Mendelian randomization provides no evidence for a causal role in the bidirectional relationship between depression
Adil Harroud1, Ruth Ann Marrie2, Kathryn C Fitzgerald3
1Department of Neurology, University of California San Francisco, San Francisco, CA, USA/Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Background:
Major depressive disorder (MDD) is common in multiple sclerosis (MS) and its incidence rises before MS diagnosis. However, the causality and direction of this association remain unclear.
Objective:
The objective is to investigate the bidirectional relationship between MS and MDD using Mendelian randomization (MR).
Methods:
We selected genetic instruments associated with risk of MDD (n = 660,937 cases; 1,453,489 controls) and MS (n = 47,429 cases; 68,374 controls). Using two-sample MR, we examined putative causal effects in either direction, with sensitivity analyses to assess pleiotropy. Also, we adjusted for body mass index (BMI) in multivariable MR.
Results:
We found no effect of genetic liability to MDD on the odds of MS (OR = 1.07/doubling in odds, 95% CI = 0.90-1.28). Similarly, our findings did not support a causal effect of genetic liability to MS on MDD (OR = 1.00/doubling in odds, 95% CI = 0.99-1.01). Despite heterogeneity, sensitivity analyses indicated that bias from pleiotropy was unlikely. Conversely, genetic predisposition toward higher BMI increased the odds of MS (OR = 1.34/SD increase, 95% CI = 1.09-1.65) and MDD (OR = 1.08, 95% CI = 1.01-1.15).
Conclusion:
This study does not support a causal association between MDD genetic liability and MS susceptibility, and vice versa. Genetic evidence suggesting commonality of obesity to both conditions may partly explain the increased incidence of depression pre-MS diagnosis.
Insights
This study found no causal link between major depressive disorder (MDD) and multiple sclerosis (MS) using genetic data. Obesity, however, was linked to increased risk for both MDD and MS.
Area of Science:
- Neuroscience
- Genetics
- Epidemiology
Background:
- Major depressive disorder (MDD) is frequently observed in patients with multiple sclerosis (MS).
- The incidence of MDD often precedes an MS diagnosis, raising questions about causality.
- The bidirectional relationship between MS and MDD requires further investigation.
Purpose of the Study:
- To investigate the potential causal relationship between MS and MDD.
- To examine the directionality of the association between MS and MDD using Mendelian randomization.
Main Methods:
- Utilized two-sample Mendelian randomization (MR) with large genetic datasets for MDD and MS.
- Employed sensitivity analyses to detect and mitigate pleiotropy.
- Conducted multivariable MR analyses, adjusting for body mass index (BMI).
Main Results:
- No evidence supported a causal effect of genetic liability for MDD on MS risk.
- No evidence supported a causal effect of genetic liability for MS on MDD risk.
- Genetic predisposition to higher BMI was associated with increased odds of both MS and MDD.
Conclusions:
- The study does not support a causal association between the genetic liability of MDD and MS susceptibility, or vice versa.
- Obesity may be a shared genetic factor contributing to the increased incidence of depression observed before MS diagnosis.
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