Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Spain.
Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain.
J Affect Disord. 2019 Feb 15;245:971-977. doi: 10.1016/j.jad.2018.11.085. Epub 2018 Nov 13.
Major depressive disorder (MDD) is accompanied by atypical brain structure affecting grey and white matter from the early stages. Neuroimaging studies of first-episode depression (FED) have provided evidence on this regard, but most of the studies are cross-sectional. The aim of this longitudinal study was to test potential changes in grey matter (GM) and white matter (WM) volumes in FED.
Thirty-three untreated FED patients (DSM-IV criteria) and 33 healthy controls (HC) underwent a 3T structural magnetic resonance imaging (sMRI) at baseline and after 2 years. Depressive symptoms were assessed at baseline and throughout the study with the 17-item Hamilton Depressive Rating Scale (HDRS-17). Recurrences of FED patients were also collected along the follow-up. To analyze GM and WM differences, whole-brain voxel-based morphometry (VBM, SPM12) was employed (FWE corrected).
FED patients showed significant reductions compared to HC in WM volumes of prefrontal cortex (left anterior corona radiata). No differences were found in GM volumes. Full factorial longitudinal analysis of the whole sample revealed no significant effect in GM nor in WM, while the full factorial longitudinal analysis comparing recurrent and non-recurrent patients showed increments in WM volumes of left posterior corona radiata and right posterior thalamic radiation in the recurrent group.
Limited sample size, especially in the follow-up.
The present findings provided some new evidence of the role of white matter alterations in the early stages of MDD and in the progression of the illness.
重度抑郁症(MDD)伴有影响灰质和白质的非典型大脑结构,从早期开始。对首发抑郁症(FED)的神经影像学研究为此提供了证据,但大多数研究都是横断面研究。本纵向研究旨在检验 FED 患者灰质(GM)和白质(WM)体积的潜在变化。
33 名未经治疗的 FED 患者(DSM-IV 标准)和 33 名健康对照者(HC)在基线和 2 年后接受了 3T 结构磁共振成像(sMRI)检查。在基线和整个研究过程中,使用 17 项汉密尔顿抑郁评定量表(HDRS-17)评估抑郁症状。FED 患者的复发情况也在随访过程中收集。为了分析 GM 和 WM 的差异,采用全脑基于体素的形态计量学(VBM,SPM12)(FWE 校正)。
与 HC 相比,FED 患者的 WM 体积在前额皮质(左侧前冠状辐射)显著减少。GM 体积无差异。对全样本进行全因子纵向分析,GM 和 WM 均无显著影响,而对复发和非复发患者进行全因子纵向分析显示,复发组左后冠状辐射和右后丘脑辐射的 WM 体积增加。
样本量有限,尤其是在随访中。
本研究结果为 WM 改变在 MDD 的早期阶段和疾病进展中的作用提供了一些新的证据。