Research Article
Incidental findings of brain magnetic resonance imaging in patients with treatment-resistant depression
Abstract
Aim: In this study, incidental findings of brain magnetic resonance imaging (MRI) of patients diagnosed with treatment-resistant depression (TRD) were compared with healthy controls (HC).
Materials and Methods: The study included 68 patients with TRD (42 females, 26 males) and 72 HC (35 females, 37 males). Global assessment scale (GAS) was administered.
Results: In the TRD group, those with general cerebral atrophy were found to have significantly lower global assessment scale (GAS) scores (p<0.001). In the TRD group, those with cavum veli interpositi (CVI) were found to have significantly lower GAS scores (p=0.001). In the TRD group, when the effect of age was controlled, a significant correlation was found between the GAS score and the duration of the disorder (r=-0.400; p=0.001).
Conclusion: CVI, a neurodevelopmental abnormality, has been shown to be more common in patients diagnosed with TRD.
Keywords
magnetic resonance imaging Treatment-resistant major depressive disorder Incidental finding
Ethical Statement
Ethics committee approval was obtained from Adıyaman University for this study (Date of Decision: May 21, 2024; IRB Number: 2024/5-16). All procedures were utilized in accordance with the Declaration of Helsinki.
Supporting Institution
No financial support was received for this study.
Thanks
None.
References
- Greenberg PE, Fournier AA, Sisitsky T, et al. The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018). Pharmacoeconomics. 2021;39(6):653-665. doi: 10.1007/s40273-021-01019-4
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- Kessler RC, Berglund P, Demler O, Jin R, Merikingas KR, Walters EE. How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Arch Gen Psychiatry. 2005;62(7):593–602.
- Nihalani N, Simionescu M, Dunlop BW. Depression: phenomenology, epidemiology, and pathophysiology. In: Schwartz TL, Petersen T, eds. Depression: treatment strategies and management. Boca Raton, Florida, FL: CRC Press, 2016: 1–22.
- Malhi GS, Mann JJ. Depression. Lancet. 2018; 392: 2299–2312.
- Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013;10(11):e1001547. doi: 10.1371/journal.pmed.1001547
- Rybak YE, Lai KSP, Ramasubbu R, et al. Treatment‐resistant major depressive disorder: Canadian expert consensus on definition and assessment. Depress Anxiety. 2021;38:456–467.
- Zhdanava M, Pilon D, Ghelerter I, et al. The prevalence and national buren of treatment-resistant depression and major depressive disorder in the United States. J Clin Psychiatry. 2021;82(2):20m13699.
- Dunner DL, Rush AJ, Russell JM, et al. Prospective, long-term, multicenter study of the naturalistic outcomes of patients with treatment-resistant depression. J Clin Psychiatry. 2006;67(5):688-695. doi: 10.4088/jcp.v67n0501
- Sankar T, Chakravarty MM, Jawa N, et al. Neuroanatomical predictors of response to subcallosal cingulate deep brain stimulation for treatment-resistant depression. J Psychiatry Neurosci. 2020;45(1):45-54. doi: 10.1503/jpn.180207
- Ma C DJ, Li J, Guo W, Long Z, et al. Resting-state functional connectivity bias of middle temporal gyrus and caudate with altered gray matter volume in major depression. PLoS One. 2012; 7: e45263.
- Shah PJ, Glabus MF, Goodwin GM, Ebmeier KP. Chronic, treatment-resistant depression and right fronto-striatal atrophy. Br J Psychiatry. 2002; 180: 434–440.
- Serra-Blasco M, Portella MJ, Gomez-Anson B, et al. Effects of illness duration and treatment-resistance on grey matter abnormalities in major depression. Br J Psychiatry. 2013; 202: 434–440.
- de Diego-Adelino J, Pires P, Gomez-Anson B, et al. Microstructural white-matter abnormalities associated with treatment resistance, severity and duration of illness in major depression. Psychol Med. 2014; 44: 1171–1182.
- McIntyre RS, Alsuwaidan M, Baune BT, et al. Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions. World Psychiatry. 2023;22(3):394-412. doi: 10.1002/wps.21120
- Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351-356. doi: 10.2214/ajr.149.2.351.
