Skip to main content
Erschienen in: Journal of Neurology 5/2015

01.05.2015 | Original Communication

Brain structural abnormalities in patients with major depression with or without generalized anxiety disorder comorbidity

verfasst von: Elisa Canu, Milutin Kostić, Federica Agosta, Ana Munjiza, Pilar M. Ferraro, Danilo Pesic, Massimiliano Copetti, Amir Peljto, Dusica Lecic Tosevski, Massimo Filippi

Erschienen in: Journal of Neurology | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

An overlap frequently occurs between major depression disorder (MDD) and generalized anxiety disorder (GAD). Aim of this study was to assess cortical and white matter (WM) alterations in MDD patients with or without GAD comorbidity. Seventy-one MDD patients and 71 controls were recruited. All subjects underwent T1-weighted and diffusion tensor (DT)/MRI. MRI metrics of cortical thickness and WM integrity were obtained from atlas-based cortical regions and the interhemispheric and major long association WM tracts. Between-group MRI comparisons and multiple regressions with clinical scale scores were performed. Compared to controls, both MDD and MDD-GAD patients showed a cortical thinning of the middle frontal cortex bilaterally, left medial frontal gyrus and frontal pole. Compared to controls and MDD patients, MDD-GAD cases also showed a thinning of the right medial orbitofrontal and fusiform gyri, and left temporal pole and lateral occipital cortices. Compared to controls, MDD patients showed DT MRI abnormalities of the right parahippocampal tract and superior longitudinal fasciculus bilaterally, while no WM alterations were found in MDD-GAD. In all patients, brain abnormalities were related with symptom severity. MDD and MDD-GAD share a common pattern of cortical alterations located in the frontal regions. However, while both the cortex and WM integrity are affected in MDD, only the former is affected in MDD-GAD. These findings support the notion of MDD-GAD as a distinct clinical entity, providing insights into patient vulnerability for specific networks as well as into patient resilience factors reflected by the integrity of other cerebral circuits.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Association AP (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Arlington Association AP (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Arlington
6.
Zurück zum Zitat Bruce SE, Yonkers KA, Otto MW, Eisen JL, Weisberg RB, Pagano M, Shea MT, Keller MB (2005) Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry 162(6):1179–1187. doi:10.1176/appi.ajp.162.6.1179 PubMedCentralCrossRefPubMed Bruce SE, Yonkers KA, Otto MW, Eisen JL, Weisberg RB, Pagano M, Shea MT, Keller MB (2005) Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry 162(6):1179–1187. doi:10.​1176/​appi.​ajp.​162.​6.​1179 PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Rush AJ, Zimmerman M, Wisniewski SR, Fava M, Hollon SD, Warden D, Biggs MM, Shores-Wilson K, Shelton RC, Luther JF, Thomas B, Trivedi MH (2005) Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord 87(1):43–55. doi:10.1016/j.jad.2005.03.005 CrossRefPubMed Rush AJ, Zimmerman M, Wisniewski SR, Fava M, Hollon SD, Warden D, Biggs MM, Shores-Wilson K, Shelton RC, Luther JF, Thomas B, Trivedi MH (2005) Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features. J Affect Disord 87(1):43–55. doi:10.​1016/​j.​jad.​2005.​03.​005 CrossRefPubMed
8.
Zurück zum Zitat Frodl T, Schaub A, Banac S, Charypar M, Jager M, Kummler P, Bottlender R, Zetzsche T, Born C, Leinsinger G, Reiser M, Moller HJ, Meisenzahl EM (2006) Reduced hippocampal volume correlates with executive dysfunctioning in major depression. J Psychiatry Neurosci 31(5):316–323PubMedCentralPubMed Frodl T, Schaub A, Banac S, Charypar M, Jager M, Kummler P, Bottlender R, Zetzsche T, Born C, Leinsinger G, Reiser M, Moller HJ, Meisenzahl EM (2006) Reduced hippocampal volume correlates with executive dysfunctioning in major depression. J Psychiatry Neurosci 31(5):316–323PubMedCentralPubMed
9.
