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Altered white-matter architecture in treatment-naive adolescents with clinical depression

Published online by Cambridge University Press:  16 December 2013

M. Aghajani*
Affiliation:
Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, The Netherlands Leiden Institute for Brain and Cognition (LIBC), The Netherlands
I. M. Veer
Affiliation:
Leiden Institute for Brain and Cognition (LIBC), The Netherlands Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Charité Universitätsmedizin, Berlin, Germany
N. D. J. van Lang
Affiliation:
Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, The Netherlands Leiden Institute for Brain and Cognition (LIBC), The Netherlands
P. H. F. Meens
Affiliation:
Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, The Netherlands
B. G. van den Bulk
Affiliation:
Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, The Netherlands Leiden Institute for Brain and Cognition (LIBC), The Netherlands Institute of Psychology, Leiden University, The Netherlands
S. A. R. B. Rombouts
Affiliation:
Leiden Institute for Brain and Cognition (LIBC), The Netherlands Institute of Psychology, Leiden University, The Netherlands Department of Radiology, Leiden University Medical Center, The Netherlands
R. R. J. M. Vermeiren
Affiliation:
Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, The Netherlands Leiden Institute for Brain and Cognition (LIBC), The Netherlands
N. J. van der Wee
Affiliation:
Leiden Institute for Brain and Cognition (LIBC), The Netherlands Department of Psychiatry, Leiden University Medical Center, The Netherlands
*
*Address for correspondence: M. Aghajani, M.Sc., Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, PO Box 15, 2300 AA Leiden, The Netherlands. (Email: M.Aghajani@curium.nl)

Abstract

Background

Depressive disorders are highly prevalent in adolescence and confer a heightened risk of recurrence in adulthood. Insight into the developmental neurocircuitry of depression could advance our understanding of depression and aid the development of effective treatment strategies. Whereas white-matter (WM) abnormalities are strongly implicated in adult depression, we still lack a firm understanding of WM architecture in adolescent depression. Using diffusion tensor imaging (DTI), we set out to investigate WM microstructure in a sample of clinically depressed adolescents relative to matched controls.

Method

We employed tract-based spatial statistics (TBSS) to examine WM microstructure in 25 treatment-naive adolescents with clinical depression relative to 21 matched controls. Using TBSS, we examined fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD). Threshold-free cluster enhancement (TFCE) with family-wise error (FWE) correction was used to control for multiple comparisons.

Results

Our analysis revealed abnormal WM microstructure in clinically depressed adolescents. More specifically, whole-brain analysis revealed that patients had lower FA values in the body of the corpus callosum (CC), coupled with elevated RD and MD, and preserved AD. Conversely, region-of-interest analysis revealed that patients had higher FA values in the uncinate fasciculus (UF), coupled with elevated AD, reduced RD and preserved MD.

Conclusions

In line with neurocircuitry models of depression, our findings suggest that WM abnormalities within pathways facilitating cognitive and emotional functioning are involved in the pathophysiology of depression. Importantly, our findings show that these WM abnormalities are already present early in the course of the disorder.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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