- Born CM, Meisenzahl EM, Frodl T, et al. The septum pellucidum and its variants. An MRI study. Eur Arch Psychiatry Clin Neurosci. 2004;254(5):295-302. doi: 10.1007/s00406-004-0496-z
- Endicott J, Spitzer RL. Psychiatric rating scales. In: Kaplan HI, Sadock BJ, eds. Comprehensive textbook of psychiatry (5th ed). Baltimore, MD: Williams & Wilkins, 1989: 2391–409.
- Alves M, Pita Lobo P, Azevedo Kauppila L, et al. Neuroimaging cerebrovascular biomarkers in Parkinson’s Disease. Neuroradiol J. 2022;35:490–496.
- Young VG, Halliday GM, Kril JJ. Neuropathologic correlates of white matter hyperintensities. Neurology. 2008;71(11):804-811. doi: 10.1212/01.wnl.0000319691.50117.54
- Park MK, Jo I, Park MH, Kim TK, Jo SA, Shin C. Cerebral white matter lesions and hypertension status in the elderly Korean: the Ansan Study. Arch Gerontol Geriatr. 2005;40(3):265-273. doi: 10.1016/j.archger.2004.09.003
- Murray AD, Staff RT, Shenkin SD, Deary IJ, Starr JM, Whalley LJ. Brain white matter hyperintensities: relative importance of vascular risk factors in nondemented elderly people. Radiology. 2005;237(1):251-257. doi: 10.1148/radiol.2371041496
- Tamura Y, Araki A. Diabetes mellitus and white matter hyperintensity. Geriatr Gerontol Int. 2015;15(1):34-42. doi: 10.1111/ggi.12666
- Park JH, Lee SB, Lee JJ, et al. Depression Plays a Moderating Role in the Cognitive Decline Associated With Changes of Brain White Matter Hyperintensities. J Clin Psychiatry. 2018;79(5):17m11763. doi: 10.4088/JCP.17m11763
- Herrmann LL, Le Masurier M, Ebmeier KP. White matter hyperintensities in late life depression: a systematic review. J Neurol Neurosurg Psychiatry. 2008;79(6):619-624. doi: 10.1136/jnnp.2007.124651
- Wang L, Leonards CO, Sterzer P, Ebinger M. White matter lesions and depression: a systematic review and meta-analysis. J Psychiatr Res. 2014;56:56-64. doi: 10.1016/j.jpsychires.2014.05.005.
- Serafini G, Pompili M, Borgwardt S, et al. The role of white matter abnormalities in treatment-resistant depression: a systematic review. Curr Pharm Des. 2015;21(10):1337-1346. doi: 10.2174/1381612820666140929094531
- Aizenstein HJ, Khalaf A, Walker SE, Andreescu C. Magnetic resonance imaging predictors of treatment response in late-life depression. J Geriatr Psychiatry Neurol. 2014;27(1):24-32. doi: 10.1177/0891988713516541
- Swaab DF, Bao AM, Lucassen PJ. The stress system in the human brain in depression and neurodegeneration. Ageing Res Rev. 2005;4(2):141-194. doi: 10.1016/j.arr.2005.03.003
- Zhang FF, Peng W, Sweeney JA, Jia ZY, Gong QY. Brain structure alterations in depression: Psychoradiological evidence. CNS Neurosci Ther. 2018;24(11):994-1003. doi: 10.1111/cns.12835
- Klok MPC, van Eijndhoven PF, Argyelan M, Schene AH, Tendolkar I. Structural brain characteristics in treatment-resistant depression: review of magnetic resonance imaging studies. BJPsych Open. 2019;5(5):e76. doi: 10.1192/bjo.2019.58
- Hammar A, Ardal G. Cognitive functioning in major depression--a summary. Front Hum Neurosci. 2009;3:26. doi: 10.3389/neuro.09.026.2009.
