Background Morphologic changes of the brainstem in major depressive disorder (MDD) have rarely been reported in neuroimaging studies, even though, monoaminergic neurotransmitters are synthesized in several brainstem regions. We aimed to investigate volume changes in each region of the brainstem and their association with antidepressant use or the remission status of MDD. Methods A total of 126 patients with MDD and 101 healthy controls underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of each brainstem region, including the medulla oblongata, pons, midbrain, and superior cerebellar peduncle, and the volume of the whole brainstem using the FreeSurfer. Results The patients with MDD had significantly greater midbrain volumes (P=0.013) compared to healthy controls. In particular, drug-naïve patients with MDD had significantly greater brainstem volumes compared to healthy controls (P=0.007), while no significant findings were observed between the antidepressant treatment group and healthy controls. The remitted patient group had reduced pons (P=0.002) and midbrain (P=0.005) volumes compared to healthy controls, while the non-remitted MDD patient group had significantly greater midbrain volumes compared to the healthy controls (P=0.017). Limitations We could not distinguish gray versus white matter volumes changes in our analysis. Conclusions We observed that the midbrain is enlarged in patients with a current depressive episode, who are not undergoing antidepressant treatment. This volume then returns to normal after antidepressant treatment, and is even reduced, when the patient is in remission. Further studies are needed to confirm our observations.
Bibliographical noteFunding Information:
This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology ( NRF-2011-0023272 ), and the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea ( HI12C0003 ). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
© 2016 Elsevier B.V.
- Major depressive disorder
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health