Quantitative MRI of the hippocampus and amygdala in severe depression

Department of Clinical Neurophysiology, University Hospital of Kuopio, Finland.
Psychological Medicine (Impact Factor: 5.94). 02/2000; 30(1):117-25.
Source: PubMed


There is little evidence to support possible structural changes in the amygdala and hippocampus of patients with severe depression.
Quantitative MRI of the amygdala and hippocampus, as well as proton spectroscopy (MRS) of mesial temporal structures were studied in 34 drug-resistant in-patients with major depression and compared with 17 age-matched controls. Volumetric MRI data were normalized for brain size.
The volume of the left hippocampus was significantly smaller in the patients compared with the controls. Both groups exhibited similar significant hippocampal asymmetry (left smaller than right). The patients, but not the controls, had significant asymmetry of the amygdalar volumes (right smaller than left). No differences were observed between the patients and controls in the T2 relaxation times for the hippocampus and amygdala. Mesial temporal lobe MRS revealed a significantly elevated choline/creatine ratio in the patients compared with the controls.
This quantitative MRI study provides support for a possible association between structural and biochemical substrates and severe drug-resistant major depression.

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    • "Several neuroimaging studies increasingly described that reduced hippocampal volume is present in subjects suffering from Major Depressive Disorder (MDD) (Sheline et al., 1996; Bremner et al., 2000; Mervaala et al., 2000; Steffens et al., 2000; MacQueen et al., 2003). However, findings can vary significantly across studies and, consequently, it is still unclear if smaller volume of the hippocampal formation can be considered a neurobiological signature of depression. "
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    ABSTRACT: Several neuroimaging studies report reduced hippocampal volume in depressed patients. However, it is still unclear if hippocampal changes in healthy individuals can be considered a risk factor for progression to clinical depression. Here, we investigated subclinical depression and its hippocampal correlates in a non-clinical sample of healthy individuals, with particular regard to gender differences. One-hundred-two participants underwent a comprehensive clinical assessment, a high-resolution T1-weighted magnetic resonance imaging and diffusion tensor imaging protocol using a 3T MRI scanner. Data of macro-(volume) and micro-(mean diffusivity, MD) structural changes of the hippocampus were analyzed with reference to the Beck Depression Inventory score. Results of multivariate regression analyses revealed reduced bilateral volume, along with increased bilateral MD in hippocampal formation predicting subclinical depressive phenomenology only in healthy males. Conversely, subclinical depressive phenomenology in healthy female was accounted for by only lower educational level, in the absence of any hippocampal structure variations. To date, this is the only evidence reporting a relationship between subclinical depressive phenomenology and changes in hippocampal formation in healthy individuals. Our findings demonstrated that reduced volume, along with increased MD in hippocampal formation, is significantly associated with subclinical depressive phenomenology in healthy males. This encourages to study the hypothesis that early macro- and microstructural changes in hippocampi associated with subclinical depression may constitute a risk factor of developing depressive disorders in males.
    Full-text · Article · Jun 2013 · Journal of Affective Disorders
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    • "During acute stressors, the amygdala (and related subcortical structures) orchestrate the brain's rapid fight or flight response [23], which can be adaptive in some contexts but repeated, excessive, or prolonged stress responses (including amygdala reactivity) are thought to place organisms at risk for a broad range of stress-related diseases [25], [26], [27], [28]. Indeed, the amygdala has been shown to be a key player in mental and emotional health, with abnormal amygdala function identified in depression, anxiety, posttraumatic stress disorder, phobias, and panic disorders [27], [28], [29], [30], [31], [32], [33]. And moreover, some recent work suggests that reductions in perceived stress covary with reduced amygdala gray matter density [34]. "
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    ABSTRACT: Mindfulness, a psychological process reflecting attention and awareness to what is happening in the present moment, has been associated with increased well-being and decreased depression and anxiety in both healthy and patient populations. However, little research has explored underlying neural pathways. Recent work suggests that mindfulness (and mindfulness training interventions) may foster neuroplastic changes in cortico-limbic circuits responsible for stress and emotion regulation. Building on this work, we hypothesized that higher levels of dispositional mindfulness would be associated with decreased grey matter volume in the amgydala. In the present study, a self-report measure of dispositional mindfulness and structural MRI images were obtained from 155 healthy community adults. Volumetric analyses showed that higher dispositional mindfulness is associated with decreased grey matter volume in the right amygdala, and exploratory analyses revealed that higher dispositional mindfulness is also associated with decreased grey matter volume in the left caudate. Moreover, secondary analyses indicate that these amygdala and caudate volume associations persist after controlling for relevant demographic and individual difference factors (i.e., age, total grey matter volume, neuroticism, depression). Such volumetric differences may help explain why mindful individuals have reduced stress reactivity, and suggest new candidate structural neurobiological pathways linking mindfulness with mental and physical health outcomes.
    Full-text · Article · May 2013 · PLoS ONE
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    • "We hypothesized that assessment of local morphological changes in the brain might serve as an auxiliary diagnostic method for MDD. Using a voxel-based specific regional analysis system for Alzheimer’s disease (VSRAD® plus, Eisai Co, Ltd, Tokyo, Japan), which was developed based on the voxel-based morphometry method and is now freely available,1–4 we investigated the subgenual anterior cingulate cortex (sACC), amygdala, hippocampus, and prefrontal area, reported to be associated with MDD in earlier studies,5–23 and made the following observations. Atrophy of the sACC was noted in 65 of 71 MDD patients, and the prevalence was higher than that observed in the hippocampus, amygdala, and prefrontal area (in 35, 21, and 20 patients, respectively). "
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    ABSTRACT: Despite being a very common psychiatric disorder, physicians often have difficulty making a diagnosis of major depressive disorder (MDD) because, without established diagnostic criteria, they have to depend on interviews with patients and observation to assess psychiatric symptoms. However, previous researchers have reported that magnetic resonance imaging (MRI) scans identify morphological changes in the brains of patients with MDD, which inspired us to hypothesize that assessment of local changes in the brain using voxel-based morphometry would serve as an auxiliary diagnostic method for MDD. Therefore, we focused on the VSRAD(®) plus (voxel-based specific regional analysis system for Alzheimer's disease), a diagnostic support system for use in early Alzheimer's disease, which allowed us to identify regional atrophy in the brain easily based on images obtained from MRI scans. The subjects were 75 patients with MDD, 15 with bipolar disorder, and 30 healthy subjects, aged 54-82 years. First, 1.5 T MRI equipment was used to scan three-dimensional T(1)-weighted images for the individual subjects, and the imaged data were analyzed by VSRAD advance (voxel-based morphometric software developed for diagnosis of early Alzheimer's disease). The efficacy of the equipment for diagnosis of MDD was evaluated based on the distribution of atrophy in the subgenual anterior cingulate cortex (sACC) on the z-score map obtained. No significant difference in atrophy was noted between the left and right sACCs. The VSRAD advance used in the present study was more effective than the VSRAD plus for diagnosis of MDD, with a sensitivity of 90.7%, specificity of 86.7%, accuracy of 89.5%, a positive predictive value of 94.4%, and a negative predictive value of 78.8%. In particular, atrophy was observed in the subcallosal area of the sACC. The identification of atrophy in the sACC, in particular of the subcallosal area, with the use of updated voxel-based morphometric software proved to be effective as an auxiliary diagnostic method for MDD.
    Full-text · Article · Aug 2012 · International Journal of General Medicine
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