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Quantitative Cerebral Anatomy in Depression: A Controlled Magnetic Resonance Imaging Study

Quantitative Cerebral Anatomy in Depression: A Controlled Magnetic Resonance Imaging Study Abstract • Magnetic resonance imaging was used to examine cerebral anatomy in 48 inpatients with severe depression who were referred for electroconvulsive therapy and in 76 normal control subjects. The magnetic resonance imaging measures included determinations of regional cerebral volumes and ratings of the frequency and severity of cortical atrophy, lateral ventricular enlargement, and subcortical hyperintensity. The mean total frontal lobe volume was found to be 7% smaller in the inpatients with severe depression (235.88 mL) than in the normal control subjects (254.32 mL)—a difference that was statistically significant even after adjusting for the effects of age, sex, education, and intracranial size. No group differences were observed in the volumes of the cerebral hemispheres, the temporal lobes, or the amygdala-hippocampal complex, nor in the frequency of cortical atrophy. Neither did the groups differ with respect to the total volumes of the lateral and third ventricles, nor in the frequency of lateral ventricular enlargement. Patients with depression had a significantly higher frequency of subcortical hyperintensity in the periventricular white matter, with an odds ratio of 5.32. References 1. Shelton RC, Weinberger DR. X-ray computerized tomography studies in schizophrenia: a review and synthesis . In: Nasrallah HA, Weinberger DR, eds. The Neurology of Schizophrenia. Handbook of Schizophrenia . Amsterdam, the Netherlands: Elsevier Science Publishers; 1986;1:207-250. 2. Kelsoe JR, Cadet JL, Pickar D, Weinberger DR. Quantitative neuroanatomy in schizophrenia: a controlled magnetic resonance imaging study . Arch Gen Psychiatry . 1988;45:533-541.Crossref 3. Suddath RC, Casanova MF, Goldberg TE, Daniel DG, Kelsoe JR, Weinberger DR. Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study . Am I Psychiatry . 1989;146:464-472. 4. Gur RE, Mozley PD, Resnick SM, Shatsel D, Kuhn M, Zimmerman R, Herman G, Atlas S, Grossman R, Erwin R, Gur RC. Magnetic resonance imaging in schizophrenia, I: volumetric analysis of brain and cerebrospinal fluid . Arch Gen Psychiatry . 1991;48:407-412.Crossref 5. Pfefferbaum A, Lim KO, Rosenbloom M, Zipursky RB. Brain magnetic resonance imaging: approaches for investigating schizophrenia . Schizophr Bull . 1990;16:453-476.Crossref 6. Andreasen NC, Ehrhardt JC, Swayze VW, Alliger RJ, Yuh WTC, Cohen G, Ziebell S. Magnetic resonance imaging of the brain in schizophrenia: the pathophysiologic significance of structural abnormalities . Arch Gen Psychiatry . 1990;47:35-44.Crossref 7. Nasrallah HA, Coffman JA, Olson SC. Structural brain-imaging findings in affective disorders: an overview . I Neuropsychiatry Clin Neurosci . 1989;1:21-26. 8. Jeste DV, Lohr JB, Goodwin FK. Neuroanatomical studies of major affective disorders: a review and suggestions for further research . Br J Psychiatry . 1988;153:444-459.Crossref 9. Rabins PV, Pearlson GD, Aylward E, Kumar A), Dowell K. Cortical magnetic resonance imaging changes in elderly inpatients with major depression . Am J Psychiatry . 1991;148:617-620. 10. Beeson JAO, Henderson JG, Foreman El, Smith FW. An NMR study of lithium-responding manic-depressive patients . Magn Reson Imaging . 1987;5:273-277.Crossref 11. Johnstone EC, Owens DCG, Crow TJ, Frith CD, Alexandropolis K, Bydder G, Colter N. Temporal lobe structure as determined by nuclear magnetic resonance in schizophrenia and bipolar affective disorder . J Neurol Neurosurg Psychiatry . 1989;52:736-741.Crossref 12. Swayze VW, Andreasen NC, Alliger RJ, Ehrhardt JC, Yuh WTC. Structural brain abnormalities in bipolar affective disorder: ventricular enlargement and focal signal hyperintensities . Arch Gen Psychiatry . 1990;47:1054-1059.Crossref 13. Lesser IM, Miller BL, Boone KB, Hill-Gutierrez E, Mehringer CM, Wang K, Mena I. Brain injury and cognitive function in late-onset psychotic depression . J Neuropsychiatry Clin Neurosci . 1991;3:33-40. 14. Lewine RRJ, Risch SC, Risby E, Stipetic M, Jewar TRD, Eccard M, Candle J, Pollard W. Lateral ventricle-brain ratio and balance between CSF HVA and 5-HIAA in schizophrenia . Am I Psychiatry . 1991;148:1189-1194. 15. Hauser P, Altshuler LL, Berrettini W, Dauphinais ID, Gelernter J, Post RM. Temporal lobe measurement in primary affective disorder by magnetic resonance imaging . J Neuropsychiatry Clin Neurosci . 1989;1:128-134. 16. Altshuler LL, Conrad A, Hauser P, Li X, Guze BH, Denikoff K, Tour- tellotte W, Post RM. Reduction of temporal lobe volume in bipolar disorder: a preliminary report of magnetic resonance imaging . Arch Gen Psychiatry . 1991;48:482-483.Crossref 17. Coffman JA, Bornstein RA, Olson SC, Schwarzkopf SB, Nasrallah HA. Cognitive impairment and cerebral structure by MRI in bipolar disorder . Biol Psychiatry . 1990;27:1188-1196.Crossref 18. Hauser R, Dauphinais ID, Berrettini W, Delisi LE, Gelernter J, Post RM. Corpus callosum dimensions measured by magnetic resonance imaging in bipolar affective disorder and schizophrenia . Biol Psychiatry . 1989;26:659-668.Crossref 19. Lammers CH, Doraiswamy PM, Husain MM, Figiel GS, Lurie SN, Boyko OB, Ellinwood EH, Nemeroff CB, Krishnan KRR. MRI of corpus callosum and septum pellucidum in depression . Biol Psychiatry . 1991;29:300-301.Crossref 20. Coffey CE, Figiel GS, Djang WT, Saunders WB, Weiner RD. Subcortical white matter hyperintensity on magnetic resonance imaging: clinical and neuroanatomic correlates in the depressed elderly . J Neuropsychiatry Clin Neurosci . 1989;1:135-144. 21. Coffey CE, Figiel GS, Djang WT, Weiner RD. Subcortical hyperintensity on magnetic resonance imaging: a comparison of normal and depressed elderly subjects . 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American Medical Association
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Copyright © 1993 American Medical Association. All Rights Reserved.
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0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1993.01820130009002
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Abstract

