Adolescent depression and brain development: evidence from voxel-based morphometry

Adolescent depression and brain development: evidence from voxel-based morphometry

J Psychiatry Neurosci 2019;44(4):237-245 | PDF | Appendix

Joana Straub, PhD; Rebecca Brown, PhD; Kathrin Malejko, MD; Martina Bonenberger, PhD; Georg Grön, PhD; Paul L. Plener, MD; Birgit Abler, MD

Background: Investigating adolescents and young adults may provide a unique opportunity to understand developmental aspects of the neurobiology of depression. During adolescence, a considerable physiologic reorganization of both grey and white matter of the brain takes place, and it has been suggested that differences in grey-matter volumes during adolescence may reflect different maturational processes.

Methods: We investigated grey-matter volumes in a comparatively large sample (n = 103) of adolescents and young adults (aged 12 to 27 years), 60 of them with a diagnosis of current depression.

Results: Replicating previous studies, we found a clear whole-brain effect of age: the older the participants, the lower their global grey-matter volumes, particularly in the paracingulate and prefrontal cortices. Contrasting depressed and healthy youth in a whole-brain approach, we found greater grey-matter volumes in the dorsolateral prefrontal cortex of those with depression. Furthermore, a region-of-interest analysis indicated lower grey-matter volumes in the hippocampus in participants with depression compared with healthy controls.

Limitations: The present study was limited because of a skewed sex distribution, its cross-sectional design and the fact that some participants were taking an antidepressant.

Conclusion: During adolescence, restructuring of the brain is characterized by marked decreases in prefrontal grey-matter volumes, interpreted as a correlate of brain maturation. Findings of greater volumes in the prefrontal cortex, particularly in younger adolescents with depression, may suggest that these participants were more prone to delayed brain maturation or increased neuroplasticity. This finding may represent a risk factor for depression or constitute an effect of developing depression.

Submitted Nov. 23, 2017; Revised May 30, 2018; Revised July 30, 2018; Accepted Sept. 22, 2018; Published online Feb. 5, 2019

Affiliations: From the Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital, Ulm, Germany (Straub, Brown, Bonenberger, Plener); the Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Ulm, Germany (Malejko, Grön, Abler); and the Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria (Plener).

Competing interests: P. Plener declares grants from Servier and Lundbeck for clinical studies outside the submitted work. No other competing interests declared.

Contributors: J. Straub, P. Plener and B. Abler designed the study. J. Straub, R. Brown, K. Malejko and M. Bonenberger acquired the data, which J. Straub, G. Grön and B. Abler analyzed. J. Straub, G. Grön and B. Abler wrote the article, which all authors reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.

DOI: 10.1503/jpn.170233

Correspondence to: J. Straub, Universitatsklinikum Ulm Klinik fur Kinder- und Jugendpsychiatrie Psychotherapie, Steinhoevelstrasse 5 Ulm, Baden-Württemberg 89075, Germany;