Abnormal Cerebellar Volume in Patients with Remitted Major Depression with Persistent Cognitive Deficits

Malte S Depping,Lena Listunova,Katharina M Kubera,Claudia Bach,Mike M Schmitgen,R Christian Wolf,Daniela Roesch-Ely,Johanna Kienzle

doi:10.1007/s12311-020-01157-z

Malte S Depping, Lena Listunova + Show 6 more

Open Access

https://doi.org/10.1007/s12311-020-01157-z

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Journal: The Cerebellum	Publication Date: Jul 8, 2020
Citations: 15	License type: open-access

Affiliation: Heidelberg University

Abstract

Cerebellar involvement in major depressive disorder (MDD) has been demonstrated by a growing number of studies, but it is unknown whether cognitive functioning in depressed individuals is related to cerebellar gray matter volume (GMV) abnormalities. Impaired attention and executive dysfunction are characteristic cognitive deficits in MDD, and critically, they often persist despite remission of mood symptoms. In this study, we investigated cerebellar GMV in patients with remitted MDD (rMDD) that showed persistent cognitive impairment. We applied cerebellum-optimized voxel-based morphometry in 37 patients with rMDD and with cognitive deficits, in 12 patients with rMDD and without cognitive deficits, and in 36 healthy controls (HC). Compared with HC, rMDD patients with cognitive deficits had lower GMV in left area VIIA, crus II, and in vermal area VIIB. In patients with rMDD, regression analyses demonstrated significant associations between GMV reductions in both regions and impaired attention and executive dysfunction. Compared with HC, patients without cognitive deficits showed increased GMV in bilateral area VIIIB. This study supports cerebellar contributions to the cognitive dimension of MDD. The data also point towards cerebellar area VII as a potential target for non-invasive brain stimulation to treat cognitive deficits related to MDD.

Highlights

Cognitive dysfunction is a highly relevant symptom domain in major depressive disorder (MDD), affecting about twothirds of acutely depressed patients [1]
This study investigated cerebellar gray matter volume (GMV) in patients with remitted MDD with or without cognitive deficits compared with healthy controls
Two main findings emerged: First, patients with remitted MDD and cognitive deficits showed reduced GMV within area VIIA, crus II, and vermal area VIIB, which was associated with attention deficits and impaired executive rMDD with c.D. < healthy controls (HC)

Summary

Introduction

Cognitive dysfunction is a highly relevant symptom domain in major depressive disorder (MDD), affecting about twothirds of acutely depressed patients [1]. Cognitive dysfunction in depression typically includes deficits of attention and executive functions [1, 3]. In 30–50% of patients with MDD, cognitive dysfunction persists despite remission of mood symptoms [1, 4]. Against this background, there is an urgent need for a more detailed understanding of the neural mechanisms of cognitive dysfunction in MDD. Using structural and functional magnetic resonance imaging (MRI), neural correlates of cognitive dysfunction in depression have been identified by numerous studies, including meta-analyses [10,11,12,13]. Since approximately half of the cerebellar cortex is associated with non-motor functions, i.e., cognitive, affective, and selfreferential functions [15], this may be a serious omission

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