Structural Brain Changes in remitted Major Depression
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1 Structural Brain Changes in remitted Major Depression Andreas Berger unter der Anleitung von Assoc.Prof. Priv.Doz. Dr. Lukas Pezawas Universitätsklinik für Psychiatrie und Psychotherapie Medizinische Universität Wien Juli 2014 Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
2 Introduction There is no single pathology in MDD that could properly account for the illness. There are subtle alterations in brain structure associated with MDD. Such alterations are the topic of this thesis. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
3 Previous studies and brain regions Most reports are of gray matter volume reductions. Prominent brain regions: 1 Hippocampus 2 Basal ganglia 3 Medial prefrontal cortex 1 Subgenual anterior cingulate cortex (sacc) 2 Orbitofrontal cortex (OFC) Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
4 Regions of interest Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
5 There are several measures to choose from 1 Gray matter volume 2 Cortical thickness 3 Surface area 4... Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
6 The radial unit hypothesis Rakic, P. (1988, Jul). Specification of cerebral cortical areas. Science 241 (4862), Mountcastle, V. B. (1997, Apr). The columnar organization of the neocortex. Brain 120 ( Pt 4), Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
7 Objective Region-of-interest analysis Is there a group difference in sacc or OFC volume? Cortex-wide analysis Is there a group difference in cortical thickness or surface area anywhere in the cortex? Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
8 Sample Participants were recruited via ads in Vienna and Dresden. Assessment included SCID-I, SCID-II, HAM-D. n = rmdd 108 lifetime-healthy age gender 128 female and 88 male MRI scanning was done using a 3 Tesla Siemens TIM Trio scanner with a 12-channel head coil. Anatomical images were acquired using MPRAGE with TR/TE = 2300/4.21ms, flip angle 9 degrees, inversion time 900ms, voxel size 1x1x1.1mm. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
9 MRI image processing using FreeSurfer Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
10 MRI image processing using FreeSurfer Segmentation Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
11 MRI image processing using FreeSurfer Tesselation Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
12 MRI image processing using FreeSurfer Tesselation Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
13 MRI image processing using FreeSurfer Pial surface Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
14 MRI image processing using FreeSurfer Inflation Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
15 MRI image processing using FreeSurfer Spherical projection Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
16 Drawing of ROIs Mapped to each subject via the sphere Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
17 Statistical Analysis using the General Linear Model y i = β 1 x i1 + β 2 x i2 + β 3 x i3 + ε i Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
18 Results Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
19 Result from region-of-interest analysis Group difference in gray matter volume of the left sacc 1100 lh.sacc.label 900 GrayVol (mean + residuals) lifetime_healthy Clinical.Status remitted_mdd_or_bpii Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
20 Results from cortex-wide analysis Correlation of cortical thickness with age Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
21 Results from cortex-wide analysis Correlation of cortical thickness with age vertex vertex thickness (mean + residuals) 2.5 thickness (mean + residuals) Age Age Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
22 Results from cortex-wide analysis Interaction effect between surface area and clinical status Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
23 Results from cortex-wide analysis Interaction effect between surface area and clinical status vertex area (mean + residuals) 0.5 Clinical.Status lifetime_healthy remitted_mdd_or_bpii Age Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
24 Summary 1 Former patients have slightly larger left sacc volumes than lifetime-healthy participants. This is unexpected. 2 There is a strong correlation of cortical thickness and age even in relatively young people. This has been documented before. 3 The effect of age on the surface area of a premotor region depends on the clinical status. The meaning of this is unclear. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
25 Summary 1 Former patients have slightly larger left sacc volumes than lifetime-healthy participants. This is unexpected. 2 There is a strong correlation of cortical thickness and age even in relatively young people. This has been documented before. 3 The effect of age on the surface area of a premotor region depends on the clinical status. The meaning of this is unclear. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
26 Summary 1 Former patients have slightly larger left sacc volumes than lifetime-healthy participants. This is unexpected. 2 There is a strong correlation of cortical thickness and age even in relatively young people. This has been documented before. 3 The effect of age on the surface area of a premotor region depends on the clinical status. The meaning of this is unclear. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
27 Summary 1 Former patients have slightly larger left sacc volumes than lifetime-healthy participants. This is unexpected. 2 There is a strong correlation of cortical thickness and age even in relatively young people. This has been documented before. 3 The effect of age on the surface area of a premotor region depends on the clinical status. The meaning of this is unclear. Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
28 How not to interpret statistics Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
29 Danke für die Aufmerksamkeit! Andreas Berger (Meduniwien) Structural Brain Changes in rmdd Juli / 26
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