Analysis of the presence or absence of atrophy of the subgenual and subcallosal cingulate cortices using voxel-based morphometry on MRI is useful to select prescriptions for patients with depressive symptoms

Abstract

ObjectiveWe objectively evaluated the presence or absence of atrophy of the subgenual anterior cingulate cortex (sgACC) and the subcallosal anterior cingulate cortex (scACC), using new voxel-based morphometry (VBM) software employing Statistical Parametric Mapping software v8 and diffeomorphic anatomic registration through an exponentiated lie algebra. We prepared a database covering young-mature adulthood and investigated the clinical usefulness of the evaluation.Subjects and methodsOne hundred seven patients with major depressive disorder (MDD), 74 patients with bipolar disorder (BD), and 240 healthy control subjects underwent 1.5T magnetic resonance imaging scanning. Using new VBM software and databases covering young-mature adults and the elderly, target volumes of interest were set in the sgACC and scACC, four indicators (severity, extent, ratio, and whole-brain extent) were determined, and the presence or absence of atrophy of the sgACC and scACC was evaluated on the basis of the indicators. In addition, the relationships between the presence or absence of atrophy of the sgACC and scACC and performance of diagnosing MDD and BD and therapeutic drugs were investigated.ResultsIt was clarified that the disease is likely to be MDD when atrophy is detected in the sgACC, and likely to be BD when no atrophy is detected in the sgACC but is detected in the scACC. Regarding the relationship with therapeutic drugs, it was clarified that, when atrophy is detected in both the sgACC and the scACC, concomitant administration of mood stabilizers and atypical antipsychotics acting as dopamine-system stabilizers is necessary in many cases.ConclusionVBM on magnetic resonance imaging enabled automatic analysis of atrophy in the sgACC and scACC, and findings obtained by this procedure are useful not only for differentiation of MDD and BD patients but also for selection of prescriptions.

Depressive symptom in the first-episode schizophrenic patients is related to the reduction of grey matter volume in the subgenual anterior cingulate cortex - a pilot study

“…Simultaneously, according to some previous studies, structural and functional alterations in the temporal lobe and sgACC overlap in patients with major depression and schizophrenia [8,9,10,37]. Our findings converged with the previous findings to support the hypothesis that the sgACC is a pathological centre in patients with MDD and the hypothesis that the sgACC is a common pathological feature in patients with schizophrenia and depression [32][33][34][35][36][37]. To some extent, our findings provide indirect evidence for the postulation that the sgACC may be one of the specific pathological features of depressive symptoms in patients with schizophrenia, although conclusive evidence supporting this postulate is lacking and requires further study for confirmation.…”

“…Many previous studies have focused on investigating the pathological features of depression and confirmed that structural and functional alterations in the sgACC are pathological features of patients with depression. Moreover, these alterations are also related to the treatment response, particularly in patients with treatment-refractory depression [32][33][34][35][36]. Simultaneously, according to some previous studies, structural and functional alterations in the temporal lobe and sgACC overlap in patients with major depression and schizophrenia [8,9,10,37].…”

Regional brain volume reductions in major depressive disorder and bipolar disorder: An analysis by voxel‐based morphometry

“…HC individuals were recruited from the community through website advertisements at Nanbu Hospital. A portion of the sample was originally collected for our previous study . We newly enrolled 10 subjects with MDD and seven subjects with BD for this study.…”

“…The sgACC and SCA are reportedly difficult to separate. However, we successfully discriminated between the sgACC and SCA using MRI and VBM . First, a comprehensive cross‐sectional study revealed that volume reduction in patients with MDD under treatment was more consistently observed in the sgACC than in any other brain region such as the amygdala, hippocampus, and the prefrontal cortex .…”

“…These results suggest MRI evaluation for the existence of volume reduction in the sgACC may be useful as an objective adjunctive tool for the diagnosis of MDD. By contrast, cases whose volume reduction was limited to the SCA were more likely to have BD and prescription control was difficult . We therefore hypothesized that most patients with volume reduction in the sgACC may belong to MDD, and those with volume reduction in the SCA are more likely to have BD.…”