EK, Perry RH, Fairbairn AF, Ferrier IN (1990). Cortical concentrations of corticotropin-releasing hormone and its receptor in Alzheimer type dementia and major depression. Biol Psychiatry 28: 603–608.
Lechner SM, Curtis AL, Brons R, Valentino RJ (1997). Locus coeruleus activation by colon distention: role of corticotropin-releasing factor and excitatory amino acids. Brain Res 756: 114–124.
Makino S, Shibasaki T, Yamauchi N, Nishioka T, Mimoto T, Wakabayashi I, Gold PW, Hashimoto K (1999). Psychological stress increased corticotropin-releasing hormone mRNA and content in the central nucleus of the amygdala but not in the hypothalamic paraventricular nucleus in the rat. Brain Res 850: 136–143.
Melia KR, Duman RS (1991). Involvement of corticotropin-releasing factor in chronic stress regulation of the brain noradrenergic system. Proc Natl Acad Sci 88: 8382–8386.
Melia KR, Rasmussen K, Terwilliger RZ, Haycock JW, Nestler EJ, Duman RS (1992). Coordinate regulation of the cyclic AMP system with firing rate and expression of tyrosine hydroxylase in the rat locus coeruleus: effects of chronic stress and drug treatments. J Neurochem 58: 494–502.
Nemeroff CB, Bissette G, Akil H, Fink M (1991). Neuropeptide concentrations in the cerebrospinal fluid of depressed patients treated with electroconvulsive therapy: corticotropin-releasing factor, ß-endorphin and somatostatin. Br J Psychiatry 158: 59–63.
Nemeroff CB, Owens MJ, Bissette G, Andorn AC, Stanley M (1988). Reduced corticotropin-releasing factor binding sites in the frontal cortex of suicide victims. Arch Gen Psychiatry 45: 577–579.
Nemeroff CB, Widerlov E, Bissette G, Walleus H, Karlsson I, Eklund K, Kilts CD, Loosen PT, Vale W (1984). Elevated concentrations of CSF corticotropin-releasing factor-like immunoreactivity in depressed patients. Science 226: 1342–1344.
Nestler EJ, Alreja M, Aghajanian GK (1999). Molecular control of locus coeruleus neurotransmission. Biol Psychiatry 46: 1131–1139.
Ordway GA, Farley JT, Dilley GE, Overholser JC, Meltzer HY, Balraj EK, Stockmeier CA, Klimek V (1999). Quantitative distribution of monoamine oxidase A in brainstem monoamine nuclei is normal in major depression. Brain Res 847: 71–79.
Ordway GA, Stockmeier CA, Cason GW, Klimek V (1997). Pharmacology and distribution of norepinephrine transporters in the human locus coeruleus and raphe nuclei. J Neurosci 17: 1710–1719.
Ordway GA, Streator-Smith K, Haycock J (1994). Elevated tyrosine hydroxylase in the locus coeruleus of suicide victims. J Neurochem 62: 680–685.
Owens MJ, Nemeroff CB, Bissette G (2000). Neuropeptides: biology and regulation. In: Sadock BJ, Sadock VA (eds) Comprehensive Textbook of Psychiatry. Lippincott, Williams & Wilkins, Philadelphia, PA, Baltimore, MD. pp 60–70.
Pacak K, Palkovits M, Kopin IJ, Goldstein DS (1995). Stress-induced norepinephrine release in the hypothalamic paraventricular nucleus and pituitary-adrenocortical and sympathoadrenal activity: in vivo microdialysis studies. Front Neuroendocrinol 16: 89–150.
Pacak K, Palkovits M, Kvetnansky R, Kopin IJ, Goldstein DS (1993). Stress-induced norepinephrine release in the paraventricular nucleus of rats with brainstem hemisections: a microdialysis study. Neuroendocrinology 58: 196–201.
Page ME, Abercrombie ED (1999). Discrete local application of corticotropin-releasing factor increases locus coeruleus discharge and extracellular norepinephrine in rat hippocampus. Synapse 33: 304–313.
Petrov T, Krukoff TL, Jhamandas JH (1993). Branching projections of catecholaminergic brainstem neurons to the paraventricular hypothalamic nucleus and the central nucleus of the amygdala. Brain Res 609: 81–92.
Raadsheer FC, Hoogendijk WJ, Stam FC, Tilders FJ, Swaab DF (1994). Increased numbers of corticotropin-releasing hormone expressing neurons in the hypothalamic paraventricular nucleus of depressed patients. Neuroendocrinology 60: 436–444.
Robbins L, Cottler L, Keating S (1989). NIMH Diagnostic Interview Schedule, Version III, Revised (DIS-III-R) Department of Psychiatry, Washington University, St Louis, MO.
Robbins TW, Everitt BJ (1995). Central norepinephrine neurons and behavior. In: Bloom FE, Kupfer DJ (eds) Psychopharmacology: The Fourth Generation of Progress. Raven Press: New York. pp 363–372.
Roy A (1992). Hypothalamic–pituitary–adrenal axis function and suicidal behavior in depression. Biol Psychiatry 32: 812–816.
