J Psychiatry Neurosci 2010; 35(5): 311-320
Johanna Scheuerecker, PhD; Eva M. Meisenzahl, MD; Nikolaos Koutsouleris, MD; Martin Roesner, Cand Med; Veronika Schöpf, PhD; Jennifer Linn, MD; Martin Wiesmann, MD; Hartmut Brückmann, MD; Hans- JürgenMöller, MD; Thomas Frodl, MD
Scheurecker, Meisenzahl, Koutsouleris, Roesner, Schöpf, Linn, Wiesmann, Brückmann, Möller, Frodl — Departments of Psychiatry and Psychotherapy and Neuroradiology, Ludwig-Maximilians-University Munich, Germany; Frodl — Department of Psychiatry and Psychotherapy and Institute of Neuroscience, Trinity College Dublin, Ireland
Background: Major depressive disorder is associated with both structural and functional alterations in the emotion regulation network of the central nervous system. The relation between structural and functional changes is largely unknown. Therefore, we sought to determine the relation between structural differences and functional alterations during the recognition of emotional facial expressions.
Methods: We examined 13 medication-free patients with major depression and 15 healthy controls by use of structural T1-weighted high-resolution magnetic resonance imaging (MRI) and functional MRI during 1 session. We set the statistical threshold for the analysis of imaging data to p < 0.001 (uncorrected). Results: As shown by voxel-based morphometry, depressed patients had reductions in orbitofrontal cortex volume and increases in cerebellar volume. Additionally, depressed patients showed increased activity during emotion recognition in the middle frontal cortex, caudate nucleus, precuneus and lingual gyrus. Within this cerebral network, the orbitofrontal volumes were negatively correlated in depressed patients but not in healthy controls with changes in blood oxygen level–dependent signal in the middle frontal gyrus, caudate nucleus, precuneus and supplementary motor area..
Limitations: Our results are limited by the relatively small sample size.
Conclusions: This combined functional and structural MRI study provides evidence that the orbitofrontal cortex is a key area in major depression and that structural changes result in functional alterations within the emotional circuit. Whether these alterations in the orbitofrontal cortex are also related to persistent emotional dysfunction in remitted mental states and, therefore, are related to the risk of depression needs further exploration.
Submitted July 3, 2009; Revised Dec. 2, 2009, Feb. 15, 22, 2010; Accepted Feb. 23, 2010.
Acknowledgments: This study was supported by the Eli Lilly International Foundation.
Competing interests: Koutsouleris, Brückmann, Schöpf, Wiesmann and Scheuerecker and Mr. Roesner. Dr. Möller has received research grants or support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Eisai, Glaxo-SmithKline, Janssen Cilag, Lundbeck, Merck, Novartis, Organon, Pfizer, Sanofi Aventis, Sepracor, Servier, Wyeth. He has served as a consultant or on advisory boards for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Organon, Pfizer, Sepracor, Servier and Wyeth, and he is a member of the speaker bureau for AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Eisai, GlaxoSmithKline, Janssen Cilag, Lundbeck, Organon, Pfizer, Sanofi Aventis and Sepracor.
Contributors: None declared for Drs. Frodl, Linn, Meisenzahl, Drs. Koutsouleris, Meisenzahl and Frodl conceived the study and its design. Drs. Frodl, Scheuerecker, Schöpf, Wiesmann, and Brückmann and Mr. Roesner acquired the data, which was analyzed by Drs. Linn, Frodl and Scheuerecker. The article was written by Drs. Frodl, Scheuerecker and Koutsouleris; it was critically revised by Drs. Frodl, Meisenzahl, Koutsouleris, Wiesmann, Brückmann, Schöpf and Linn and Mr. Roesner. All authors approved the final version submitted for publication.
Correspondence to: Dr. J. Scheuerecker, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich,
Nussbaumstrasse 7, 80336 Munich, Germany; firstname.lastname@example.org