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Brain MRI lesions and atrophy are related to depression in multiple sclerosis
R Bakshi1, D Czarnecki, Z A Shaikh
1Department of Neurology, University at Buffalo (SUNY) School of Medicine and Biomedical Sciences, Buffalo General Hospital, NY 14203, USA.
Abstract:
It is unclear whether brain MRI lesions are associated with depression in multiple sclerosis (MS). Neurological dysfunction in depressed (n= 19) and non-depressed (n = 29) MS patients was rated by expanded disability status scale (EDSS). EDSS was weakly predictive of the presence of (p = 0.03) and severity of (p = 0.01) depression. After correcting for EDSS, the presence of depression was predicted by superior frontal and superior parietal hypointense TI lesions (p<0.01); the severity of depression was predicted by superior frontal, superior parietal and temporal TI lesions, lateral and third ventricular enlargement, and frontal atrophy (p<0.01). Depression was not related to bright T2 lesions or enhancement. We conclude that atrophy and cortical-subcortical disconnection due to frontal and parietal white matter destructive lesions may contribute to depression in MS.
Insights
Brain MRI lesions, specifically hypointense TI lesions in the frontal and parietal areas, are linked to depression in multiple sclerosis (MS) patients. Atrophy and white matter lesions may contribute to MS-related depression.
Area of Science:
- Neurology
- Neuroimaging
- Psychiatry
Background:
- Depression is a common comorbidity in multiple sclerosis (MS).
- The relationship between brain magnetic resonance imaging (MRI) findings and depression in MS remains unclear.
- Understanding these associations can inform clinical management and research.
Purpose of the Study:
- To investigate the association between specific brain MRI lesion characteristics and depression in patients with MS.
- To determine if MRI-derived measures predict the presence and severity of depression in MS.
Main Methods:
- A cohort of 48 MS patients (19 depressed, 29 non-depressed) underwent neurological assessment using the Expanded Disability Status Scale (EDSS).
- Brain MRI scans were analyzed for hypointense TI lesions, T2 hyperintensities, contrast enhancement, ventricular enlargement, and brain atrophy.
- Statistical analyses were performed to correlate MRI findings with depression status and severity, controlling for EDSS.
Main Results:
- EDSS showed a weak association with the presence (p=0.03) and severity (p=0.01) of depression.
- After adjusting for EDSS, hypointense TI lesions in the superior frontal and parietal regions predicted the presence of depression (p<0.01).
- Depression severity was associated with superior frontal, superior parietal, and temporal TI lesions, ventricular enlargement, and frontal atrophy (p<0.01).
- No significant association was found between depression and T2 hyperintensities or contrast-enhancing lesions.
Conclusions:
- Atrophy and cortical-subcortical disconnection, potentially resulting from white matter lesions in the frontal and parietal lobes, may contribute to depression in MS.
- Specific MRI findings, beyond general disability, are associated with depression in MS patients.
- These findings highlight the neuroanatomical underpinnings of depression in MS and suggest potential imaging biomarkers.