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9 - Structural imaging of major depression

from Section II - Mood Disorders

Published online by Cambridge University Press:  10 January 2011

Anand Kumar
Affiliation:
Department of Psychiatry University of Illinois at Chicago Chicago, IL, USA
Olusola Ajilore
Affiliation:
Department of Psychiatry University of Illinois at Chicago Chicago, IL, USA
Martha E. Shenton
Affiliation:
VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School
Bruce I. Turetsky
Affiliation:
University of Pennsylvania
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Summary

Introduction

An important step in our understanding of the pathophysiology of mood disorders has been made with the advent of neuroimaging. Studies exploring structural changes in the brain associated with unipolar major depression have identified key regions that may underlie the pathogenesis, course, and prognosis of major depression. This chapter will review structural imaging findings in major depression focusing on MRI methodologies such as volumetric analysis, shape analysis, magnetization transfer, and diffusion tensor imaging. We will first examine morphological changes associated with major depression. Then we will discuss white matter changes such as signal hyperintensities and microstructural alterations identified by novel MR-based techniques. We will also explore the pathological and cognitive correlates, as well as the clinical significance of these structural findings.

Cerebral cortex

Initial studies showing neuroanatomical changes associated with major depression explored global cortical alterations, typically characterized by evidence of volume loss. An early qualitative study demonstrating cortical changes showed greater cerebral sulcal and temporal sulcal atrophy in addition to larger ventricles (Rabins et al., 1991). Global gray matter volume losses have been associated with major depression and correlated with clinical variables, such as illness duration (Lampe et al.., 2003).

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