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Hippocampal and left subcallosal anterior cingulate atrophy in psychotic depression.

Bijanki KR, Hodis B, Brumm MC, Harlynn EL, McCormick LM - PLoS ONE (2014)

Bottom Line: The volumes of these regions were compared between groups.Hippocampal atrophy was found in all patients with psychotic depression, but reduced left scACC volume was found only in the patients with a family history of depression.Patients with psychotic depression showed significant reduction in hippocampal volume bilaterally, perhaps due to high cortisol states associated with this illness.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, United States of America.

ABSTRACT

Background: Psychotic depression is arguably the most diagnostically stable subtype of major depressive disorder, and an attractive target of study in a famously heterogeneous mental illness. Previous imaging studies have identified abnormal volumes of the hippocampus, amygdala, and subcallosal region of the anterior cingulate cortex (scACC) in psychotic depression, though studies have not yet examined the role of family history of depression in these relationships.

Methods: 20 participants with psychotic depression preparing to undergo electroconvulsive therapy and 20 healthy comparison participants (13 women and 7 men in each group) underwent structural brain imaging in a 1.5 T MRI scanner. 15 of the psychotic depression group had a first-degree relative with diagnosed affective disorders, while the healthy control group had no first-degree relatives with affective disorders. Depression severity was assessed with the Hamilton Depression Rating Scale and duration of illness was assessed in all patients. Automated neural nets were used to isolate the hippocampi and amygdalae in each scan, and an established manual method was used to parcellate the anterior cingulate cortex into dorsal, rostral, subcallosal, and subgenual regions. The volumes of these regions were compared between groups. Effects of laterality and family history of affective disorders were examined as well.

Results: Patients with psychotic depression had significantly smaller left scACC and bilateral hippocampal volumes, while no group differences in other anterior cingulate cortex subregions or amygdala volumes were present. Hippocampal atrophy was found in all patients with psychotic depression, but reduced left scACC volume was found only in the patients with a family history of depression.

Conclusions: Patients with psychotic depression showed significant reduction in hippocampal volume bilaterally, perhaps due to high cortisol states associated with this illness. Reduced left scACC volume may be a vulnerability factor related to family history of depression.

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Related in: MedlinePlus

Parcellations of the anterior cingulate cortex.Dorsal anterior cingulate cortex (ACC) shown in blue, rostral ACC in red, subcallosal ACC in green, subgenual ACC in yellow. Figure reprinted with permission from John Wiley and Sons, from McCormick et al., (2008), license number 3103240766914.
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pone-0110770-g001: Parcellations of the anterior cingulate cortex.Dorsal anterior cingulate cortex (ACC) shown in blue, rostral ACC in red, subcallosal ACC in green, subgenual ACC in yellow. Figure reprinted with permission from John Wiley and Sons, from McCormick et al., (2008), license number 3103240766914.

Mentions: An important terminological shift must be acknowledged in the literature on the ventral anterior cingulate. Early research on the anatomy and function of the area used the term “subgenual” to define the entirety of the ventral anterior cingulate cortex underlying the genu of the corpus callosum. In recent years, the term “subgenual” has been revised to include only a small volume of the posterior ventral ACC, also frequently termed “Brodmann Area 25” (Figure 1, yellow region). The anterior section of the ventral ACC, or ventral Brodmann Area 24 has since been termed “subcallosal” (Figure 1, green region). For example, decreased activity has been shown in the “subgenual cingulate” (identical to the subcallosal + subgenual cingulate as defined in the current study) in patients with familial unipolar major depressive disorder and that this decrease in activity corresponded with a 48% reduction in volume of the structure [18].


Hippocampal and left subcallosal anterior cingulate atrophy in psychotic depression.

Bijanki KR, Hodis B, Brumm MC, Harlynn EL, McCormick LM - PLoS ONE (2014)

Parcellations of the anterior cingulate cortex.Dorsal anterior cingulate cortex (ACC) shown in blue, rostral ACC in red, subcallosal ACC in green, subgenual ACC in yellow. Figure reprinted with permission from John Wiley and Sons, from McCormick et al., (2008), license number 3103240766914.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4206433&req=5

pone-0110770-g001: Parcellations of the anterior cingulate cortex.Dorsal anterior cingulate cortex (ACC) shown in blue, rostral ACC in red, subcallosal ACC in green, subgenual ACC in yellow. Figure reprinted with permission from John Wiley and Sons, from McCormick et al., (2008), license number 3103240766914.
Mentions: An important terminological shift must be acknowledged in the literature on the ventral anterior cingulate. Early research on the anatomy and function of the area used the term “subgenual” to define the entirety of the ventral anterior cingulate cortex underlying the genu of the corpus callosum. In recent years, the term “subgenual” has been revised to include only a small volume of the posterior ventral ACC, also frequently termed “Brodmann Area 25” (Figure 1, yellow region). The anterior section of the ventral ACC, or ventral Brodmann Area 24 has since been termed “subcallosal” (Figure 1, green region). For example, decreased activity has been shown in the “subgenual cingulate” (identical to the subcallosal + subgenual cingulate as defined in the current study) in patients with familial unipolar major depressive disorder and that this decrease in activity corresponded with a 48% reduction in volume of the structure [18].

Bottom Line: The volumes of these regions were compared between groups.Hippocampal atrophy was found in all patients with psychotic depression, but reduced left scACC volume was found only in the patients with a family history of depression.Patients with psychotic depression showed significant reduction in hippocampal volume bilaterally, perhaps due to high cortisol states associated with this illness.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, United States of America.

ABSTRACT

Background: Psychotic depression is arguably the most diagnostically stable subtype of major depressive disorder, and an attractive target of study in a famously heterogeneous mental illness. Previous imaging studies have identified abnormal volumes of the hippocampus, amygdala, and subcallosal region of the anterior cingulate cortex (scACC) in psychotic depression, though studies have not yet examined the role of family history of depression in these relationships.

Methods: 20 participants with psychotic depression preparing to undergo electroconvulsive therapy and 20 healthy comparison participants (13 women and 7 men in each group) underwent structural brain imaging in a 1.5 T MRI scanner. 15 of the psychotic depression group had a first-degree relative with diagnosed affective disorders, while the healthy control group had no first-degree relatives with affective disorders. Depression severity was assessed with the Hamilton Depression Rating Scale and duration of illness was assessed in all patients. Automated neural nets were used to isolate the hippocampi and amygdalae in each scan, and an established manual method was used to parcellate the anterior cingulate cortex into dorsal, rostral, subcallosal, and subgenual regions. The volumes of these regions were compared between groups. Effects of laterality and family history of affective disorders were examined as well.

Results: Patients with psychotic depression had significantly smaller left scACC and bilateral hippocampal volumes, while no group differences in other anterior cingulate cortex subregions or amygdala volumes were present. Hippocampal atrophy was found in all patients with psychotic depression, but reduced left scACC volume was found only in the patients with a family history of depression.

Conclusions: Patients with psychotic depression showed significant reduction in hippocampal volume bilaterally, perhaps due to high cortisol states associated with this illness. Reduced left scACC volume may be a vulnerability factor related to family history of depression.

Show MeSH
Related in: MedlinePlus