MRI Correlates of Depression and Anxiety in Multiple Sclerosis
Loredana Sabina Pascu1, Simona Dana Mitincu-Caramfil1, Andrei Vlad Bradeanu1
1Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University of Galati, 800008 Galati, Romania.
Background:
Multiple sclerosis (MS) is a neurodegenerative and chronic inflammatory disease, often associated with psychiatric comorbidities, particularly depression and anxiety, which play a major role in disability, cognitive dysfunction, and quality of life. Growing evidence suggests that affective symptoms in MS are not only related to psychosocial burden but also to structural and functional abnormalities in the brain that can be identified using magnetic resonance imaging (MRI).
Methods:
A systematic database search was performed to identify studies for a structured narrative review. Original articles that examined MRI correlates of depression and anxiety in adult MS patients were included. Structural MRI, diffusion imaging, and functional MRI studies evaluating lesion distribution, cortical and subcortical atrophy, white matter microstructure, and network connectivity were analyzed alongside psychometric instruments used to assess affective symptoms.
Results:
Depression in MS was consistently associated with fronto-limbic and subcortical abnormalities including cortical thinning, hippocampal and thalamic atrophy, white matter disconnection and altered connectivity within the default mode, salience and executive control networks. Diffusion MRI studies have shown microstructural damage in associative white matter tracts, and functional MRI studies have supported a model of network-level dysfunction. In contrast, anxiety had less robust and reproducible associations with conventional MRI findings, indicating a more complex interaction between inflammatory, neurobiological and psychosocial mechanisms.
Conclusions:
Multimodal MRI approaches may increase our knowledge of the neurobiological substrates of depression and anxiety in MS and may contribute to more personalized diagnostic and therapeutic strategies.
Insights
Depression in multiple sclerosis (MS) is linked to brain abnormalities in areas like the fronto-limbic system and white matter. Anxiety in MS shows less clear MRI findings, suggesting complex causes.
Area of Science:
- Neuroimaging
- Neurology
- Psychiatry
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease often accompanied by depression and anxiety.
- These psychiatric conditions significantly impact disability, cognition, and quality of life in MS patients.
- Brain abnormalities, detectable via MRI, are increasingly recognized as contributors to affective symptoms in MS.
Purpose of the Study:
- To systematically review magnetic resonance imaging (MRI) correlates of depression and anxiety in adult patients with multiple sclerosis.
- To synthesize findings from structural, diffusion, and functional MRI studies in relation to affective symptoms.
Main Methods:
- A systematic database search identified original articles on MRI findings and affective symptoms in MS.
- Studies analyzed structural MRI, diffusion imaging, and functional MRI data.
- Psychometric instruments were used to assess depression and anxiety symptoms.
Main Results:
- Depression in MS is associated with fronto-limbic and subcortical structural changes (e.g., cortical thinning, atrophy) and white matter disconnection.
- Altered network connectivity (default mode, salience, executive control) is observed in MS patients with depression.
- Anxiety in MS demonstrated less consistent MRI associations, indicating a complex interplay of factors.
Conclusions:
- Multimodal MRI techniques offer insights into the neurobiological underpinnings of depression and anxiety in MS.
- These findings may pave the way for personalized diagnostic and therapeutic approaches in MS care.
