In the study, first author Dr. Sophie Holmes and colleagues assessed inflammation in 14 patients with moderate-to-severe depression who were not currently taking any antidepressant medications. Immune cells called microglia activate as part of the body's inflammatory response, so the researchers used a brain imaging technique to measure a substance that increases in activated microglia. The evidence for immune activation was most prominent in the anterior cingulate cortex, a brain region involved in mood regulation and implicated in the biological origin of depression, confirming the results of a previous study that first identified altered microglial activation in medication-free MDD patients. Smaller increases were also found in the insula and prefrontal cortex. "The field now has two independent reports - our study and a 2015 report by Setiawan and colleagues in Toronto - showing essentially the same thing: that there is evidence for inflammation, more specifically microglial activation, in the brains of living patients during a major depressive episode," said Dr. Talbot. This link suggests that among depressed patients, neuroinflammation may be a factor contributing to the risk for suicidal thoughts or behavior. According to Dr. Talbot, the findings "emphasise the importance of further research into the question of whether novel treatments that reduce microglial activation may be effective in major depression and suicidality."