Abstract
This study was to explore the sex differences in clinical characteristics and brain gray matter volume (GMV) alterations in 29 male patients with major depressive disorder (MDDm), 53 female patients with MDD (MDDf), and in 29 male and 53 female matched healthy controls. Maps of GMV were constructed using magnetic resonance imaging data and compared between groups. We evaluated clinical symptoms using the Hamilton Rating Scale for Depression and obtained a total score and five syndrome scores. A two-factor ANCOVA model was specified using SPM8, with sex and diagnosis as the between-subject factors. We found that: (1) significant GMV increase in the left cerebellum and GMV reduction in the bilateral middle temporal gyrus and left ventral medial prefrontal gyrus occurred selectively in male patients, while the GMV reduction in the left lingual gyrus and dorsal medial prefrontal gyrus occurred selectively in female patients; (2) MDDf may have experienced more severe sleep disturbance than MDDm; and (3) the severity of sleep symptom could be predicted by the sex specific brain structural alterations in depressions. These findings suggest that sex specific anatomical alterations existed in MDD, and these alterations were associated with the clinical symptoms.
Highlights
Sex differences are observed in epidemiological and clinical aspects of major depressive disorder (MDD)
We found that the increase of gray matter volume (GMV) value in left cerebellum could predict the severity of sleep symptom in male patients with MDD (β = −0.372, p = 0.047, uncorrected), and that the decrease of GMV value of left lingual gyrus (LG) could predict the severity of sleep symptom in female patients with MDD (β = −0.302, p = 0.028, uncorrected) (Table 3)
The present study is one of the first large clinical studies in which sex difference in characteristics of MDD patients are examined by combining clinical presentation and neuroimaging phenotypes, using well-established measures
Summary
Sex differences are observed in epidemiological and clinical aspects of major depressive disorder (MDD). Untreated patients with depression usually have a smaller hippocampal volume than healthy controls[14] These findings suggest that antidepressant treatment may exert a protective effect against the decrease in hippocampus volume in female responders[15]. In this sense, larger hippocampus may function as a potential protective neurobiological factor and help enhance treatment efficacy in female responders[11] but not in male patients. Larger hippocampus may function as a potential protective neurobiological factor and help enhance treatment efficacy in female responders[11] but not in male patients All these studies indicate a possible sex difference in the mechanism of response to antidepressant treatment
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