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In addition, especially during prophase I of meiosis, spermatogonia carrying pathogenic mtDNA may accumulate large amounts of mutant mtDNA in spermatocytes, while maintaining normal mitosis, inducing mitochondrial respiratory dysfunction and decreasing OXPHOS activity [122]

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A diagnosis of MDD requires five or more of the following symptoms during the same two-week period: Depressed mood most of the day, nearly every day Loss of interest or pleasure in nearly all activities Significant changes in sleep or appetite Fatigue or loss of energy Feelings of worthlessness or excessive guilt Difficulty concentrating or making decisions Thoughts of death or suicide MDD is episodic