Zurück zum Zitat Lange C, Irle E (2004) Enlarged amygdala volume and reduced hippocampal volume in young women with major depression. Psychol Med 34(6):1059–1064CrossRefPubMed Lange C, Irle E (2004) Enlarged amygdala volume and reduced hippocampal volume in young women with major depression. Psychol Med 34(6):1059–1064CrossRefPubMed
10.
Zurück zum Zitat Mervaala E, Fohr J, Kononen M, Valkonen-Korhonen M, Vainio P, Partanen K, Partanen J, Tiihonen J, Viinamaki H, Karjalainen AK, Lehtonen J (2000) Quantitative MRI of the hippocampus and amygdala in severe depression. Psychol Med 30(1):117–125CrossRefPubMed Mervaala E, Fohr J, Kononen M, Valkonen-Korhonen M, Vainio P, Partanen K, Partanen J, Tiihonen J, Viinamaki H, Karjalainen AK, Lehtonen J (2000) Quantitative MRI of the hippocampus and amygdala in severe depression. Psychol Med 30(1):117–125CrossRefPubMed
11.
Zurück zum Zitat Sheline YI, Gado MH, Kraemer HC (2003) Untreated depression and hippocampal volume loss. Am J Psychiatry 160(8):1516–1518CrossRefPubMed Sheline YI, Gado MH, Kraemer HC (2003) Untreated depression and hippocampal volume loss. Am J Psychiatry 160(8):1516–1518CrossRefPubMed
12.
Zurück zum Zitat Wagner G, Koch K, Schachtzabel C, Reichenbach JR, Sauer H, Schlosser Md RG (2008) Enhanced rostral anterior cingulate cortex activation during cognitive control is related to orbitofrontal volume reduction in unipolar depression. J Psychiatry Neurosci 33(3):199–208PubMedCentralPubMed Wagner G, Koch K, Schachtzabel C, Reichenbach JR, Sauer H, Schlosser Md RG (2008) Enhanced rostral anterior cingulate cortex activation during cognitive control is related to orbitofrontal volume reduction in unipolar depression. J Psychiatry Neurosci 33(3):199–208PubMedCentralPubMed
17.
Zurück zum Zitat Bush G, Luu P, Posner MI (2000) Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 4(6):215–222CrossRefPubMed Bush G, Luu P, Posner MI (2000) Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 4(6):215–222CrossRefPubMed
18.
19.
Zurück zum Zitat Jia Z, Wang Y, Huang X, Kuang W, Wu Q, Lui S, Sweeney JA, Gong Q (2014) Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T. J Psychiatry Neurosci 39(3):170–177PubMedCentralCrossRefPubMed Jia Z, Wang Y, Huang X, Kuang W, Wu Q, Lui S, Sweeney JA, Gong Q (2014) Impaired frontothalamic circuitry in suicidal patients with depression revealed by diffusion tensor imaging at 3.0 T. J Psychiatry Neurosci 39(3):170–177PubMedCentralCrossRefPubMed
24.
Zurück zum Zitat Agosta F, Galantucci S, Canu E, Cappa SF, Magnani G, Franceschi M, Falini A, Comi G, Filippi M (2013) Disruption of structural connectivity along the dorsal and ventral language pathways in patients with nonfluent and semantic variant primary progressive aphasia: a DT MRI study and a literature review. Brain Lang 127(2):157–166. doi:10.1016/j.bandl.2013.06.003 CrossRefPubMed Agosta F, Galantucci S, Canu E, Cappa SF, Magnani G, Franceschi M, Falini A, Comi G, Filippi M (2013) Disruption of structural connectivity along the dorsal and ventral language pathways in patients with nonfluent and semantic variant primary progressive aphasia: a DT MRI study and a literature review. Brain Lang 127(2):157–166. doi:10.​1016/​j.​bandl.​2013.​06.​003 CrossRefPubMed
26.
