Evidence map›Paper›PMID 41703266›Full record

ArticleMolecular psychiatry2026

A brain-enriched circRNA blood biomarker can predict response to SSRI antidepressants.

Grigorios Papageorgiou, El Chérif Ibrahim, Victor Gorgievski, Gabriella Maxson, Evelyn Lozano, Eric Gordon, Antoine Lefrere, Marie-Julie Toupet, Philippe Courtet, Raoul Belzeaux and 6 more

Erratum issuedAbstract read
In one paragraph

Article in Molecular psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. The history and function of a circular RNA.Nature communications · 2026
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Grigorios PapageorgiouCircular Genomics Inc., San Diego, CA, USA.ORCID http://orcid.org/0000-0002-0309-0932
El Chérif IbrahimAix-Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille, France.ORCID http://orcid.org/0000-0003-3973-7862
Victor GorgievskiUniversité Paris Cité, Inserm, CNRS, HealthFex, F-75006, Paris, France.
Gabriella MaxsonCircular Genomics Inc., San Diego, CA, USA.
Evelyn LozanoCircular Genomics Inc., San Diego, CA, USA.
Eric GordonCircular Genomics Inc., San Diego, CA, USA.
Antoine LefrereFondation FondaMental, Créteil, France.
Marie-Julie ToupetHôpital Sainte Marguerite AP-HM, Pôle de Psychiatrie, Marseille, France.
Philippe CourtetFondation FondaMental, Créteil, France.
Raoul BelzeauxFondation FondaMental, Créteil, France.
Jane FosterUniversity of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA.ORCID http://orcid.org/0000-0002-8579-4705
Thomas CarmodyUniversity of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA.
Roy H PerlisCenter for Quantitative Health, Massachusetts General Hospital, Boston, MA, USA.
Madhukar H TrivediUniversity of Texas Southwestern Medical Center, Department of Psychiatry, Dallas, TX, USA. Madhukar.Trivedi@UTSouthwestern.edu.ORCID http://orcid.org/0000-0002-2983-1110
Eleni T TzavaraFondation FondaMental, Créteil, France. eleni.tzavara@inserm.fr.
Nikolaos MelliosCircular Genomics Inc., San Diego, CA, USA. nmellios@circulargenomics.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Major Depressive Disorder (MDD) is a debilitating psychiatric disorder that is a leading cause of disability worldwide. Although treatment with antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs), has demonstrated clinical efficacy, the "trial and error" approach in choosing the most effective antidepressant treatment for each patient allows for only a subset of patients to achieve response to the first line of treatment. Circular RNAs (circRNAs), are highly stable and brain-enriched non-coding RNAs that are mainly derived from the backsplicing and covalent joining of exons and introns of protein-coding genes. They are known to be important for brain development and function, cross the blood-brain-barrier, and be highly sensitive to changes in both synaptic activity and neuronal receptor signaling. Here we present evidence that expression of the brain-enriched circRNA, CDR1as, is associated with symptomatic response to SSRI treatment, and regulated by serotonin and Brain-Derived Neurotrophic Factor (BDNF) receptor activity. We present data using circRNA-specific PCR in baseline whole blood samples from two independent cohorts, drawn from the Establishing moderators and biosignatures of antidepressant response in clinical care (EMBARC) and the Biomarkers of ANTidepressant RESponse (ANTARES) clinical studies, showing that before treatment CDR1as is differentially expressed between future symptomatic responders and non-responders to treatment with the SSRI sertraline. Additional data from naturalistic antidepressant response studies further highlight the association between CDR1as and antidepressant effects of SSRIs as a class. In addition, we show that CDR1as levels are altered following sertraline treatment in responders with the trajectory of change post-treatment associated with long-term remission. Furthermore, we report that levels of CDR1as in the blood can specifically predict remission with SSRI treatment, but not response/remission with Placebo or Bupropion treatments. Lastly, we provide evidence in animal mechanistic and neuronal culture studies, suggesting mouse Cdr1as is strongly regulated by 5-HT2A and BDNF receptor signaling. Taken together, our data identify a brain-enriched circRNA associated with known mechanisms of antidepressant response that can serve as a blood biomarker for predicting response and remission with SSRI treatment.

Indexed as

RNA, CircularAdultAnimalsAntidepressive AgentsBiomarkersBrainBrain-Derived Neurotrophic FactorFemaleHumansMajor Depressive DisorderMaleMiddle AgedSelective Serotonin Reuptake InhibitorsSerotoninAntidepressive AgentsBiomarkersBrain-Derived Neurotrophic FactorRNA, CircularSelective Serotonin Reuptake InhibitorsSerotonin

Identifiers

PMID41703266
PMCPMC13269125

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.