Reduced echogenicity of brainstem raphe specific to unipolar depression: A transcranial color-coded real-time sonography study

Becker, Georg; Becker, Thomas; Struck, Michael; Lindner, Alfred; Burzer, Klaus; Retz, Wolfgang; Bogdahn, Ulrich; Beckmann, H.

doi:10.1016/0006-3223(94)00263-3

Cited by 107 publications

(82 citation statements)

References 8 publications

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“…In a study that used ultrasound imaging, subjects with major depression exhibited a significant trait-dependent decrease in the reflection of ultrasound waves by the midbrain and pontine raphe as compared with normal controls, subjects with bipolar affective disorder, or subjects with schizophrenia (Becker et al, 1995). Evidence for brainstem involvement in major depression has been demonstrated in a recent imaging study that showed that patients with major depression had a significant decrease in radioligand binding to the serotonin transporter in the midbrain .…”

Section: Abstract: Serotonin-1a Receptors; Dorsal Raphe Nucleus; Majmentioning

confidence: 89%

Increase in Serotonin-1A Autoreceptors in the Midbrain of Suicide Victims with Major Depression—Postmortem Evidence for Decreased Serotonin Activity

Stockmeier

Shapiro²,

Dilley³

et al. 1998

J. Neurosci.

385

243

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It has been hypothesized that a deficit in serotonin may be a crucial determinant in the pathophysiology of major depression. Serotonin-1A receptors are located on serotonin cell bodies in the midbrain dorsal raphe (DR) nucleus, and the activation of these receptors inhibits the firing of serotonin neurons and diminishes the release of this neurotransmitter in the prefrontal cortex. Repeated treatment with some antidepressant medications desensitizes serotonin-1A receptors in the rat midbrain. The present study determined whether the binding of [, an agonist at serotonin-1A receptors, is altered in the midbrain of suicide victims with major depression. Radiolabeling of the serotonin-1A receptor in the DR varied significantly along the rostral-to-caudal extent of the human midbrain. The binding of [ 3 H]8-OH-DPAT to serotonin-1A receptors was increased significantly in the midbrain DR of suicide victims with major depression as compared with psychiatrically normal control subjects. In suicide victims with major depression, the increase in the binding of [ 3 H]8-OH-DPAT to serotonin-1A receptors was detected in the entire DR and specifically localized to the dorsal and ventrolateral subnuclei. Enhanced radioligand binding of an agonist to inhibitory serotonin-1A autoreceptors in the human DR provides pharmacological evidence to support the hypothesis of diminished activity of serotonin neurons in suicide victims with major depression.

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Section: Abstract: Serotonin-1a Receptors; Dorsal Raphe Nucleus; Majmentioning

confidence: 89%

Increase in Serotonin-1A Autoreceptors in the Midbrain of Suicide Victims with Major Depression—Postmortem Evidence for Decreased Serotonin Activity

Stockmeier

Shapiro²,

Dilley³

et al. 1998

J. Neurosci.

385

243

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“…Such observations have been reported in patients with unipolar depression and in depressed patients with Parkinson disease. [11][12][13][14][15] The precise pathophysiological and morphological interpretation of brain stem raphe hypoechogenicity is still speculative. A correlation of this finding to signal alteration on magnetic resonance imaging (MRI) studies has been reported previously, suggesting that hypoechogenicity reflects a structural disruption of the mesencephalic raphe structure.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Furthermore, alterations of the brain stem raphe have been observed by TCS in patients with major depression and in depressed patients with Parkinson disease. [11][12][13][14][15] Up to now, there has been only 1 TCS study evaluating basal ganglia alterations in patients with Huntington disease. 16 The echogenicity of the brain stem raphe was not assessed in this study.…”

Section: Introductionmentioning

confidence: 99%

Depression in patients with Huntington disease correlates with alterations of the brain stem raphe depicted by transcranial sonography

