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Distinguishing between major depressive disorder and obsessive-compulsive disorder in children by measuring regional
Erin Fallucca1, Frank P MacMaster, Joseph Haddad
1Department of Psychiatry and Behavioral Neurosciences, Wayne State University, and Children’s Hospital of Michigan, Detroit, Michigan, USA.
Insights
Pediatric major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) show distinct cortical thickness differences. MDD patients exhibited thinner pericalcarine and postcentral gyri, and thicker temporal poles compared to controls.
Area of Science:
- Neuroscience
- Pediatric Psychiatry
- Neuroimaging
Background:
- Previous research indicates cortical abnormalities in major depressive disorder (MDD).
- Understanding neurobiological differences in pediatric mental health conditions is crucial.
Purpose of the Study:
- To investigate regional cortical thickness variations in children diagnosed with MDD.
- To compare these variations with those in children with obsessive-compulsive disorder (OCD) and healthy controls.
Main Methods:
- A cross-sectional study design was employed.
- Participants included psychotropic drug-naive pediatric patients with MDD (n=24), pediatric outpatients with OCD (n=24), and healthy controls (n=30).
- Magnetic resonance imaging (MRI) was utilized to measure cortical thickness.
Main Results:
- Children with MDD showed significantly thinner pericalcarine, postcentral, and superior parietal gyri in the right hemisphere compared to both OCD patients and healthy controls.
- The temporal pole was thicker in MDD patients than in OCD patients and healthy controls.
- In the left hemisphere, the supramarginal gyrus was thinner in both MDD and OCD patients compared to controls, while the temporal pole was thicker in MDD patients.
Conclusions:
- This study is the first to examine cortical thickness in pediatric MDD patients.
- Findings reveal unexpected regional differences, including the supramarginal and superior parietal gyri, warranting further investigation.
- Results suggest the need to broaden neurobiological research beyond the traditional frontal-limbic circuit in MDD.
Context:
Cortical abnormalities have been noted in previous studies of major depressive disorder (MDD).
Objective:
To hypothesize differences in regional cortical thickness among children with MDD, children with obsessive-compulsive disorder (OCD), and healthy controls.
Design:
Cross-sectional study of groups.
Setting:
Children's Hospital of Michigan in Detroit.
Participants:
A total of 24 psychotropic drug-naive pediatric patients with MDD (9 boys and 15 girls), 24 psychotropic drug-naive pediatric outpatients with OCD (8 boys and 16 girls), and 30 healthy controls (10 boys and 20 girls).
Intervention:
Magnetic resonance imaging.
Main Outcome Measure:
Cortical thickness.
Results:
In the right hemisphere of the brain, the pericalcarine gyrus was thinner in patients with MDD than in outpatients with OCD (P = .002) or healthy controls (P = .04), the postcentral gyrus was thinner in patients with MDD than in outpatients with OCD (P = .002) or healthy controls (P = .02), and the superior parietal gyrus was thinner in patients with MDD than in outpatients with OCD (P = .008) or healthy controls (P = .03). The outpatients with OCD and the healthy controls did not differ in these regions of the brain. The temporal pole was thicker in patients with MDD than in outpatients with OCD (P < .001) or healthy controls (P = .01), both of which groups did not differ in temporal pole thickness. The cuneus was thinner in patients with MDD than in outpatients with OCD (P = .008), but it did not differ from that in healthy controls. In the left hemisphere, the supramarginal gyrus was thinner in both patients with MDD (P = .04) and outpatients with OCD (P = .01) than in healthy controls, and the temporal pole was thicker in patients with MDD than in both healthy controls and outpatients with OCD (P < .001).
Conclusions:
To our knowledge, this is the first study to explore cortical thickness in pediatric patients with MDD. Although differences in some regions of the brain would be expected given neurobiological models of MDD, our study highlights some unexpected regions (ie, supramarginal and superior parietal gyri) that merit further investigation. These results underscore the need to expand exploration beyond the frontal-limbic circuit.
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