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Published on: November 27, 2019
Neuroanatomic correlates of psychopathologic components of major depressive disorder
Matthew S Milak1, Ramin V Parsey, John Keilp
1Departments of Psychiatry and Radiology, Department of Neuroscience, NY State Psychiatric Institute, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. mm2354@columbia.edu
Insights
Major depressive disorder symptoms correlate with specific brain metabolism patterns. The Hamilton Depression Rating Scale (HDRS) components link to distinct regional brain glucose metabolism, offering insights into depression's neurobiology.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- The Hamilton Depression Rating Scale (HDRS) is a standard measure for depression severity.
- Total HDRS scores correlate with brain metabolism measured by fluorodeoxyglucose F 18 ([(18)F]-FDG) positron emission tomography (PET).
- Distinct HDRS symptom clusters may relate to specific patterns of brain glucose metabolism.
Purpose of the Study:
- To investigate the associations between HDRS-derived psychopathologic clusters and resting-state cerebral glucose metabolism using [(18)F]-FDG PET.
- To analyze these associations in 298 drug-free patients diagnosed with major depressive disorder according to DSM-III-R criteria.
Main Methods:
- Five principal components (psychic depression, loss of motivated behavior, psychosis, anxiety, sleep disturbance) were extracted from the 24-item HDRS.
- [(18)F]-FDG PET scans were acquired in a subgroup of 43 patients.
- Voxel-level correlation maps were generated to assess relationships between HDRS scores and regional brain metabolism.
Main Results:
- Total HDRS score positively correlated with activity in ventral cortical and subcortical regions, including limbic, thalamic, and basal ganglia structures.
- Psychic depression showed positive correlations with metabolism in the cingulate gyrus, thalamus, and basal ganglia.
- Sleep disturbance correlated positively with metabolism in limbic structures and basal ganglia, while loss of motivated behavior was negatively associated with parietal and superior frontal cortical areas.
Conclusions:
- Specific brain regions are associated with distinct symptom components of major depression.
- These findings highlight the heterogeneous neurobiological underpinnings of depression subtypes.
- Future research should focus on identifying neurotransmitters linked to specific psychopathologic components to further elucidate mood disorder networks.
Background:
The Hamilton Depression Rating Scale (HDRS) is widely used to measure the severity of depression in mood disorders. Total HDRS score correlates with brain metabolism as measured by fludeoxyglucose F 18 ([(18)F]-FDG) positron emission tomography. The HDRS comprises distinct symptom clusters that may be associated with different patterns of regional brain glucose metabolism.
Objective:
To examine associations between HDRS component psychopathologic clusters and resting glucose cerebral metabolism assessed by [(18)F]-FDG positron emission tomography. Patients We evaluated 298 drug-free patients who met the DSM-III-R criteria for major depressive disorder.
Main Outcome Measures:
Five principal components were extracted from the 24-item HDRS for all subjects and ProMax rotated: psychic depression, loss of motivated behavior, psychosis, anxiety, and sleep disturbance. The [(18)F]-FDG scans were acquired in a subgroup of 43 drug-free patients in twelve 5-minute frames. Voxel-level correlation maps were generated with HDRS total and factor scores.
Results:
Total HDRS score correlated positively with activity in a large bilateral ventral cortical and subcortical region that included limbic, thalamic, and basal ganglia structures. Distinct correlation patterns were found with the 3 individual HDRS factors. Psychic depression correlated positively with metabolism in the cingulate gyrus, thalamus, and basal ganglia. Sleep disturbance correlated positively with metabolism in limbic structures and basal ganglia. Loss of motivated behavior was negatively associated with parietal and superior frontal cortical areas.
Conclusions:
Different brain regions correlate with discrete symptom components that compose the overall syndrome of major depression. Future studies should extend knowledge about specific regional networks by identifying responsible neurotransmitters related to specific psychopathologic components of mood disorders.
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