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Brain structural correlates of recurrence following the first episode in patients with major depressive disorder. | LitMetric

AI Article Synopsis

  • This study investigated how brain structure changes over time in patients with first-episode depression (FED) and compared them to healthy controls, focusing on areas like the dorsolateral prefrontal cortex (DLPFC), insula, and hippocampus.
  • Researchers categorized FED patients based on whether they experienced a relapse during the follow-up period, finding that those with recurrence had significant reductions in gray matter volume in the DLPFC and insula compared to those who remained in remission.
  • The results highlight that even early in the course of Major Depressive Disorder, structural brain changes linked to recurrence can occur, underscoring the need for early interventions to prevent future episodes.

Article Abstract

Former prospective studies showed that the occurrence of relapse in Major Depressive Disorder (MDD) is associated with volume loss in the insula, hippocampus and dorsolateral prefrontal cortex (DLPFC). However, these studies were confounded by the patient's lifetime disease history, as the number of previous episodes predict future recurrence. In order to analyze neural correlates of recurrence irrespective of prior disease course, this study prospectively examined changes in brain structure in patients with first-episode depression (FED) over 2 years. N = 63 FED patients and n = 63 healthy controls (HC) underwent structural magnetic resonance imaging at baseline and after 2 years. According to their disease course during the follow-up interval, patients were grouped into n = 21 FED patients with recurrence (FEDrec) during follow-up and n = 42 FED patients with stable remission (FEDrem). Gray matter volume changes were analysed using group by time interaction analyses of covariance for the DLPFC, hippocampus and insula. Significant group by time interactions in the DLPFC and insula emerged. Pairwise comparisons showed that FEDrec had greater volume decline in the DLPFC and insula from baseline to follow-up compared with FEDrem and HC. No group by time interactions in the hippocampus were found. Cross-sectional analyses at baseline and follow-up revealed no differences between groups. This longitudinal study provides evidence for neural alterations in the DLPFC and insula related to a detrimental course in MDD. These effects of recurrence are already detectable at initial stages of MDD and seem to occur without any prior disease history, emphasizing the importance of early interventions preventing depressive recurrence.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420111PMC
http://dx.doi.org/10.1038/s41398-022-02113-7DOI Listing

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