Lesion network localization of depression in multiple sclerosis.

Area of Science:

• Neuroscience
• Clinical Neurology
• Medical Imaging

Background:

• Depression is a frequent and disabling complication of multiple sclerosis (MS).
• The precise role of lesion location in the development of depression among MS patients remains poorly understood.
• Prior research suggests a common brain circuit connects stroke lesions and neuromodulation sites influencing depression.

Purpose of the Study:

• To investigate the relationship between the location of lesions in patients with MS and the severity of depression.
• To identify specific brain circuits associated with depression in MS.
• To determine if a predefined depression circuit is relevant for MS.

Main Methods:

• Utilized a clinical and radiological database of 281 MS patients.
• Estimated functional connectivity between MS lesion locations and other brain regions using a normative connectome database (1000 participants).
• Correlated functional connectivity with depression severity and other MS symptoms.

Main Results:

• Functional connectivity between MS lesion sites and a predefined depression circuit correlated significantly with depression severity (p=0.013).
• This connectivity was specific to depression, distinguishing it from other MS-related symptoms (p=0.0058).
• A data-driven circuit identified for MS depression showed topographical similarity to the predefined circuit (p=0.015), with a peak in the ventral midbrain, overlapping the ventral tegmental area.

Conclusions:

• Findings suggest a specific localization of depression within MS, linked to a shared brain circuit.
• The ventral midbrain, including the ventral tegmental area, is a key region implicated in MS-related depression.
• These insights may inform the development of targeted therapeutic strategies for depression in MS patients.