ReviewJournal of orthopaedic translation2026
Brain-bone axis dysregulation: Biological code underlying the bidirectional association between depression and musculoskeletal disorders.
Review in Journal of orthopaedic translation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- From depression to bone health: examining the skeletal effects of classical and rapid-acting antidepressants.The international journal of neuropsychopharmacology · 2026Review
- The Impact of Warm Needle Acupuncture Based on Traditional Chinese Medicine on Psychological Well-Being and Quality of Life in Osteoporotic Patients: A Retrospective Cohort Study.Patient preference and adherence · 2026Article
- Advancing the continuum of orthopaedic translation: Mechanistic insight, regenerative innovation, and converging technologies.Journal of orthopaedic translation · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Depression and musculoskeletal disorders including osteoporosis (OP), fractures, osteoarthritis (OA) and rheumatoid arthritis (RA) exhibit significant bidirectional epidemiological and pathophysiological links. Rising depression prevalence (approximately 2.7 % annually) is accompanied by the high global burden of musculoskeletal disorders. Shared mechanisms center on the neuroimmune-inflammatory axis: Depression-associated inflammation (e.g., IL-6, TNF-α) promotes bone resorption, cartilage degradation, and RA disease activity, while autonomic/endocrine dysregulation increases fracture risk through increased norepinephrine (NE) and cortisol. Contributing factors include oxidative stress, gut dysbiosis, and sex hormone imbalances. Antidepressants show divergent skeletal effects: selective serotonin reuptake inhibitors (SSRIs) may reduce bone mineral density (BMD) and increase fracture risk, while serotonin-norepinephrine reuptake inhibitors (SNRIs) can improve OA symptoms. Depression significantly worsens orthopedic outcomes, leading to increased fracture risk, pain and disability, reduced treatment response. Integrated care approaches and novel neuroimmune targets offer potential for improved comorbidity management. The Translational Potential of this Article: This review links depression with common orthopaedic disorders by synthesizing convergent neuro-immune-endocrine and metabolic pathways, and documents measurable skeletal deficits. These insights support immediate, low-cost actions: bidirectional screening, strengthened orthopaedics-psychiatry referral, and pragmatic combination care bundles. If implemented, this approach could reduce fracture risk, pain, and disability while improving recovery trajectories.
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