Zurück zum Zitat Brzezicka A (2013) Integrative deficits in depression and in negative mood states as a result of fronto-parietal network dysfunctions. Acta Neurobiol Exp 73(3):313–325 Brzezicka A (2013) Integrative deficits in depression and in negative mood states as a result of fronto-parietal network dysfunctions. Acta Neurobiol Exp 73(3):313–325
27.
Zurück zum Zitat Kowatch RA, Devous MD Sr, Harvey DC, Mayes TL, Trivedi MH, Emslie GJ, Weinberg WA (1999) A SPECT HMPAO study of regional cerebral blood flow in depressed adolescents and normal controls. Prog Neuropsychopharmacol Biol Psychiatry 23(4):643–656CrossRefPubMed Kowatch RA, Devous MD Sr, Harvey DC, Mayes TL, Trivedi MH, Emslie GJ, Weinberg WA (1999) A SPECT HMPAO study of regional cerebral blood flow in depressed adolescents and normal controls. Prog Neuropsychopharmacol Biol Psychiatry 23(4):643–656CrossRefPubMed
28.
Zurück zum Zitat Campbell S, Marriott M, Nahmias C, MacQueen GM (2004) Lower hippocampal volume in patients suffering from depression: a meta-analysis. Am J Psychiatry 161(4):598–607CrossRefPubMed Campbell S, Marriott M, Nahmias C, MacQueen GM (2004) Lower hippocampal volume in patients suffering from depression: a meta-analysis. Am J Psychiatry 161(4):598–607CrossRefPubMed
30.
Zurück zum Zitat Frodl T, Schule C, Schmitt G, Born C, Baghai T, Zill P, Bottlender R, Rupprecht R, Bondy B, Reiser M, Moller HJ, Meisenzahl EM (2007) Association of the brain-derived neurotrophic factor Val66Met polymorphism with reduced hippocampal volumes in major depression. Arch Gen Psychiatry 64(4):410–416. doi:10.1001/archpsyc.64.4.410 CrossRefPubMed Frodl T, Schule C, Schmitt G, Born C, Baghai T, Zill P, Bottlender R, Rupprecht R, Bondy B, Reiser M, Moller HJ, Meisenzahl EM (2007) Association of the brain-derived neurotrophic factor Val66Met polymorphism with reduced hippocampal volumes in major depression. Arch Gen Psychiatry 64(4):410–416. doi:10.​1001/​archpsyc.​64.​4.​410 CrossRefPubMed
31.
Zurück zum Zitat Frodl T, Meisenzahl EM, Zill P, Baghai T, Rujescu D, Leinsinger G, Bottlender R, Schule C, Zwanzger P, Engel RR, Rupprecht R, Bondy B, Reiser M, Moller HJ (2004) Reduced hippocampal volumes associated with the long variant of the serotonin transporter polymorphism in major depression. Arch Gen Psychiatry 61(2):177–183. doi:10.1001/archpsyc.61.2.177 CrossRefPubMed Frodl T, Meisenzahl EM, Zill P, Baghai T, Rujescu D, Leinsinger G, Bottlender R, Schule C, Zwanzger P, Engel RR, Rupprecht R, Bondy B, Reiser M, Moller HJ (2004) Reduced hippocampal volumes associated with the long variant of the serotonin transporter polymorphism in major depression. Arch Gen Psychiatry 61(2):177–183. doi:10.​1001/​archpsyc.​61.​2.​177 CrossRefPubMed
32.
Zurück zum Zitat Etkin A (2010) Functional neuroanatomy of anxiety: a neural circuit perspective. Curr Top Behav Neurosci 2:251–277CrossRefPubMed Etkin A (2010) Functional neuroanatomy of anxiety: a neural circuit perspective. Curr Top Behav Neurosci 2:251–277CrossRefPubMed
33.