- Petersen T, Papakostas GI, Mahal Y, et al. Psychosocial functioning in patients with treatment resistant depression. Eur Psychiatry. 2004;19(4):196-201. doi: 10.1016/j.eurpsy.2003.11.006
- Shioiri T, Oshitani Y, Kato T, et al. Prevalence of cavum septum pellucidum detected by MRI in patients with bipolar disorder, major depression and schizophrenia. Psychol Med. 1996;26(2):431-434. doi: 10.1017/s0033291700034838
- Landin-Romero R, Sarró S, Fernández-Corcuera P, et al. Prevalence of cavum vergae in psychosis and mood spectrum disorders. J Affect Disord. 2015;186:53-57. doi: 10.1016/j.jad.2015.07.020
- Born CM, Meisenzahl EM, Frodl T, et al. The septum pellucidum and its variants. An MRI study. Eur Arch Psychiatry Clin Neurosci. 2004;254(5):295-302. doi: 10.1007/s00406-004-0496-z
- Supprian T, Bengel D, Hofmann E, Fallgatter AJ, Franzek E. Cavum veli interpositi and psychotic disorder in a monocygotic twin. Eur Arch Psychiatry Clin Neurosci. 2000;250(2):76-78. doi: 10.1007/s004060070038
- Gama Marques J. Schizophrenia Misdiagnosis after Capgras and Cotard Delusions in a Patient with Infantile Cystinosis, Cavum Septi Pellucidi, Cavum Vergae and Cavum Veli Interpositi. Behav Sci (Basel). 2023;13(2):157. doi: 10.3390/bs13020157
- Chmielewski PP. Clinical anatomy of the paranasal sinuses and its terminology. Anat Sci Int. 2024;99(4):454-460. doi: 10.1007/s12565-023-00745-3
- Eggesbø HB. Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses. Eur Radiol. 2006;16(4):872-88. doi: 10.1007/s00330-005-0068-2
- Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007;22(2):E7. doi: 10.3171/foc.2007.22.2.7
- Niedzielski A, Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Bogusławska J. Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance. BMJ Paediatr Open. 2023;7(1):e001710. doi: 10.1136/bmjpo-2022-001710.
Year 2025,
Volume: 11 Issue: 1, 27 - 36, 23.04.2025
Abstract
Amaç: Bu çalışmada, tedaviye dirençli depresyon (TDD) tanılı hastaların beyin manyetik rezonans görüntüleme (MRG)’nin tesadüfi bulguları sağlıklı kontrollerle (SK) karşılaştırıldı.
Gereç ve Yöntem: Çalışmaya TDD tanılı 68 hasta (42 kadın, 26 erkek) ve 72 SK (35 kadın, 37 erkek) dahil edildi. Global değerlendirme ölçeği (GDÖ) uygulandı.
Bulgular: TDD grubunda, genel serebral atrofisi olanların global değerlendirme ölçeği (GDÖ) skorlarının anlamlı derecede düşük olduğu bulundu (p<0,001). TDD grubunda, kavum veli interpositi (KVİ) saptananların GDÖ skorlarının anlamlı derecede düşük olduğu bulundu (p=0,001). TDD grubunda, yaşın etkisi kontrol edildiğinde, GDÖ skoru ile bozukluk süresi arasında anlamlı bir korelasyon bulundu (r=-0,400; p=0,001).
Sonuç: Nörogelişimsel bir anormallik olan KVİ'nin TDD tanılı hastalarda daha yaygın olduğu gösterilmiştir.
Ethical Statement
Ethics committee approval was obtained from Adıyaman University for this study (Date of Decision: May 21, 2024; IRB Number: 2024/5-16). All procedures were utilized in accordance with the Declaration of Helsinki.
Supporting Institution
No financial support was received for this study.
Thanks
None.
References
- Greenberg PE, Fournier AA, Sisitsky T, et al. The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018). Pharmacoeconomics. 2021;39(6):653-665. doi: 10.1007/s40273-021-01019-4
- https://www.who.int/data/gho/data/indicators/indicator-details/GHO/estimated-population-based-prevalence-of-depression
- Kessler RC, Berglund P, Demler O, Jin R, Merikingas KR, Walters EE. How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Arch Gen Psychiatry. 2005;62(7):593–602.
- Nihalani N, Simionescu M, Dunlop BW. Depression: phenomenology, epidemiology, and pathophysiology. In: Schwartz TL, Petersen T, eds. Depression: treatment strategies and management. Boca Raton, Florida, FL: CRC Press, 2016: 1–22.
- Malhi GS, Mann JJ. Depression. Lancet. 2018; 392: 2299–2312.
- Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013;10(11):e1001547. doi: 10.1371/journal.pmed.1001547
- Rybak YE, Lai KSP, Ramasubbu R, et al. Treatment‐resistant major depressive disorder: Canadian expert consensus on definition and assessment. Depress Anxiety. 2021;38:456–467.
- Zhdanava M, Pilon D, Ghelerter I, et al. The prevalence and national buren of treatment-resistant depression and major depressive disorder in the United States. J Clin Psychiatry. 2021;82(2):20m13699.
- Dunner DL, Rush AJ, Russell JM, et al. Prospective, long-term, multicenter study of the naturalistic outcomes of patients with treatment-resistant depression. J Clin Psychiatry. 2006;67(5):688-695. doi: 10.4088/jcp.v67n0501
- Sankar T, Chakravarty MM, Jawa N, et al. Neuroanatomical predictors of response to subcallosal cingulate deep brain stimulation for treatment-resistant depression. J Psychiatry Neurosci. 2020;45(1):45-54. doi: 10.1503/jpn.180207
- Ma C DJ, Li J, Guo W, Long Z, et al. Resting-state functional connectivity bias of middle temporal gyrus and caudate with altered gray matter volume in major depression. PLoS One. 2012; 7: e45263.
- Shah PJ, Glabus MF, Goodwin GM, Ebmeier KP. Chronic, treatment-resistant depression and right fronto-striatal atrophy. Br J Psychiatry. 2002; 180: 434–440.
- Serra-Blasco M, Portella MJ, Gomez-Anson B, et al. Effects of illness duration and treatment-resistance on grey matter abnormalities in major depression. Br J Psychiatry. 2013; 202: 434–440.
- de Diego-Adelino J, Pires P, Gomez-Anson B, et al. Microstructural white-matter abnormalities associated with treatment resistance, severity and duration of illness in major depression. Psychol Med. 2014; 44: 1171–1182.
- McIntyre RS, Alsuwaidan M, Baune BT, et al. Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions. World Psychiatry. 2023;22(3):394-412. doi: 10.1002/wps.21120
- Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351-356. doi: 10.2214/ajr.149.2.351.
- Born CM, Meisenzahl EM, Frodl T, et al. The septum pellucidum and its variants. An MRI study. Eur Arch Psychiatry Clin Neurosci. 2004;254(5):295-302. doi: 10.1007/s00406-004-0496-z
- Endicott J, Spitzer RL. Psychiatric rating scales. In: Kaplan HI, Sadock BJ, eds. Comprehensive textbook of psychiatry (5th ed). Baltimore, MD: Williams & Wilkins, 1989: 2391–409.
- Alves M, Pita Lobo P, Azevedo Kauppila L, et al. Neuroimaging cerebrovascular biomarkers in Parkinson’s Disease. Neuroradiol J. 2022;35:490–496.
- Young VG, Halliday GM, Kril JJ. Neuropathologic correlates of white matter hyperintensities. Neurology. 2008;71(11):804-811. doi: 10.1212/01.wnl.0000319691.50117.54
- Park MK, Jo I, Park MH, Kim TK, Jo SA, Shin C. Cerebral white matter lesions and hypertension status in the elderly Korean: the Ansan Study. Arch Gerontol Geriatr. 2005;40(3):265-273. doi: 10.1016/j.archger.2004.09.003
- Murray AD, Staff RT, Shenkin SD, Deary IJ, Starr JM, Whalley LJ. Brain white matter hyperintensities: relative importance of vascular risk factors in nondemented elderly people. Radiology. 2005;237(1):251-257. doi: 10.1148/radiol.2371041496
- Tamura Y, Araki A. Diabetes mellitus and white matter hyperintensity. Geriatr Gerontol Int. 2015;15(1):34-42. doi: 10.1111/ggi.12666
- Park JH, Lee SB, Lee JJ, et al. Depression Plays a Moderating Role in the Cognitive Decline Associated With Changes of Brain White Matter Hyperintensities. J Clin Psychiatry. 2018;79(5):17m11763. doi: 10.4088/JCP.17m11763
- Herrmann LL, Le Masurier M, Ebmeier KP. White matter hyperintensities in late life depression: a systematic review. J Neurol Neurosurg Psychiatry. 2008;79(6):619-624. doi: 10.1136/jnnp.2007.124651
- Wang L, Leonards CO, Sterzer P, Ebinger M. White matter lesions and depression: a systematic review and meta-analysis. J Psychiatr Res. 2014;56:56-64. doi: 10.1016/j.jpsychires.2014.05.005.
