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Cortical Abnormalities in Adults & Adolescents with MDD

FORUM FOR PSYCHIATRY RESIDENTS :: Psychiatry :: Psychiatry-Neurology-Psychology discussion :: Neuroanatomy

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Cortical Abnormalities in Adults & Adolescents with MDD Empty Cortical Abnormalities in Adults & Adolescents with MDD

Post  Admin Sun Jul 03, 2016 12:59 pm

Cortical Abnormalities in Adults & Adolescents with MDD
ENIGMA Major Depressive Disorder Working Group

Cortical Abnormalities in Adults & Adolescents with MDD Molecu10


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.

Results:

* 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.

Conclusions:

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.
Full PDF available here:
http://www.nature.com/mp/journal/vaop/ncurrent/pdf/mp201660a.pdf
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