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Open Access Highly Accessed Review

Neuroinflammation and psychiatric illness

Souhel Najjar15*, Daniel M Pearlman25, Kenneth Alper4, Amanda Najjar3 and Orrin Devinsky145

Author Affiliations

1 Department of Neurology, New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA

2 Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, 30 Lafayette Street, HB, Lebanon, NH, 7252, 03766, USA

3 Department of Pathology, Division of Neuropathology, New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA

4 Department of Psychiatry, New York University School of Medicine, New York, NY, USA

5 New York University Comprehensive Epilepsy Center, 550 First Avenue, New York, NY, 10016, USA

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Journal of Neuroinflammation 2013, 10:43  doi:10.1186/1742-2094-10-43

Published: 1 April 2013

Abstract

Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence supporting the pathogenic role of neuroinflammation in selected classical psychiatric disorders. Understanding how psychosocial, genetic, immunological and neurotransmitter systems interact can reveal pathogenic clues and help target new preventive and symptomatic therapies.

Keywords:
Neuroinflammation; Psychoneuroimmunology; Astrocyte; Microglia; Cytokines; Oxidative stress; Depression; Obsessive-compulsive disorder; Bipolar disorder; Schizophrenia