Brain structural correlates of recurrence following the first episode in patients with major depressive disorder

Abstract

Former prospective studies showed that the occurrence of relapse in Major Depressive Disorder (MDD) is associated with volume loss in the insula, hippocampus and dorsolateral prefrontal cortex (DLPFC). However, these studies were confounded by the patient’s lifetime disease history, as the number of previous episodes predict future recurrence. In order to analyze neural correlates of recurrence irrespective of prior disease course, this study prospectively examined changes in brain structure in patients with first-episode depression (FED) over 2 years. N = 63 FED patients and n = 63 healthy controls (HC) underwent structural magnetic resonance imaging at baseline and after 2 years. According to their disease course during the follow-up interval, patients were grouped into n = 21 FED patients with recurrence (FEDrec) during follow-up and n = 42 FED patients with stable remission (FEDrem). Gray matter volume changes were analysed using group by time interaction analyses of covariance for the DLPFC, hippocampus and insula. Significant group by time interactions in the DLPFC and insula emerged. Pairwise comparisons showed that FEDrec had greater volume decline in the DLPFC and insula from baseline to follow-up compared with FEDrem and HC. No group by time interactions in the hippocampus were found. Cross-sectional analyses at baseline and follow-up revealed no differences between groups. This longitudinal study provides evidence for neural alterations in the DLPFC and insula related to a detrimental course in MDD. These effects of recurrence are already detectable at initial stages of MDD and seem to occur without any prior disease history, emphasizing the importance of early interventions preventing depressive recurrence.

Individual- and Connectivity-Based Real-Time fMRI Neurofeedback to Modulate Emotion-Related Brain Responses in Patients with Depression: A Pilot Study

“…Given the consistency of the left-accentuated BOLD response, our paradigm and setting seem to be suitable to reveal possible functional effects via similar functional pathways across subjects and to generate suitable ROIs for NF tasks. More-over, the insula and the dlPFC of the left hemisphere are explicitly known to be affected in patients with MDD [ 88 , 89 ] and to be potential targets for rt-fMRI-NF [ 90 ].…”

Altered topology of individual brain structural covariance networks in major depressive disorder

“…Evidence from previous neuroimaging studies supports the hypothesis of imbalanced activity in bilateral dlPFC in MDD (Grimm et al, 2008), postulating a relative hypoactivity in the left dlPFC and a relative hyperactivity of the right dlPFC. It has also been shown that an imbalance in the gray matter morphology of dlPFC is associated with symptoms and the recurrence of MDD (Lemke et al, 2022; Liu et al, 2016; Zaremba et al, 2018). Therefore, we speculate that the increased nodal efficiency in left SFGdor may be linked to stronger negative emotions and lead to depressive symptoms.…”

Anxious arousal predicts within-person changes in hippocampal volume in adults with a history of childhood maltreatment: A CAN-BIND4 report.

“…Further, reductions in hippocampal volume over the course of antidepressant treatment have been associated with a lower likelihood of symptom remission and higher relapse rates (Frodl, Koutsouleris, et al, 2008; cf. Lemke et al, 2022).…”