Archival ReportCross-Sectional and Longitudinal Assessment of Structural Brain Alterations in Melancholic Depression
Section snippets
Subjects
We assessed 70 MDD patients (41 female) consecutively recruited from the Mood Disorders Unit of the Bellvitge University Hospital. All but three patients were right-handed according to the Edinburgh Inventory (21). The group comprised patients with a current depression episode fulfilling DMS-IV criteria for MDD with melancholic features and who required hospital admission for treatment. Patient diagnosis was independently confirmed by two senior psychiatrists (MU and NC) using the Structured
Global Volume Measurements
There were no significant differences in global gray and white matter volumes between patients and controls (see Supplement1, Table S2).
Cross-Sectional Analyses
Patients showed a significant gray matter volume reduction in left posterior insula (Figure 1A) and a white matter volume increase in the upper brainstem tegmentum, at the level of midbrain and rostral pons (Figure 1B; see also Supplement 1, note 1). These findings did not interact with gender or age.
Gender-Specific and Age-Related Effects
Male MDD patients exhibited a gray matter reduction in the
Discussion
We used a whole-brain imaging approach to characterize structural brain alterations in a large series of melancholic patients and identified regional volumetric alterations in gray and white matter. The most significant alterations were identified in regions not commonly assessed in studies of general MDD samples (i.e., insula and brainstem). Nevertheless, as discussed subsequently, such changes may relate to the clinical and neurobiological features of melancholia. We also described gender-
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