Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
Agaplesion Diakonieklinikum Rotenburg, Centre for Psychosocial Medicine, Elise-Averdieck-Straße 17, 27356, Rotenburg (Wümme), Germany.
J Neural Transm (Vienna). 2018 Oct;125(10):1433-1447. doi: 10.1007/s00702-018-1919-8. Epub 2018 Aug 27.
Patients with major depressive disorder (MDD) exhibit gray matter volume (GMV) reductions in limbic regions. Clinical variables-such as the number of depressive episodes-seem to affect volume alterations. It is unclear whether the observed cross-sectional GMV abnormalities in MDD change over time, and whether there is a longitudinal relationship between GMV changes and the course of disorder. We investigated T1 structural MRI images of 54 healthy control (HC) and 37 MDD patients in a 3-Tesla-MRI with a follow-up interval of 3 years. The Cat12 toolbox was used to analyze longitudinal data (p < 0.05, FWE-corrected, whole-brain analysis; flexible factorial design). Interaction effects indicated increasing GMV in MDD in the bilateral amygdala, and decreasing GMV in the right thalamus between T1 and T2. Further analyses comparing patients with a mild course of disorder (MCD; 0-1 depressive episode during the follow-up) to patients with a severe course of disorder (SCD; > 1 depressive episode during the follow-up) revealed increasing amygdalar volume in MCD. Our study confirms structural alterations in limbic regions in MDD patients and an association between these impairments and the course of disorder. Thus, we assume that the reported volumetric alterations in the left amygdala (i.e. volumetric normalization) are reversible and apparently driven by the clinical phenotype. Hence, these results support the assumption that the severity and progression of disease influences amygdalar GMV changes in MDD or vice versa.
患有重度抑郁症（MDD）的患者在边缘区域表现出灰质体积（GMV）减少。临床变量（如抑郁发作次数）似乎会影响体积改变。目前尚不清楚 MDD 患者观察到的横断面 GMV 异常是否随时间变化，以及 GMV 变化与疾病过程之间是否存在纵向关系。我们使用 3-Tesla-MRI 对 54 名健康对照（HC）和 37 名 MDD 患者的 T1 结构 MRI 图像进行了研究，随访间隔为 3 年。Cat12 工具箱用于分析纵向数据（p < 0.05，FWE 校正，全脑分析；灵活因子设计）。交互效应表明，在 T1 和 T2 之间，双侧杏仁核的 GMV 增加，右侧丘脑的 GMV 减少。进一步分析比较了轻度疾病（MCD；在随访期间有 0-1 次抑郁发作）和重度疾病（SCD；在随访期间有 >1 次抑郁发作）患者，发现 MCD 患者的杏仁核体积增加。我们的研究证实了 MDD 患者边缘区域的结构改变，以及这些损伤与疾病过程之间的关联。因此，我们假设左杏仁核（即体积归一化）报告的体积改变是可逆的，显然是由临床表型驱动的。因此，这些结果支持这样的假设，即疾病的严重程度和进展会影响 MDD 中的杏仁核 GMV 变化，反之亦然。
