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Cortical Abnormalities in Adults & Adolescents with MDD
ENIGMA Major Depressive Disorder Working Group
MRI (Magnetic Resonance Imaging) studies done in MDD (Major Depression Disorder) implicated the cortical structural abnormalities in (para)limbic circuitry: Dorsomedial Prefrontal Cortex (PFC), Orbitofrontal Cortex (OFC) and (rostral) Anterior Cingulate Cortex (ACC).
But their are inconsistencies in these findings, due to differences in:
- data acquisition protocols and processing and
- statistical analyses performed.
This is the largest coordinated worldwide meta-analysis of cortical structural abnormalities in patients diagnosed with MDD relative to healthy controls.
n= 2148 MDD patients and 7957 healthy individuals.
* findings of lower cortical thickness in medial PFC and ACC are consistent with prior meta-analyses.
* findings extend previous findings by demonstrating structural abnormalities in the temporal lobe (middle and inferior temporal and fusiform gyri), posterior cingulate cortex and insula.
* These effects were most pronounced in: first episode and adult onset patients.
* Adolescents with MDD (compared to matched controls) had lower total surface area (but no difference in cortical thickness)
* Adolescents with MDD (compared to matched controls) had regional reductions: medial OFC, superior frontal gyrus, primary and higher order visual, somatosensory and motor areas.
* Highest effect found in recurrent adolescent patients.
* Medial OFC was consistently implicated across analyses—in adults, adolescents and analyses of clinical correlations.
* Cortical thickness measurements showed greater differences than surface area measures in adult MDD, but consistent surface area deficits were found in adolescent MDD.
These findings suggests that MDD may impact brain structure in a highly dynamic way, with different patterns of alterations at different stages of life
Source: Schmaal L et al., Mol Psychiatry. 2016 May 3.
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