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Fronto-limbic disconnection in patients with multiple sclerosis and depression
Quinten van Geest1, Rosa E Boeschoten2, Matthijs J Keijzer1
1Department of Anatomy & Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|March 29, 2018
Summary
Depression in multiple sclerosis (MS) is linked to fronto-limbic disconnection, with depressed MS patients showing reduced white matter volume and altered functional connectivity. These brain changes help explain depression severity in MS patients.
Area of Science:
- Neuroscience
- Neurology
- Psychiatry
Background:
- The biological mechanisms underlying depression in multiple sclerosis (MS) remain poorly understood.
- Existing research in major depressive disorder suggests fronto-limbic disconnection may play a significant role.
Purpose of the Study:
- To investigate structural and functional alterations in the fronto-limbic pathways of depressed MS (DMS) patients compared to non-depressed MS (nDMS) patients.
- To explore the relationship between these brain changes and the severity of depression in MS.
Main Methods:
- A retrospective study involving 22 DMS patients, 21 nDMS patients, and 12 healthy controls.
- Neuropsychological testing and 1.5T MRI were used to assess brain volumes, lesion load, fractional anisotropy (FA) of fronto-limbic tracts, and resting-state functional connectivity (FC).
Main Results:
- DMS patients exhibited lower white matter (WM) volume, decreased FA in the uncinate fasciculus, and reduced amygdala-frontal FC compared to nDMS patients.
- Disease duration, FA of the uncinate fasciculus, and amygdala FC collectively explained 48% of the variance in depression severity.
- No significant cognitive differences were observed between the groups.
Conclusions:
- Depressed MS patients demonstrate more significant structural and functional damage in temporo-frontal regions, indicative of fronto-limbic disconnection.
- These findings highlight the importance of fronto-limbic pathways in the pathophysiology of depression in MS.
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