The Course of Disease in Major Depressive Disorder Is Associated With Altered Activity of the Limbic System During Negative Emotion Processing

Lemke, Hannah; Probst, Stefanie; Warneke, Antonia; Waltemate, Lena; Winter, Alexandra; Thiel, Katharina; Meinert, Susanne; Enneking, Verena; Breuer, Fabian; Klug, Melissa; Goltermann, Janik; Hülsmann, Carina; Grotegerd, Dominik; Redlich, Ronny; Dohm, Katharina; Leehr, Elisabeth J.; Repple, Jonathan; Meller, Tina; Pfarr, Julia‐Katharina; Ringwald, Kai G.; Schmitt, Simon; Stein, Frederike; Krug, Axel; Jansen, Andreas; Nenadić, Igor; Kircher, Tilo; Hahn, Tim; Dannlowski, Udo

doi:10.1016/j.bpsc.2021.05.008

Cited by 10 publications

(13 citation statements)

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“…Employing a PCA approach to characterize disease course, our study confirmed a two-component structure with Duration of Illness and Hospitalization as previously described in two studies (Lemke et al, 2021;Zaremba et al, 2018b). The component Duration of Illness showed a negative correlation with left hippocampus and right DLPFC GMVs.…”

Section: Discussionsupporting

confidence: 86%

“…In an independent sample of acutely depressed in‐patients, the authors found reduced hippocampal, temporal and frontal volumes in association with higher Hospitalization scores and reduced insula volumes related to higher Duration of Illness scores. These components have been further replicated in a recent task‐based functional neuroimaging study, reporting that reduced hippocampal and insula activation during negative emotion processing were linked to higher lifetime Hospitalization scores (Lemke et al, 2021).…”

Section: Introductionmentioning

confidence: 71%

“…(1) To find a similar two-component structure with Hospitalization and Duration of Illness characterizing lifetime disease course by employing a PCA (Lemke et al, 2021;Zaremba et al, 2018b).…”

Section: Introductionmentioning

confidence: 99%

“…We included currently depressed and remitted patients as well as first‐episode and recurrent patients to ensure sufficient sample heterogeneity regarding disease course. We expected the following: To find a similar two‐component structure with Hospitalization and Duration of Illness characterizing lifetime disease course by employing a PCA (Lemke et al, 2021; Zaremba et al, 2018b). Based on former literature that the hippocampus, insula and DLPFC are specifically related to disease progression in cross‐sectional and longitudinal studies (Frodl et al, 2008; Schmaal et al, 2017; Zaremba et al, 2018a, 2018b), we expected negative associations between component scores and GMV reductions in these three brain areas employing a regions of interest (ROI) approach.…”

Section: Introductionmentioning

confidence: 99%

“…The second component accounted for 25.59% of the variance and was associated with time since first psychiatric symptoms, and number and duration of lifetime depressive episodes. Relating to both previous studies, the first component was termed Hospitalization and the second component Duration of Illness(Lemke et al, 2021;Zaremba et al, 2018b).…”

mentioning

confidence: 99%

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Association of disease course and brain structural alterations in major depressive disorder

Lemke

Romankiewicz

Förster

et al. 2022

Depression and Anxiety

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Introduction The investigation of disease course‐associated brain structural alterations in Major Depressive Disorder (MDD) have resulted in heterogeneous findings, possibly due to low reliability of single clinical variables used for defining disease course. The present study employed a principal component analysis (PCA) on multiple clinical variables to investigate effects of cumulative lifetime illness burden on brain structure in a large and heterogeneous sample of MDD patients. Methods Gray matter volumes (GMV) was estimated in n = 681 MDD patients (mean age: 35.87 years; SD = 12.89; 66.6% female) using voxel‐based‐morphometry. Five clinical variables were included in a PCA to obtain components reflecting disease course to associate resulting components with GMVs. Results The PCA yielded two main components: Hospitalization reflected by patients' frequency and duration of inpatient treatment and Duration of Illness reflected by the frequency and duration of depressive episodes. Hospitalization revealed negative associations with bilateral dorsolateral prefrontal cortex (DLPFC) and left insula volumes. Duration of Illness showed significant negative associations with left hippocampus and right DLPFC volumes. Results in the DLPFC and hippocampus remained significant after additional control for depressive symptom severity, psychopharmacotherapy, psychiatric comorbidities, and remission status. Conclusion This study shows that a more severe and chronic lifetime disease course in MDD is associated with reduced volume in brain regions relevant for executive and cognitive functions and emotion regulation in a large sample of patients representing the broad heterogeneity of MDD disease course. These findings were only partly influenced by other clinical characteristics (e.g., remission status, psychopharmacological treatment).

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%