Zurück zum Zitat Catani M, Howard RJ, Pajevic S, Jones DK (2002) Virtual in vivo interactive dissection of white matter fasciculi in the human brain. Neuroimage 17(1):77–94CrossRefPubMed Catani M, Howard RJ, Pajevic S, Jones DK (2002) Virtual in vivo interactive dissection of white matter fasciculi in the human brain. Neuroimage 17(1):77–94CrossRefPubMed
35.
Zurück zum Zitat Ma N, Li L, Shu N, Liu J, Gong G, He Z, Li Z, Tan L, Stone WS, Zhang Z, Xu L, Jiang T (2007) White matter abnormalities in first-episode, treatment-naive young adults with major depressive disorder. Am J Psychiatry 164(5):823–826. doi:10.1176/appi.ajp.164.5.823 CrossRefPubMed Ma N, Li L, Shu N, Liu J, Gong G, He Z, Li Z, Tan L, Stone WS, Zhang Z, Xu L, Jiang T (2007) White matter abnormalities in first-episode, treatment-naive young adults with major depressive disorder. Am J Psychiatry 164(5):823–826. doi:10.​1176/​appi.​ajp.​164.​5.​823 CrossRefPubMed
36.
Zurück zum Zitat Zou K, Huang X, Li T, Gong Q, Li Z, Ou-yang L, Deng W, Chen Q, Li C, Ding Y, Sun X (2008) Alterations of white matter integrity in adults with major depressive disorder: a magnetic resonance imaging study. J Psychiatry Neurosci 33(6):525–530PubMedCentralPubMed Zou K, Huang X, Li T, Gong Q, Li Z, Ou-yang L, Deng W, Chen Q, Li C, Ding Y, Sun X (2008) Alterations of white matter integrity in adults with major depressive disorder: a magnetic resonance imaging study. J Psychiatry Neurosci 33(6):525–530PubMedCentralPubMed
37.
Zurück zum Zitat Frodl T, Zill P, Baghai T, Schule C, Rupprecht R, Zetzsche T, Bondy B, Reiser M, Moller HJ, Meisenzahl EM (2008) Reduced hippocampal volumes associated with the long variant of the tri- and diallelic serotonin transporter polymorphism in major depression. Am J Med Genet B Neuropsychiatr Genet 147B(7):1003–1007. doi:10.1002/ajmg.b.30680 CrossRefPubMed Frodl T, Zill P, Baghai T, Schule C, Rupprecht R, Zetzsche T, Bondy B, Reiser M, Moller HJ, Meisenzahl EM (2008) Reduced hippocampal volumes associated with the long variant of the tri- and diallelic serotonin transporter polymorphism in major depression. Am J Med Genet B Neuropsychiatr Genet 147B(7):1003–1007. doi:10.​1002/​ajmg.​b.​30680 CrossRefPubMed
38.
Zurück zum Zitat Cotter D, Mackay D, Chana G, Beasley C, Landau S, Everall IP (2002) Reduced neuronal size and glial cell density in area 9 of the dorsolateral prefrontal cortex in subjects with major depressive disorder. Cereb Cortex 12(4):386–394CrossRefPubMed Cotter D, Mackay D, Chana G, Beasley C, Landau S, Everall IP (2002) Reduced neuronal size and glial cell density in area 9 of the dorsolateral prefrontal cortex in subjects with major depressive disorder. Cereb Cortex 12(4):386–394CrossRefPubMed
39.
Zurück zum Zitat Uranova NA, Vostrikov VM, Orlovskaya DD, Rachmanova VI (2004) Oligodendroglial density in the prefrontal cortex in schizophrenia and mood disorders: a study from the Stanley Neuropathology Consortium. Schizophr Res 67(2–3):269–275. doi:10.1016/S0920-9964(03)00181-6 CrossRefPubMed Uranova NA, Vostrikov VM, Orlovskaya DD, Rachmanova VI (2004) Oligodendroglial density in the prefrontal cortex in schizophrenia and mood disorders: a study from the Stanley Neuropathology Consortium. Schizophr Res 67(2–3):269–275. doi:10.​1016/​S0920-9964(03)00181-6 CrossRefPubMed
40.
