Structural brain changes in patients with recurrent major depressive disorder presenting with anxiety symptoms.

Background And Purpose: Major depressive disorder (MDD) presents with extensive clinical heterogeneity. In particular, overlap with anxiety symptoms is common during depressive episodes and as a comorbid disorder. The aim of this study was to test for morphological brain differences between patients having a history of recurrent MDD with, and without, anxiety symptoms (MDD+A and MDD-A).

Methods: T1-weighted magnetic resonance images of age-, gender- and ethnically matched groups of MDD+A (n= 49) and MDD-A (n= 96) patients were available for voxel-based morphometry analysis of regional gray matter (GM) volume differences. Brain structural images were also contrasted with 183 age-, gender-, and ethnicity-matched healthy controls.

Results: MDD+A patients had greater GM volume (P(FWE) = .002) than MDD-A patients in the right temporal cortex extending from the mid-posterior superior temporal gyrus into the posterior middle and inferior temporal gyrus. The MDD patients together showed lower GM volume than healthy controls in the superior parietal lobe.

Conclusions: Regional volume differences in patients are consistent with altered neuronal or glial microstructure. The temporolateral cortical differences distinguishing the 2 MDD groups suggest neurobiological differences related to the expression of anxiety symptoms in depression and provide further rationale for considering these groups independently for therapeutic outcomes studies.