Sabban EL, Kvetnansky R (2001). Stress-triggered activation of gene expression in catecholaminergic systems: dynamics of transcriptional events. Trends Neurosci 24: 91–98.
Sachar EJ, Hellman L, Roffwarg HP, Halpern FS, Fukushima DK, Gallagher TF (1973). Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Arch Gen Psychiatry 28: 19–24.
Smagin GN, Harris RB, Ryan DH (1996). Corticotropin-releasing factor receptor antagonist infused into the locus coeruleus attenuates immobilization stress-induced defensive withdrawal in rats. Neurosci Lett 220: 167–170.
Smagin GN, Swiergiel AH, Dunn AJ (1995). Corticotropin-releasing factor administered into the locus coeruleus, but not the parabrachial nucleus, stimulates norepinephrine release in the prefrontal cortex. Brain Res Bull 36: 71–76.
Suda T, Yajima F, Tomori N, Sumitomo T, Nakagami Y, Ushiyama T, Demura H, Shizume K (1987). Inhibitory effect of norepinephrine on immunoreactive corticotropin-releasing factor release from the rat hypothalamus in vitro. Life Sci 40: 1645–1649.
Traskman-Bendz L, Ekman R, Regnell G, Ohman R (1992). HPA-related CSF neuropeptides in suicide attempters. Eur J Neuropsychopharmacol 2: 99–106.
Tsagarakis S, Holly JM, Rees LH, Besser GM, Grossman A (1988). Acetylcholine and norepinephrine stimulate the release of corticotropin-releasing factor-41 from the rat hypothalamus in vitro. Endocrinology 123: 1962–1969.
Valentino RJ, Page M, van Bockstaele E, Aston-Jones G (1992). Corticotropin-releasing factor innervation of the locus coeruleus region: distribution of fibers and sources of input. Neuroscience 48: 689–705.
Valentino RJ, Page ME, Curtis AL (1991). Activation of noradrenergic locus coeruleus neurons by hemodynamic stress is due to local release of corticotropin-releasing factor. Brain Res 555: 25–34.
Valentino RJ, Aston-Jones GS (1995). Physiological and anatomic determinants of locus coeruleus discharge: behavioral and clinical implications. In: Bloom FE, Kupfer DJ (eds) Psychopharmacology: The Fourth Generation of Progress. Raven Press: New York. pp 373–386.
Valentino RJ, Chen S, Zhu Y, Aston-Jones G (1996). Evidence for divergent projections to the brain noradrenergic system and the spinal parasympathetic system from Barrington's nucleus. Brain Res 732: 1–15.
Van Bockstaele EJ, Colago EE, Valentino RJ (1996). Corticotropin-releasing factor-containing axon terminals synapse onto catecholamine dendrites and may presynaptically modulate other afferents in the rostral pole of the nucleus locus coeruleus in the rat brain. J Comp Neurol 364: 523–534.
Van Bockstaele EJ, Colago EE, Valentino RJ (1998). Amygdaloid corticotropin-releasing factor targets locus coeruleus dendrites: substrate for the co-ordination of emotional and cognitive limbs of the stress response. J Neuroendocrinol 10: 743–757.
Westrin A, Ekman R, Regnell, Taskman-Bendz L (2001). A follow-up study of suicide attempters: increase of CSF-somatostatin but no change in CSF-CRH. Eur J Neuropsychopharmacol 11: 135–143.
Zobel AW, Nickel T, Kunzel HE, Ackl N, Sonntag A, Ising M, Holsboer F (2000). Effects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression: the first 20 patients treated. J Psychiatr Res 34: 171–181.
Zhu M-Y, Klimek V, Dilley GE, Haycock JW, Stockmeier CA, Overholser JC, Meltzer HY, Ordway GA (1999). Elevated levels of tyrosine hydroxylase in the locus coeruleus in major depression. Biol Psychiatry 46: 1275–1286.
Acknowledgements
This work was supported by NIH Grants MH-46692 and MH-45488 and the National Alliance for Research in Schizophrenia and Affective Disorders (NARSAD).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bissette, G., Klimek, V., Pan, J. et al. Elevated Concentrations of CRF in the Locus Coeruleus of Depressed Subjects. Neuropsychopharmacol 28, 1328–1335 (2003). https://doi.org/10.1038/sj.npp.1300191
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.npp.1300191
Keywords
This article is cited by
-
Corticotropin releasing hormone receptor CRHR1 gene is associated with tianeptine antidepressant response in a large sample of outpatients from real-life settings
Translational Psychiatry (2020)
-
Neurochemically distinct circuitry regulates locus coeruleus activity during female social stress depending on coping style
Brain Structure and Function (2019)
-
Stress weakens prefrontal networks: molecular insults to higher cognition
Nature Neuroscience (2015)
-
Neuronal correlates of depression
Cellular and Molecular Life Sciences (2015)
-
Sex differences in stress-related receptors: ″micro″ differences with ″macro″ implications for mood and anxiety disorders
Biology of Sex Differences (2013)