Abstract • Magnetic resonance imaging was used to examine cerebral anatomy in 48 inpatients with severe depression who were referred for electroconvulsive therapy and in 76 normal control subjects. The magnetic resonance imaging measures included determinations of regional cerebral volumes and ratings of the frequency and severity of cortical atrophy, lateral ventricular enlargement, and subcortical hyperintensity. The mean total frontal lobe volume was found to be 7% smaller in the inpatients with severe depression (235.88 mL) than in the normal control subjects (254.32 mL)—a difference that was statistically significant even after adjusting for the effects of age, sex, education, and intracranial size. No group differences were observed in the volumes of the cerebral hemispheres, the temporal lobes, or the amygdala-hippocampal complex, nor in the frequency of cortical atrophy. Neither did the groups differ with respect to the total volumes of the lateral and third ventricles, nor in the frequency of lateral ventricular enlargement. Patients with depression had a significantly higher frequency of subcortical hyperintensity in the periventricular white matter, with an odds ratio of 5.32. References 1. Shelton RC, Weinberger DR. X-ray computerized tomography studies in schizophrenia: a review and synthesis . In: Nasrallah HA, Weinberger DR, eds. The Neurology of Schizophrenia. Handbook of Schizophrenia . Amsterdam, the Netherlands: Elsevier Science Publishers; 1986;1:207-250. 2. Kelsoe JR, Cadet JL, Pickar D, Weinberger DR. Quantitative neuroanatomy in schizophrenia: a controlled magnetic resonance imaging study . Arch Gen Psychiatry . 1988;45:533-541.Crossref 3. Suddath RC, Casanova MF, Goldberg TE, Daniel DG, Kelsoe JR, Weinberger DR. Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study . Am I Psychiatry . 1989;146:464-472. 4. Gur RE, Mozley PD, Resnick SM, Shatsel D, Kuhn M, Zimmerman R, Herman G, Atlas S, Grossman R, Erwin R, Gur RC. Magnetic resonance imaging in schizophrenia, I: volumetric analysis of brain and cerebrospinal fluid . Arch Gen Psychiatry . 1991;48:407-412.Crossref 5. Pfefferbaum A, Lim KO, Rosenbloom M, Zipursky RB. Brain magnetic resonance imaging: approaches for investigating schizophrenia . Schizophr Bull . 1990;16:453-476.Crossref 6. Andreasen NC, Ehrhardt JC, Swayze VW, Alliger RJ, Yuh WTC, Cohen G, Ziebell S. Magnetic resonance imaging of the brain in schizophrenia: the pathophysiologic significance of structural abnormalities . Arch Gen Psychiatry . 1990;47:35-44.Crossref 7. Nasrallah HA, Coffman JA, Olson SC. Structural brain-imaging findings in affective disorders: an overview . I Neuropsychiatry Clin Neurosci . 1989;1:21-26. 8. Jeste DV, Lohr JB, Goodwin FK. Neuroanatomical studies of major affective disorders: a review and suggestions for further research . Br J Psychiatry . 1988;153:444-459.Crossref 9. Rabins PV, Pearlson GD, Aylward E, Kumar A), Dowell K. Cortical magnetic resonance imaging changes in elderly inpatients with major depression . Am J Psychiatry . 1991;148:617-620. 10. Beeson JAO, Henderson JG, Foreman El, Smith FW. An NMR study of lithium-responding manic-depressive patients . Magn Reson Imaging . 1987;5:273-277.Crossref 11. Johnstone EC, Owens DCG, Crow TJ, Frith CD, Alexandropolis K, Bydder G, Colter N. Temporal lobe structure as determined by nuclear magnetic resonance in schizophrenia and bipolar affective disorder . J Neurol Neurosurg Psychiatry . 1989;52:736-741.Crossref 12. Swayze VW, Andreasen NC, Alliger RJ, Ehrhardt JC, Yuh WTC. Structural brain abnormalities in bipolar affective disorder: ventricular enlargement and focal signal hyperintensities . Arch Gen Psychiatry . 1990;47:1054-1059.Crossref 13. 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Archives of General PsychiatryAmerican Medical Association

Published: Jan 1, 1993

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