From the Journals

White matter volume reduced in first-episode depression

Decrements ‘seem to vanish’ after 2-year follow-up


 

FROM THE JOURNAL OF AFFECTIVE DISORDERS

White matter volume was significantly reduced initially in patients with first-episode depression, but not after a 2-year follow-up, according to Mar Carceller-Sindreu, MD, of the department of psychiatry at Hospital de la Santa Creu i Sant Pau in Barcelona, and her associates.

A total of 33 patients with first-episode depression and 33 healthy controls were included in the study. Among them, 27 first-episode depression patients and 17 controls completed the 2-year follow-up. They underwent structural MRIs at baseline and at follow-up, the Hamilton Depressive Rating Scale was administered throughout the study period, and whole-brain, voxel-based morphometry was used to measure white matter and gray matter, Dr. Carceller-Sindreu and her associates wrote. The report is in the Journal of Affective Disorders.

At baseline, the white matter volume in the prefrontal cortex of patients with first-episode depression was significantly lower than in healthy controls; no difference was seen in gray matter volume. At the 2-year follow-up, no difference was seen in either white matter or gray matter volume. In other words, the baseline differences “seem to vanish, as if they were normalized,” Dr. Carceller-Sindreu said. The normalization of white matter might have been caused by treatment normalization or attributable to lack of study power, she and her associates noted.

In addition, patients who had recurring depression over the study period had higher white matter volume in the left posterior corona radiata and right posterior thalamic radiation at follow-up, compared with patients whose depression did not recur. This finding “could represent compensatory effects to cope with the disease,” the investigators wrote.

In future studies, larger and longer follow-up of [first-episode depression] patients should be performed, so as to unveil many of the open questions,” they concluded.

The study was supported by the Spanish FIS grant, the European Regional Development Fund, and the CERCA Programme. Two study authors reported conflicts of interest with numerous pharmaceutical companies.

SOURCE: Carceller-Sindreu M et al. J Affect Disord. 2018 Nov 13. doi: 10.1016/j.jad.2018.11.085.

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