Cerebral diffusion kurtosis imaging to assess the pathophysiology of postpartum depression

Yuri Sasaki,Rie Oyama,Makoto Sasaki,Kentaro Fukumoto,Hanae Kawamura,Kenji Ito,Tsukasa Baba

doi:10.1038/s41598-020-72310-1

Yuri Sasaki, Rie Oyama + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-72310-1

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Journal: Scientific Reports	Publication Date: Sep 21, 2020
Citations: 7	License type: open-access

Affiliation: Iwate Medical University

Abstract

Postpartum depression (PPD), a main cause of maternal suicide, is an important issue in perinatal mental health. Recently, cerebral diffusion tensor imaging (DTI) studies have shown reduced fractional anisotropy (FA) in major depressive disorder (MDD) patients. There are, however, no reports using diffusion kurtosis imaging (DKI) for evaluation of PPD. This was a Japanese single-institutional prospective study from 2016 to 2019 to examine the pathophysiological changes in the brain of PPD patients using DKI. The DKI data from 3.0 T MRI of patients one month after delivery were analyzed; the patients were examined for PPD by a psychiatrist. The mean kurtosis (MK), FA and mean diffusivity (MD) were calculated from the DKI data and compared between PPD and non-PPD groups using tract-based spatial statistics analysis. Of the 75 patients analyzed, eight patients (10.7%) were diagnosed as having PPD. In the PPD group, FA values in the white matter and thalamus were significantly lower and MD values in the white matter and putamen were significantly higher. The area with significant differences in MD value was more extensive (40.8%) than the area with significant differences in FA value (6.5%). These findings may reflect pathophysiological differences of PPD compared with MDD.

Highlights

Postpartum depression (PPD), a main cause of maternal suicide, is an important issue in perinatal mental health
Our major findings were that patients with PPD showed a significant decrease in fractional anisotropy (FA) value, a significant increase in mean diffusivity (MD) value, and no significant difference in mean kurtosis (MK) value compared with non-PPD patients
Significant differences in MD values were found in a wider area than in areas where FA values were significantly different

Summary

Introduction

Postpartum depression (PPD), a main cause of maternal suicide, is an important issue in perinatal mental health. Cerebral diffusion tensor imaging (DTI) studies have shown reduced fractional anisotropy (FA) in major depressive disorder (MDD) patients. There are, no reports using diffusion kurtosis imaging (DKI) for evaluation of PPD. This was a Japanese single-institutional prospective study from 2016 to 2019 to examine the pathophysiological changes in the brain of PPD patients using DKI. Diffusion MRI is a widely used in-vivo imaging technique that measures the movement of water molecules in tissue, and recently, it has been used for clinical applications to diagnose neurodegenerative or psychiatric disorders[9,10]. DKI can sharply depict the structure of tissue by correcting the degree of restriction due to the structure of the tissue on the diffusion of water molecules as kurtosis[14,15] Parameter Repetition time/echo time b values Motion probing gradients Matrix size Field of view Slice thickness Number of excitations Reduction factors of parallel imaging Acquisition time

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