Cross-sectional and longitudinal assessment of structural brain alterations in melancholic depression

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Author list: Soriano-Mas C
Publisher: Elsevier: 12 months
Publication year: 2011
Journal: Biological Psychiatry (0006-3223)
Volume number: 69
Issue number: 4
Start page: 318
End page: 325
Number of pages: 8
ISSN: 0006-3223
Languages: English-Great Britain (EN-GB)


BACKGROUND: Whole-brain imaging approaches may contribute to the
characterization of neuroanatomic alterations in major depression,
especially in clinically homogenous patient groups such as those with
melancholic features. We assessed brain anatomic alterations, both
cross-sectionally and longitudinally, in patients with melancholic
depression using a whole-brain voxel-wise approach. METHODS: Whole-brain
magnetic resonance images were collected from a relatively aged sample
of 70 consecutively recruited major depressive disorder inpatients with
melancholic features and from a group of 40 healthy control subjects.
All patients were clinically followed for at least 2 years, and a subset
of 30 depressive patients and 20 control subjects were rescanned after a
7-year period. Imaging data were analyzed with voxel- and tensor-based
morphometry techniques. RESULTS: Melancholic patients showed gray matter
reductions in the left insula and white matter increases in the upper
brainstem tegmentum. Male patients showed gray matter decreases in the
right thalamus, and periventricular white matter reductions were
specifically observed in older patients. Volume decreases in the left
insula, hippocampus, and lateral parietal cortex predicted a slower
recovery after treatment initiation. In longitudinal assessment, white
matter of the upper brainstem tegmentum showed a different temporal
evolution between groups. Additionally, bilateral gray matter reductions
in the insulae were associated with the number of relapses during
follow-up. CONCLUSIONS: Structural alterations were identified in
regions potentially related to relevant aspects of melancholia
pathophysiology. Longitudinal analyses indicated region-specific
interactions of baseline alterations with age as well as a significant
association of clinical severity with focal changes occurring over time.


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Last updated on 2019-13-08 at 00:45