Alterations in the brainstem volume of patients with major depressive disorder and their relationship with antidepressant treatment

Kyu Man Han, Daseul Kim, Youngbo Sim, June Kang, Aram Kim, Eunsoo Won, Woo Suk Tae, Byung-Joo Ham

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Morphologic changes of the brainstem in major depressive disorder (MDD) have rarely been reported in neuroimaging studies, even though, monoaminergic neurotransmitters are synthesized in several brainstem regions. We aimed to investigate volume changes in each region of the brainstem and their association with antidepressant use or the remission status of MDD. Methods A total of 126 patients with MDD and 101 healthy controls underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of each brainstem region, including the medulla oblongata, pons, midbrain, and superior cerebellar peduncle, and the volume of the whole brainstem using the FreeSurfer. Results The patients with MDD had significantly greater midbrain volumes (P=0.013) compared to healthy controls. In particular, drug-naïve patients with MDD had significantly greater brainstem volumes compared to healthy controls (P=0.007), while no significant findings were observed between the antidepressant treatment group and healthy controls. The remitted patient group had reduced pons (P=0.002) and midbrain (P=0.005) volumes compared to healthy controls, while the non-remitted MDD patient group had significantly greater midbrain volumes compared to the healthy controls (P=0.017). Limitations We could not distinguish gray versus white matter volumes changes in our analysis. Conclusions We observed that the midbrain is enlarged in patients with a current depressive episode, who are not undergoing antidepressant treatment. This volume then returns to normal after antidepressant treatment, and is even reduced, when the patient is in remission. Further studies are needed to confirm our observations.

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalJournal of Affective Disorders
Volume208
DOIs
Publication statusPublished - 2017 Jan 15

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Major Depressive Disorder
Antidepressive Agents
Brain Stem
Mesencephalon
Pons
Therapeutics
Medulla Oblongata
Neuroimaging
Neurotransmitter Agents
Magnetic Resonance Imaging
Control Groups
Pharmaceutical Preparations

Keywords

  • Antidepressant
  • Brainstem
  • Major depressive disorder
  • Midbrain
  • Pons

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Alterations in the brainstem volume of patients with major depressive disorder and their relationship with antidepressant treatment. / Han, Kyu Man; Kim, Daseul; Sim, Youngbo; Kang, June; Kim, Aram; Won, Eunsoo; Tae, Woo Suk; Ham, Byung-Joo.

In: Journal of Affective Disorders, Vol. 208, 15.01.2017, p. 68-75.

Research output: Contribution to journalArticle

Han, Kyu Man ; Kim, Daseul ; Sim, Youngbo ; Kang, June ; Kim, Aram ; Won, Eunsoo ; Tae, Woo Suk ; Ham, Byung-Joo. / Alterations in the brainstem volume of patients with major depressive disorder and their relationship with antidepressant treatment. In: Journal of Affective Disorders. 2017 ; Vol. 208. pp. 68-75.
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AB - Background Morphologic changes of the brainstem in major depressive disorder (MDD) have rarely been reported in neuroimaging studies, even though, monoaminergic neurotransmitters are synthesized in several brainstem regions. We aimed to investigate volume changes in each region of the brainstem and their association with antidepressant use or the remission status of MDD. Methods A total of 126 patients with MDD and 101 healthy controls underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of each brainstem region, including the medulla oblongata, pons, midbrain, and superior cerebellar peduncle, and the volume of the whole brainstem using the FreeSurfer. Results The patients with MDD had significantly greater midbrain volumes (P=0.013) compared to healthy controls. In particular, drug-naïve patients with MDD had significantly greater brainstem volumes compared to healthy controls (P=0.007), while no significant findings were observed between the antidepressant treatment group and healthy controls. The remitted patient group had reduced pons (P=0.002) and midbrain (P=0.005) volumes compared to healthy controls, while the non-remitted MDD patient group had significantly greater midbrain volumes compared to the healthy controls (P=0.017). Limitations We could not distinguish gray versus white matter volumes changes in our analysis. Conclusions We observed that the midbrain is enlarged in patients with a current depressive episode, who are not undergoing antidepressant treatment. This volume then returns to normal after antidepressant treatment, and is even reduced, when the patient is in remission. Further studies are needed to confirm our observations.

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