Microstructural brain abnormalities, affective temperaments, and suicidal behavior in patients with major depression

Serafini, Gianluca; Amore, Mario; Rihmer, Zoltán

doi:10.4103/2347-8659.167301

Cited by 5 publications

(5 citation statements)

References 119 publications

(168 reference statements)

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“…In this study, we found generally decreased MD and increased FA in the MDD subjects compared to the healthy controls. While many studies have reported increased MD and decreased FA in MDD compared to HC (Arnold et al, 2012; Benedetti et al, 2011; Osoba et al, 2013; Serafini et al, 2015; Vasavada et al, 2016; Wang et al, 2013b; Zalsman et al, 2017), other works have found different change directions (similar to our results), as follows. Decreased MD values in MDD were found in left-hemisphere CB (Arnold et al, 2012; Lyden et al, 2014; Wang et al, 2013b) and TF (Lyden et al, 2014; Schnyer et al, 2017; Wang et al, 2013b).…”

Section: Discussionsupporting

confidence: 82%

Investigation into local white matter abnormality in emotional processing and sensorimotor areas using an automatically annotated fiber clustering in major depressive disorder

Zhang

Makris

et al. 2018

NeuroImage

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This work presents an automatically annotated fiber cluster (AAFC) method to enable identification of anatomically meaningful white matter structures from the whole brain tractography. The proposed method consists of 1) a study-specific whole brain white matter parcellation using a well-established data-driven groupwise fiber clustering pipeline to segment tractography into multiple fiber clusters, and 2) a novel cluster annotation method to automatically assign an anatomical tract annotation to each fiber cluster by employing cortical parcellation information across multiple subjects. The novelty of the AAFC method is that it leverages group-wise information about the fiber clusters, including their fiber geometry and cortical terminations, to compute a tract anatomical label for each cluster in an automated fashion. We demonstrate the proposed AAFC method in an application of investigating white matter abnormality in emotional processing and sensorimotor areas in major depressive disorder (MDD). Seven tracts of interest related to emotional processing and sensorimotor functions are automatically identified using the proposed AAFC method as well as a comparable method that uses a cortical parcellation alone. Experimental results indicate that our proposed method is more consistent in identifying the tracts across subjects and across hemispheres in terms of the number of fibers. In addition, we perform a between-group statistical analysis in 31 MDD patients and 62 healthy subjects on the identified tracts using our AAFC method. We find statistical differences in diffusion measures in local regions within a fiber tract (e.g. 4 fiber clusters within the identified left hemisphere cingulum bundle (consisting of 14 clusters) are significantly different between the two groups), suggesting the ability of our method in identifying potential abnormality specific to subdivisions of a white matter structure.

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Section: Discussionsupporting

confidence: 82%

Investigation into local white matter abnormality in emotional processing and sensorimotor areas using an automatically annotated fiber clustering in major depressive disorder

Zhang

Makris

et al. 2018

NeuroImage

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“…While some could not demonstrate a long-term association between WMH progression and depression [ 176 ], large confluent WMHs were associated with a higher incidence of depression in individuals over age 60 years [ 83 ], with persistent depressive symptoms, poorer executive function, and cognitive impairment [ 20 , 177 , 178 ]. WMHs especially within cortico–subcortical neuronal circuits can be interpreted as sequelae of microstructural dysfunctions affecting major brain connections, indicating an association between CVD and depression [ 179 , 180 ], whereas, according to others, structural alterations in the cerebellum may underlie the mechanisms of depressive symptoms in patients with LLD [ 181 ].…”

Section: Structural Brain Lesions In Vadmentioning

confidence: 99%

Pathomechanisms of Vascular Depression in Older Adults

Jellinger¹

2021

IJMS

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Depression in older individuals is a common complex mood disorder with high comorbidity of both psychiatric and physical diseases, associated with high disability, cognitive decline, and increased mortality The factors predicting the risk of late-life depression (LLD) are incompletely understood. The reciprocal relationship of depressive disorder and age- and disease-related processes has generated pathogenic hypotheses and provided various treatment options. The heterogeneity of depression complicates research into the underlying pathogenic cascade, and factors involved in LLD considerably differ from those involved in early life depression. Evidence suggests that a variety of vascular mechanisms, in particular cerebral small vessel disease, generalized microvascular, and endothelial dysfunction, as well as metabolic risk factors, including diabetes, and inflammation that may induce subcortical white and gray matter lesions by compromising fronto–limbic and other important neuronal networks, may contribute to the development of LLD. The “vascular depression” hypothesis postulates that cerebrovascular disease or vascular risk factors can predispose, precipitate, and perpetuate geriatric depression syndromes, based on their comorbidity with cerebrovascular lesions and the frequent development of depression after stroke. Vascular burden is associated with cognitive deficits and a specific form of LLD, vascular depression, which is marked by decreased white matter integrity, executive dysfunction, functional disability, and poorer response to antidepressive therapy than major depressive disorder without vascular risk factors. Other pathogenic factors of LLD, such as neurodegeneration or neuroimmune regulatory dysmechanisms, are briefly discussed. Treatment planning should consider a modest response of LLD to antidepressants, while vascular and metabolic factors may provide promising targets for its successful prevention and treatment. However, their effectiveness needs further investigation, and intervention studies are needed to assess which interventions are appropriate and effective in clinical practice.

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“…These lesions, associated with CSVD, induce disruptions of frontal–subcortical pathways involved in mood regulation. WMHs are associated with advanced age, cerebrovascular risk factors (diabetes, hypertension, cardiac disease, blood pressure variability, and reduced cerebral blood flow) (for a review, see [38, 121, 197, 198]). The correlation between WMHs and altered default-mode network connectivity supported the role of vascular changes in the etiopathogenesis of VaDep [140, 145] and diminished neuropsychological performance was related to microstructural white matter abnormalities [199].…”

Section: Discussionmentioning

confidence: 99%

“…VaDep is associated with poorer endothelial function, potentially contributing to greater WMH load and basal ganglia microangiopathy [138]. WMHs in patients with LLD, especially within cortico-subcortical neural circuits, should be interpreted as the consequence of underlying microstructural dysfunctions affecting brain connectivity, mediating the association between CSVD and depression [38, 139, 200, 201], although not all studies supported the existence of WMHs as assessed by diffusion tensor imaging MRI in VaDep [202–204]. Others, however, suggested that apathy, but not depression, in CSVD is related to damage to cortical–subcortical networks associated with regulation of emotions [155].…”

Section: Discussionmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

220

145

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BackgroundVascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”.DiscussionThis diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed.ConclusionThe multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

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Microstructural brain abnormalities, affective temperaments, and suicidal behavior in patients with major depression

Cited by 5 publications

References 119 publications

Investigation into local white matter abnormality in emotional processing and sensorimotor areas using an automatically annotated fiber clustering in major depressive disorder

Investigation into local white matter abnormality in emotional processing and sensorimotor areas using an automatically annotated fiber clustering in major depressive disorder

Pathomechanisms of Vascular Depression in Older Adults

Vascular depression consensus report – a critical update

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