Abstract
BackgroundWhite matter abnormalities can cause network dysfunction that underlies major depressive disorder (MDD). Diffusion tensor imaging (DTI) is used to examine the neural connectivity and integrity of the white matter. Previous studies have implicated frontolimbic neural networks in the pathophysiology of MDD. Approximately 30% of MDD patients demonstrate treatment-resistant depression (TRD). However, the neurobiology of TRD remains unclear.MethodsWe used a voxel-based analysis method to analyze DTI data in young patients with TRD (n = 30; 19 males, 11 females) compared with right-handed, age- and sex-matched healthy volunteers (n = 25; 14 males, 11 females).ResultsWe found a significant decrease in fractional anisotropy (FA) (corrected, cluster size >50) in the left middle frontal gyrus (peak coordinates [−18 46–14]), left limbic lobe uncus (peak coordinates [−18 2–22]), and right cerebellum posterior lobe (peak coordinates [26–34 -40]). There was no increase in FA in any brain region in patients. We also found a significant negative correlation between mean regional FA values in the three areas and Beck Depression Inventory symptom scores.ConclusionsWe found significant differences in white matter FA in the frontal lobe, limbic lobe and cerebellum between TRD patients and controls. These data suggest that abnormalities of cortical-limbic-cerebellar white matter networks may contribute to TRD in young patients.
Highlights
White matter abnormalities can cause network dysfunction that underlies major depressive disorder (MDD)
Previous studies using Diffusion tensor imaging (DTI) have mainly focused on affective disorders including MDD, BD [13,14], and young and geriatric depression [15,16], and the results showed the abnormal brain regions include the superior, middle, and medial frontal gyrus [9,16,17], the subgenual anterior cingulate cortex (ACC), amygdala [14], hippocampus [18], and basal ganglia [19]
Diffusion tensor imaging of treatment-resistant depression patients Voxelwise analysis revealed reduced fractional anisotropy (FA) in three areas in the TRD group compared with control subjects (P < 0.001, uncorrected, cluster size > 50)
Summary
White matter abnormalities can cause network dysfunction that underlies major depressive disorder (MDD). Previous studies using DTI have mainly focused on affective disorders including MDD, BD [13,14], and young and geriatric depression [15,16], and the results showed the abnormal brain regions include the superior, middle, and medial frontal gyrus [9,16,17], the subgenual anterior cingulate cortex (ACC), amygdala [14], hippocampus [18], and basal ganglia [19] These abnormal brain regions are predominantly located in the limbiccortical-striatal-pallidal-thalamic tract (LCSPT) [20,21], which is considered related to emotional behavior on the basis of its anatomical connectivity with visceral control structures that mediate emotional expression [19]
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