The brain disturbances that place a person at risk for developing depression are unknown. We imaged the brains of 131 individuals, ages 6 to 54 years, who were biological descendants (children or grandchildren) of individuals identified as having either moderate to severe, recurrent, and functionally debilitating depression or as having no lifetime history of depression. We compared cortical thickness across high-and low-risk groups, detecting large expanses of cortical thinning across the lateral surface of the right cerebral hemisphere in persons at high risk. Thinning correlated with measures of current symptom severity, inattention, and visual memory for social and emotional stimuli. Mediator analyses indicated that cortical thickness mediated the associations of familial risk with inattention, visual memory, and clinical symptoms. These findings suggest that cortical thinning in the right hemisphere produces disturbances in arousal, attention, and memory for social stimuli, which in turn may increase the risk of developing depressive illness.
is a highly familial illness (1).It is the leading cause of disability worldwide for persons 15 to 44 years of age (2), and it is associated with increased mortality resulting from cardiovascular disorder (3), poor personal care (4), and suicide (5). Genetic and environmental factors and their interactions are important in its pathogenesis (6), but the abnormalities of brain structure and function that mediate these effects have not yet been identified. Brain-imaging studies have suggested the involvement of the limbic system and related frontal cortices in persons suffering from MDD, although findings from those studies have been inconsistent and have had relatively small effect sizes. Moreover, studies reporting abnormalities in brain structure and function in already-affected individuals have been unable to discern whether those abnormalities represent the causes of depressive illness, the compensatory neural responses that help to promote recovery or the attenuation of symptoms, the epiphenomenal effects of chronic illness or stress, or the effects of prior or ongoing treatment.To address these limitations of prior neurobiological studies of already-affected individuals, we undertook a study of brain structure in individuals who are at high familial risk for developing MDD. These individuals belonged to a 3-generation cohort in which the first 2 generations have been followed for more than 20 years. The first generation (G1) comprised 2 groups of adults: 1 group that was clinically ascertained during treatment of moderate to severe, recurrent, and functionally debilitating MDD; and a control group composed of a sample of matched adults, ascertained from the same community, who had no discernible lifetime history of depression. The second generation (G2) comprised the biological offspring of the first generation, and the third generation (G3) comprised the offspring of the second generation. Longitudinal assessments in this sample (7) and in similar 2-generation stu...