Anterior cingulate cortex does not differ between patients with major depression and healthy controls, but relatively large anterior cingulate cortex predicts a good clinical course

The anterior cingulate cortex (ACC) is involved in the regulation of emotion processing, and its volume has been found to be reduced in patients with major depression. Furthermore, larger ACC volumes have been associated with faster symptom improvement under therapy. The aims of the study were to examine whether volumes of the anterior cingulate cortex are altered and are related to the clinical course of major depression. Subjects comprised 78 inpatients with major depression and 78 age-, gender- and handedness- matched healthy volunteers, who were investigated with structural magnetic resonance imaging (MRI). The ACC was subdivided into the subgenual, pre-callosal, rostral-anterior and caudal-anterior ACC. No significant differences were observed for ACC volumes between patients and healthy controls. Left ACC volumes showed a significant negative correlation with the number of hospitalizations. These findings suggest that ACC volumes are not altered in patients with major depression, but that patients with larger ACC have a better clinical outcome than patients with smaller ACC.

[1]  M. Thase,et al.  Use of FMRI to predict recovery from unipolar depression with cognitive behavior therapy. , 2006, The American journal of psychiatry.

[2]  M E Phelps,et al.  Regional brain metabolic changes in patients with major depression treated with either paroxetine or interpersonal therapy: preliminary findings. , 2001, Archives of general psychiatry.

[3]  R. C. Oldfield The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[4]  I. Hickie,et al.  Subcortical hyperintensities on magnetic resonance imaging: Clinical correlates and prognostic significance in patients with severe depression , 1995, Biological Psychiatry.

[5]  H. Mayberg Limbic-cortical dysregulation: a proposed model of depression. , 1997, The Journal of neuropsychiatry and clinical neurosciences.

[6]  M. Raichle,et al.  Subgenual prefrontal cortex abnormalities in mood disorders , 1997, Nature.

[7]  John Suckling,et al.  Attenuation of the neural response to sad faces in major depression by antidepressant treatment: a prospective, event-related functional magnetic resonance imaging study. , 2004, Archives of general psychiatry.

[8]  Marcus E Raichle,et al.  Volumetric reduction in left subgenual prefrontal cortex in early onset depression , 2002, Biological Psychiatry.

[9]  M. Lowe,et al.  Activity and Connectivity of Brain Mood Regulating Circuit in Depression: A Functional Magnetic Resonance Study , 2005, Biological Psychiatry.

[10]  M. Posner,et al.  Cognitive and emotional influences in anterior cingulate cortex , 2000, Trends in Cognitive Sciences.

[11]  John Suckling,et al.  Brain Imaging Correlates of Depressive Symptom Severity and Predictors of Symptom Improvement After Antidepressant Treatment , 2007, Biological Psychiatry.

[12]  Jair C. Soares,et al.  Smaller Cingulate Volumes in Unipolar Depressed Patients , 2006, Biological Psychiatry.

[13]  C. Olson,et al.  Functional heterogeneity in cingulate cortex: the anterior executive and posterior evaluative regions. , 1992, Cerebral cortex.

[14]  Wolfgang Maier,et al.  Response-dependent differences in regional cerebral blood flow changes with citalopram in treatment of major depression. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  N C Andreasen,et al.  Image processing for the study of brain structure and function: problems and programs. , 1992, The Journal of neuropsychiatry and clinical neurosciences.

[16]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[17]  Bruce S. McEwen,et al.  Exposure to excess glucocorticoids alters dendritic morphology of adult hippocampal pyramidal neurons , 1990, Brain Research.

[18]  B. Vogt,et al.  Contributions of anterior cingulate cortex to behaviour. , 1995, Brain : a journal of neurology.

[19]  C. Coffey,et al.  White matter hyperintensity on magnetic resonance imaging: clinical and neuroanatomic correlates in the depressed elderly. , 1989, The Journal of neuropsychiatry and clinical neurosciences.

[20]  M. Keshavan,et al.  Decrease in thalamic volumes of pediatric patients with obsessive-compulsive disorder who are taking paroxetine. , 2000, Archives of general psychiatry.

[21]  James T Becker,et al.  Brain morphometric abnormalities in geriatric depression: long-term neurobiological effects of illness duration. , 2002, The American journal of psychiatry.

[22]  B. McEwen,et al.  Controversies surrounding glucocorticoid-mediated cell death in the hippocampus , 1997, Journal of Chemical Neuroanatomy.

[23]  Arthur W Toga,et al.  Anterior cingulate, gyrus rectus, and orbitofrontal abnormalities in elderly depressed patients: an MRI-based parcellation of the prefrontal cortex. , 2004, The American journal of psychiatry.

[24]  M S Buchsbaum,et al.  Prediction of antidepressant effects of sleep deprivation by metabolic rates in the ventral anterior cingulate and medial prefrontal cortex. , 1999, The American journal of psychiatry.

[25]  Klaus P. Ebmeier,et al.  Cortical grey matter reductions associated with treatment-resistant chronic unipolar depression , 1998, British Journal of Psychiatry.

[26]  J. Morrison,et al.  Chronic behavioral stress induces apical dendritic reorganization in pyramidal neurons of the medial prefrontal cortex , 2004, Neuroscience.

[27]  Hans-Jürgen Möller,et al.  Hippocampal and amygdala changes in patients with major depressive disorder and healthy controls during a 1-year follow-up. , 2004, The Journal of clinical psychiatry.

[28]  R. Sapolsky,et al.  Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. , 2000, Archives of general psychiatry.

[29]  H. Kraemer,et al.  Untreated depression and hippocampal volume loss. , 2003, The American journal of psychiatry.

[30]  Eric Vermetten,et al.  Reduced volume of orbitofrontal cortex in major depression , 2002, Biological Psychiatry.

[31]  B. Vogt,et al.  Human cingulate cortex: Surface features, flat maps, and cytoarchitecture , 1995, The Journal of comparative neurology.

[32]  T. Paus Primate anterior cingulate cortex: Where motor control, drive and cognition interface , 2001, Nature Reviews Neuroscience.

[33]  H. Brückmann,et al.  Cerebral Differences in Explicit and Implicit Emotional Processing – An fMRI Study , 2007, Neuropsychobiology.