Longitudinal MRI study of cortical thickness, perfusion, and metabolite levels in major depressive disorder

Acta Psychiatr Scand. 2011 Dec;124(6):435-46. doi: 10.1111/j.1600-0447.2011.01766.x. Epub 2011 Sep 16.

Abstract

Objective: To determine whether patients with major depressive disorder (MDD) display morphologic, functional, and metabolic brain abnormalities in limbic-cortical regions at a baseline magnetic resonance (MR) scan and whether these changes are normalized in MDD patients in remission at a follow-up scan.

Method: A longitudinal 3.0-Tesla (T) magnetic resonance imaging (MRI) study was carried out with cortical thickness measurements with a surface-based approach, perfusion measurements with three-dimensional (3D) pseudo-continuous arterial spin labeling (pCASL), and spectroscopy (1H-MRS) measurements in the anterior cingulate cortex (ACC) with water as an internal reference adjusted for cerebrospinal fluid content. We examined 23 MDD patients and 26 healthy controls. MDD patients underwent a baseline MRI at inclusion and were invited to a follow-up scan when they were in remission or after a 6-month follow-up period.

Results: Major findings were a significantly thinner posterior cingulate cortex in non-remitters than in remitters, a significant decrease in perfusion in the frontal lobes and the ACC in non-remitters compared with healthy controls at baseline and significantly reduced N-acetylaspartate, myo-inositol, and glutamate levels in MDD patients compared with healthy controls at baseline.

Conclusion: Using novel MRI techniques, we have found abnormalities in cerebral regions related to cortical-limbic pathways in MDD patients.

MeSH terms

  • Adult
  • Antidepressive Agents / pharmacokinetics
  • Antidepressive Agents / therapeutic use
  • Biological Availability
  • Brain Mapping
  • Cerebral Cortex* / drug effects
  • Cerebral Cortex* / metabolism
  • Cerebral Cortex* / pathology
  • Cerebrospinal Fluid / metabolism*
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Major* / metabolism
  • Female
  • Humans
  • International Classification of Diseases
  • Limbic System* / drug effects
  • Limbic System* / metabolism
  • Limbic System* / pathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neurotransmitter Agents / metabolism*
  • Perfusion / methods*
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Synaptic Transmission

Substances

  • Antidepressive Agents
  • Neurotransmitter Agents