Krogias

Strassburger

Eyding

et al. 2011

jpn

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Background: Transcranial sonography (TCS) has become a new diagnostic tool in the evaluation of extrapyramidal disorders. Studies of TCS report alterations of the mesencephalic raphe in patients with depression. The aim of this study was to evaluate TCS findings in patients with Huntington disease in correlation with their neurologic and psychiatric status. Methods: We recruited patients with genetically confirmed Huntington disease. The neurological and psychiatric status of participants was assessed by independent physicians. Echogenicities were investigated according to examination protocol for extrapyramidal disorders using a Siemens Sonoline Elegra system. The sonography examiner was blinded for clinical data. Results: We included 39 patients in our study; 21 patients (53.8%) showed symptoms of depression at the time of evaluation and, of those, 15 (71.4%) had hypoechogenic raphe structures. Thirty patients (76.9%) had a history of depressive episodes, 19 (63.3%) of them with hypoechogenic raphe structures. All 9 patients without a history of depressive episodes showed normal echogenicity of raphe structures (sensitivity 63.3%, specificity 100%). Twelve (70.6%) of the 17 patients with Huntington disease who showed psychiatric disturbances prior to the occurrence of motor symptoms exhibited pathological raphe echogenicity (sensitivity 70.6%, specificity 68.2%). Limitations: Most of the patients were taking antichoreatic medication, which particularly influences neurologic status. Thus, a meaningful interpretation of the correlation between TCS findings and neurologic features was limited. Conclusion: As a novel finding, a relation between mesencephalic raphe echogenicity and depressive state could be identified in patients with Huntington disease. An alteration of the serotonergic brain stem raphe might be involved in the pathogenesis of depression in these patients.

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“…Moreover, the assessment of the raphe is anatomically restricted to the lower midbrain with obligatory simultaneous visualization of the red nucleus. While in early reports 4 grades of echogenicity were applied (1: raphe not visible; 2: reduced or interrupted echogenicity; 3: normal, i. e. continuous line with an echogenicity similar to that of red nucleus, 4: increased echogenicity) [26], a current consensus guideline recommends the discrimination of only of two grades (normal vs. reduced echogenicity) ( • " Fig. 2) [2].…”

Section: Visualization and Assessmentmentioning

confidence: 99%

“…tion of the central serotonergic system [26,36]. Also PD and Huntington's disease patients with associated depression often exhibit this TCS feature [36 -38].…”

Section: Diagnostic Relevancementioning

confidence: 99%

Transcranial Sonography (TCS) of Brain Parenchyma in Movement Disorders: Quality Standards, Diagnostic Applications and Novel Technologies

Walter

Školoudík

2014

Ultraschall in Med

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Transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. Compared to other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography, TCS can be performed today with portable machines and has the advantages of noninvasiveness and high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized or can only be visualized with significant effort with other imaging methods. In the field of movement disorders, TCS has been established mainly as a tool for the early and differential diagnosis of Parkinson?s disease. The postoperative position control of deep brain stimulation electrodes, especially in the subthalamic nucleus, can reliably and safely be performed with TCS.?The present update review summarizes the current methodological standards and defines quality criteria of adequate TCS imaging and assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles. Finally, an overview is given on recent technological advances including TCS-MRI fusion imaging and upcoming technologies of digitized image analysis aiming at a more investigator-independent assessment of deep brain structures on TCS.

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Reduced echogenicity of brainstem raphe specific to unipolar depression: A transcranial color-coded real-time sonography study

Cited by 107 publications

References 8 publications

Increase in Serotonin-1A Autoreceptors in the Midbrain of Suicide Victims with Major Depression—Postmortem Evidence for Decreased Serotonin Activity

Increase in Serotonin-1A Autoreceptors in the Midbrain of Suicide Victims with Major Depression—Postmortem Evidence for Decreased Serotonin Activity

Depression in patients with Huntington disease correlates with alterations of the brain stem raphe depicted by transcranial sonography

Transcranial Sonography (TCS) of Brain Parenchyma in Movement Disorders: Quality Standards, Diagnostic Applications and Novel Technologies

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