Prefrontal cortical abnormalities in currently depressed versus currently remitted patients with major depressive disorder.
NeuroImage. 2011-02-01; 54(4): 2643-2651
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Previous neuromorphometric investigations of major depressive disorder (MDD) have
reported abnormalities in gray matter in several regions, although the results
have been inconsistent across studies. Some discrepancies in the results across
studies may reflect design limitations such as small sample sizes, whereas others
may reflect biological variability that potentially manifests as differences in
clinical course. For example, it remains unclear whether the abnormalities found
in persistently depressed MDD subjects extend to or persist in patients who
experience prolonged remission. The aim of the present study was to investigate
gray matter (GM) differences in unmedicated, currently-depressed participants
(dMDD) and unmedicated, currently-remitted (rMDD) participants with MDD compared
to healthy controls (HC). The GM density and volume were compared across groups
using voxel-based morphometry, a quantitative neuroanatomical technique, and
high-resolution MRI images from 107 HC, 58 dMDD and 27 rMDD subjects. Relative to
the HC group the dMDD group had reduced GM in the dorsal anterolateral (DALPFC),
the dorsomedial (DMPFC) and the ventrolateral prefrontal cortex (VLPFC). Relative
to the rMDD group the dMDD group showed reduced GM in the DALPFC, the VLPFC, the
anterior cingulate cortex (ACC), the precuneus and the inferior parietal lobule.
No regions were identified in which the rMDD group showed significantly lower GM
compared to the HC group after p-values were corrected for the number of
comparisons performed. In unmedicated patients in the depressed phase of MDD, we
found evidence of morphometric abnormalities in DALPFC and in medial prefrontal
cortical regions belonging to the visceromotor network. These findings, along
with the absence of GM abnormalities in the remitted sample imply a possible link
between greater GM tissue and better clinical outcome. Consistent with other
neuroimaging and post-mortem neuropathological studies of MDD, we also found
evidence of decreased white matter in patients with dMDD and rMDD.
Published by Elsevier Inc.
PMID: 21073959 [Indexed for MEDLINE]