- Serafini G, Pompili M, Borgwardt S, et al. The role of white matter abnormalities in treatment-resistant depression: a systematic review. Curr Pharm Des. 2015;21(10):1337-1346. doi: 10.2174/1381612820666140929094531
- Aizenstein HJ, Khalaf A, Walker SE, Andreescu C. Magnetic resonance imaging predictors of treatment response in late-life depression. J Geriatr Psychiatry Neurol. 2014;27(1):24-32. doi: 10.1177/0891988713516541
- Swaab DF, Bao AM, Lucassen PJ. The stress system in the human brain in depression and neurodegeneration. Ageing Res Rev. 2005;4(2):141-194. doi: 10.1016/j.arr.2005.03.003
- Zhang FF, Peng W, Sweeney JA, Jia ZY, Gong QY. Brain structure alterations in depression: Psychoradiological evidence. CNS Neurosci Ther. 2018;24(11):994-1003. doi: 10.1111/cns.12835
- Klok MPC, van Eijndhoven PF, Argyelan M, Schene AH, Tendolkar I. Structural brain characteristics in treatment-resistant depression: review of magnetic resonance imaging studies. BJPsych Open. 2019;5(5):e76. doi: 10.1192/bjo.2019.58
- Hammar A, Ardal G. Cognitive functioning in major depression--a summary. Front Hum Neurosci. 2009;3:26. doi: 10.3389/neuro.09.026.2009.
- Petersen T, Papakostas GI, Mahal Y, et al. Psychosocial functioning in patients with treatment resistant depression. Eur Psychiatry. 2004;19(4):196-201. doi: 10.1016/j.eurpsy.2003.11.006
- Shioiri T, Oshitani Y, Kato T, et al. Prevalence of cavum septum pellucidum detected by MRI in patients with bipolar disorder, major depression and schizophrenia. Psychol Med. 1996;26(2):431-434. doi: 10.1017/s0033291700034838
- Landin-Romero R, Sarró S, Fernández-Corcuera P, et al. Prevalence of cavum vergae in psychosis and mood spectrum disorders. J Affect Disord. 2015;186:53-57. doi: 10.1016/j.jad.2015.07.020
- Born CM, Meisenzahl EM, Frodl T, et al. The septum pellucidum and its variants. An MRI study. Eur Arch Psychiatry Clin Neurosci. 2004;254(5):295-302. doi: 10.1007/s00406-004-0496-z
- Supprian T, Bengel D, Hofmann E, Fallgatter AJ, Franzek E. Cavum veli interpositi and psychotic disorder in a monocygotic twin. Eur Arch Psychiatry Clin Neurosci. 2000;250(2):76-78. doi: 10.1007/s004060070038
- Gama Marques J. Schizophrenia Misdiagnosis after Capgras and Cotard Delusions in a Patient with Infantile Cystinosis, Cavum Septi Pellucidi, Cavum Vergae and Cavum Veli Interpositi. Behav Sci (Basel). 2023;13(2):157. doi: 10.3390/bs13020157
- Chmielewski PP. Clinical anatomy of the paranasal sinuses and its terminology. Anat Sci Int. 2024;99(4):454-460. doi: 10.1007/s12565-023-00745-3
- Eggesbø HB. Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses. Eur Radiol. 2006;16(4):872-88. doi: 10.1007/s00330-005-0068-2
- Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007;22(2):E7. doi: 10.3171/foc.2007.22.2.7
- Niedzielski A, Chmielik LP, Mielnik-Niedzielska G, Kasprzyk A, Bogusławska J. Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance. BMJ Paediatr Open. 2023;7(1):e001710. doi: 10.1136/bmjpo-2022-001710.
There are 42 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Central Nervous System |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 23, 2025 |
| Submission Date | October 26, 2024 |
| Acceptance Date | January 15, 2025 |
| Published in Issue | Year 2025 Volume: 11 Issue: 1 |
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