Abnormalities of cortical-limbic-cerebellar white matter networks may contribute to treatment-resistant depression: a diffusion tensor imaging study

Abstract

BackgroundWhite matter abnormalities can cause network dysfunction that underlies major depressive disorder (MDD). Diffusion tensor imaging (DTI) is used to examine the neural connectivity and integrity of the white matter. Previous studies have implicated frontolimbic neural networks in the pathophysiology of MDD. Approximately 30% of MDD patients demonstrate treatment-resistant depression (TRD). However, the neurobiology of TRD remains unclear.MethodsWe used a voxel-based analysis method to analyze DTI data in young patients with TRD (n = 30; 19 males, 11 females) compared with right-handed, age- and sex-matched healthy volunteers (n = 25; 14 males, 11 females).ResultsWe found a significant decrease in fractional anisotropy (FA) (corrected, cluster size >50) in the left middle frontal gyrus (peak coordinates [−18 46–14]), left limbic lobe uncus (peak coordinates [−18 2–22]), and right cerebellum posterior lobe (peak coordinates [26–34 -40]). There was no increase in FA in any brain region in patients. We also found a significant negative correlation between mean regional FA values in the three areas and Beck Depression Inventory symptom scores.ConclusionsWe found significant differences in white matter FA in the frontal lobe, limbic lobe and cerebellum between TRD patients and controls. These data suggest that abnormalities of cortical-limbic-cerebellar white matter networks may contribute to TRD in young patients.

Proton Magnetic Resonance Spectroscopy Study on the Metabolism Changes of Cerebellum in Patients with Post-Stroke Depression

“…Based on the present study, the degree of cerebellar metabolism variation was correlated with the severity of PSD. Similar studies around the world supported this conclusion, for example, in DTI image study by Peng et al, the abnormality of cerebellar white matter network in refractory depression patients showed a significant correlation with the severity of depression [11]. While Sui et al also indicated the degree of cerebellar volume decrease was associated with the severity of PSD [23].…”

“…But in the field of depression, many studies also found the change of cerebellar function in depression patients through functional MRI (fMRI) technique. Besides, many studies have displayed that the cerebellar structure varies, which necessarily leads to the functional changes [11, 27, 28]. Lassalle-Lagadec et al found significantly decreased volume of PSD patients’ cerebellum [28].…”

“…Moreover, the magnetic resonance diffusion tensor imaging study about depression also showed obvious abnormality of patients’ cerebellar white matter network. Namely, the cerebellar structure has changed [11]. …”

“…Accumulative neuroimaging studies in recent years have showed that the mental disorders such as depression, infantile autism, etc. were associated with cerebellar lesions [11, 12]. …”

Microstructural brain abnormalities in medication-free patients with major depressive disorder: a systematic review and meta-analysis of diffusion tensor imaging

“…74 Studies reported that FA reductions in the cerebellar hemisphere exhibited a positive correlation with depression severity. 24,77 In addition, significant FA differences in the white matter of the frontal lobe, limbic lobe and cerebellum between patients with treatment-resistant depression (TRD) and controls suggest that abnormalities of corticallimbic-cerebellar white matter networks may contribute to TRD in young patients. 77 In sum, our finding of decreased FA in the white matter of the right cerebellar hemispheric lobule is supportive of implications that the cerebellum may play a critical role in the neuropathology of MDD.…”