Zurück zum Zitat Regenold WT, Phatak P, Marano CM, Gearhart L, Viens CH, Hisley KC (2007) Myelin staining of deep white matter in the dorsolateral prefrontal cortex in schizophrenia, bipolar disorder, and unipolar major depression. Psychiatry Res 151(3):179–188. doi:10.1016/j.psychres.2006.12.019 CrossRefPubMed Regenold WT, Phatak P, Marano CM, Gearhart L, Viens CH, Hisley KC (2007) Myelin staining of deep white matter in the dorsolateral prefrontal cortex in schizophrenia, bipolar disorder, and unipolar major depression. Psychiatry Res 151(3):179–188. doi:10.​1016/​j.​psychres.​2006.​12.​019 CrossRefPubMed
41.
Zurück zum Zitat Thomas AJ, Perry R, Barber R, Kalaria RN, O’Brien JT (2002) Pathologies and pathological mechanisms for white matter hyperintensities in depression. Ann N Y Acad Sci 977:333–339CrossRefPubMed Thomas AJ, Perry R, Barber R, Kalaria RN, O’Brien JT (2002) Pathologies and pathological mechanisms for white matter hyperintensities in depression. Ann N Y Acad Sci 977:333–339CrossRefPubMed
42.
Zurück zum Zitat Thomas AJ, O’Brien JT, Davis S, Ballard C, Barber R, Kalaria RN, Perry RH (2002) Ischemic basis for deep white matter hyperintensities in major depression: a neuropathological study. Arch Gen Psychiatry 59(9):785–792CrossRefPubMed Thomas AJ, O’Brien JT, Davis S, Ballard C, Barber R, Kalaria RN, Perry RH (2002) Ischemic basis for deep white matter hyperintensities in major depression: a neuropathological study. Arch Gen Psychiatry 59(9):785–792CrossRefPubMed
43.
Zurück zum Zitat O’Brien J, Desmond P, Ames D, Schweitzer I, Harrigan S, Tress B (1996) A magnetic resonance imaging study of white matter lesions in depression and Alzheimer’s disease. Br J Psychiatry 168(4):477–485CrossRefPubMed O’Brien J, Desmond P, Ames D, Schweitzer I, Harrigan S, Tress B (1996) A magnetic resonance imaging study of white matter lesions in depression and Alzheimer’s disease. Br J Psychiatry 168(4):477–485CrossRefPubMed
45.
Zurück zum Zitat Basser PJ, Pierpaoli C (1996) Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson, Ser B 111(3):209–219CrossRef Basser PJ, Pierpaoli C (1996) Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson, Ser B 111(3):209–219CrossRef
47.
48.
Zurück zum Zitat Von Der Heide RJ, Skipper LM, Klobusicky E, Olson IR (2013) Dissecting the uncinate fasciculus: disorders, controversies and a hypothesis. Brain 136(Pt 6):1692–1707. doi:10.1093/brain/awt094 CrossRef Von Der Heide RJ, Skipper LM, Klobusicky E, Olson IR (2013) Dissecting the uncinate fasciculus: disorders, controversies and a hypothesis. Brain 136(Pt 6):1692–1707. doi:10.​1093/​brain/​awt094 CrossRef
49.
Metadaten
Titel
Brain structural abnormalities in patients with major depression with or without generalized anxiety disorder comorbidity
verfasst von
Elisa Canu
Milutin Kostić
Federica Agosta
Ana Munjiza
Pilar M. Ferraro
Danilo Pesic
Massimiliano Copetti
Amir Peljto
Dusica Lecic Tosevski
Massimo Filippi
Publikationsdatum
01.05.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 5/2015
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-015-7701-z

Weitere Artikel der Ausgabe 5/2015

Journal of Neurology 5/2015 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.